Successful Completion of Adjuvant Chemotherapy in a Patient With Colon Cancer Experiencing 5-Fluorouracil-Induced Cardiac Vasospasm.

Fluoropyrimidines are the chemotherapy backbone in the treatment of adenocarcinoma of the colon. Adjuvant 5-fluorouracil (5-FU)/leucovorin (LV) has been shown to significantly increase recurrence-free survival compared to surgery alone for patients with stage III colon cancer. Furthermore, the addition of oxaliplatin to 5-FU/LV (FOLFOX) in the adjuvant setting has been shown to provide an improved disease free survival compared to adjuvant 5-FU/LV therapy alone. Cardiotoxicity associated with 5-FU or capecitabine is a rare but serious adverse effect that can present as cardiomyopathy, vasospastic angina, coronary thrombosis and dissection, ventricular arrhythmias, and sudden cardiac death. We report a case of successful completion of adjuvant FOLFOX therapy in a patient who experienced 5-FU einduced cardiotoxicity. This was completed through aggressive inpatient supportive care and cardiac monitoring. The patient showed no signs of delayed cardiotoxicity or colon cancer recurrence at 10-month follow-up.