Resumen
Presentamos 4 pacientes diagnosticados de carcinoma colorrectal metastásico tratados con quimioterapia: 5-fluoracilo (5FU), ácido folínico y oxaliplatino, esquema de De Gramont (FOLFOX 6 modificado) que presentaron fiebre de probable origen medicamentoso en relación con la infusión de oxaliplatino. Los 4 pacientes fueron sometidos repetidamente a estudios microbiológicos y se descartó la etiología infecciosa. Todos los episodios fueron autolimitados y se inciaron durante, o poco después de la infusión de oxaliplatino. No se objetivaron durante el primer ciclo de tratamiento, pero se repitieron en todos los ciclos posteriores al primer episodio de fiebre en 3 de los 4 pacientes. La eficacia de los fármacos antitérmicos fue muy limitada, tanto durante los episodios febriles como en el intento de prevención de los mismos. Consideramos muy probable en este grupo de pacientes la relación causa-efecto de fiebre debida a la infusión de oxaliplatino, aunque hasta el momento desconocemos el
Abstract
We report 4 patients diagnosed of metastatic colorectal cancer, treated with chemotherapy: 5-fluoracil (5FU), folinic acid and oxaliplatin, De Gramont schedule (FOLFOX 6 modified), who showed fever of drug-related origin, probably due to oxaliplatin infusion. The four patients repeatedly underwent microbiological studies, and infectious pathology was ruled out.
All events were self-limited and started during or soon after oxaliplatin infusion. They weren't reported in the first cycle of treatment, but they were repeated in every cycle after the first occurrence of fever, in three of four patients. The efficacy of antipyretic drugs was very limited, as much during febrile events as during the attempts to prevent them.
We consider it likely that, in this group of patients, there was a cause-effect relationship of oxaliplatin-induced fever, although at the moment we don't know the exact trigger mechanism.
Article PDF
Avoid common mistakes on your manuscript.
Bibliografía
Culy Cr, Clemett D, Wiseman R. Oxaliplatin. A review of its pharmacological properties and clinical efficacy in metastatic colorectal cancer and its potential in other malignancies. Drugs 2000; 60 (4): 895–924.
Cvitkovic E, Bekradda M. Oxaliplatin: a new therapeutic option in colorectal cancer. Semin Oncol 1999; 26: 647–662.
Ulrich-Pur H, Fiebiger WCC, Schüll B, et al. Oxaliplatin-induced fever and release of IL-6. Oncology 2000; 59: 187–189.
Maindraut-Goebel F, Louvet C, André T, et al. Oxaliplatin added to the simplified bimonthly leucovorin and 5-fluoracil regimen as second-line therapy for metastatic colorectal cancer (FOLFOX 6). Eur J Cancer 1999; 35 (9): 1.338–1.342.
De Gramont A, Vignoud J, Tournigand C, et al. Oxaliplatin with high leucovorin and 5-fluoracil 48-h continuous infusion in pretreated metastatic colorectal cancer. Eur J Cancer 1997; 33 (2): 214–219.
Giacchetti S, Itzhaki M, Gruia G, et al. Supervivencia a largo plazo de los pacientes con metástasis hepáticas irresecables de cáncer colorrectal después de una quimioterapia con infusión de 5-fluoracilo, leucovorín, oxaliplatino y cirugía. Ann Oncol (ed esp) 1999; 8 (8): 881–887.
Wiseman LR, Adkins JC, Plosker GL, Goa KL. Oxaliplatin. A review of its use in the management of metastatic colorectal cancer. Drugs Aging 1999; 14 (6): 459–475.
Salinas P, Amador ML, Ciruelos E, et al. Analysis of biweekly oxaliplatin + folinic acid (FA) + 5-fluoracil (FU) in metastatic gastrointestinal carcinoma. Ann Oncol 2000; 11 (4 supl): 50:217.
Medioni J, Coulon MA, Morere JF, et al. Anaphylaxis after oxaliplatin. Ann Oncol 1999; 10 (3): 610.
Rintala E, Pulkki K, Mertola J, et al. Endotoxin, interleukin-6 and phospholipase A2 as markers of sepsis in patients with hematological malignancies. Scand J Infect Dis 1995; 27 (1): 39–43.
Salinas P, Arias L, Terceño, Gandía I. Vías centrales de larga duración con reservorio subcutáneo. Experiencia en una Unidad de Oncología. Medicina Paliativa 1998; 5 (3): 136–140.
Carrato A, Barón JM, Díaz N. Complicaciones metabólicas en el enfermo con cáncer I: fiebre de origen tumoral. En: González Barón, Ordóñez, Feliú, Zamora, Espinosa, eds. Tratado de medicina paliativa. Madrid: Panamericana, 1996; 529–538.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hernández, P.S., Cortés-Funes, H. & Sabag, R.H. Oxaliplatino y fiebre: presentación de 4 casos. Rev Oncol 3, 155–158 (2001). https://doi.org/10.1007/BF02711442
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF02711442