Fluorouracil-Based Chemotherapy in Patients with Gastrointestinal Malignancies: Influence of Nutritional Folate Status on Toxicity

• Published in: Journal of chemotherapy (Florence) Vol. 19; no. 6; pp. 744 - 749
• Main Authors: Alvarez-Cabellos, R., Garcia-Carbonero, R., Garcia-Lacalle, C., Gomez, P., Tercero, A., Sanchez, D., Paz-Ares, L.
• Format: Journal Article
• Language: English
• Published: Firenze Taylor & Francis 01-12-2007; EIFT
• Subjects: Adult; Aged; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Cisplatin - administration & dosage; Female; Fluoropyrimidines; Fluorouracil - administration & dosage; Fluorouracil - adverse effects; folate; Folic Acid - blood; Gastroenterology. Liver. Pancreas. Abdomen; gastrointestinal cancer; Gastrointestinal Neoplasms - drug therapy; homocysteine; Homocysteine - blood; Humans; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; toxicity; Tumors; Vitamin B 12 - blood; Vitamin B 12 - metabolism; vitamin B12; Antineoplastic agent; Toxicity; Vitamin; Folate; Homocystein; Intestinal disease; vitamin B12; Nutritional status; Gastric disease; Fluorouracil; Human; homocysteine; Thiol; Enzyme; Gastrointestinal cancer; Transferases; Fluoropyrimidine derivatives; Enzyme inhibitor; Malignant tumor; Thymidylate synthase; Cyanocobalamin; Sulfur containing aminoacid; Fluoropyrimidines; Chemotherapy; Treatment; Antimetabolic; Methyltransferases; Pyrimidine derivatives; Digestive diseases; Cancer
• ISSN: 1120-009X; 1973-9478
• DOI: 10.1179/joc.2007.19.6.744

This study aimed to prospectively evaluate the potential influence of folate status on the toxicity induced by 5-fluorouracil (5-FU)-based chemotherapy in patients with gastrointestinal tumors. 105 patients with colorectal, pancreatic or gastric cancer were entered into the study. Treatment regimens consisted of bolus 5-FU/leucovorin or infusional 5-FU combined with cisplatin. Baseline homocysteine, vitamin B
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olic acid serum levels were determined in all patients. Univariate and multivariate logistic regression models were used to identify predictive factors for toxicity. Univariate analysis showed a significant association between older age, low BSA, gastric/pancreatic cancer and treatment with 5-FU/cisplatin and the incidence of grade 3-4 hematological toxicity, and between female sex, low BSA and gastric/pancreatic cancer and the incidence of severe non-hematological toxicity. Variables that retained independent prognostic value in the multivariate model were tumor type, chemotherapy schedule and BSA for both hematological and non-hematological toxicities. Baseline homocysteine, vitamin B
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or folate status were not significant predictors of any kind of toxicity either according to univariate or multivariate analysis. This study failed to demonstrate a significant association between a patient's nutritional folate status and the toxicity induced by fluoropyrimidinebased chemotherapy in a cohort of patients with various gastrointestinal malignancies.