Abstract
ABSTRACT BACKGROUND AND OBJECTIVES: Peripheral neuropathy caused by chemotherapeutic drugs is today one of the major limiting factors in cancer pharmacological therapy due to its negative influence in the cancer patient's quality of life. Its incidence varies depending on the pharmacological nature of the therapy used. Peripheral neurotoxicity caused by 5-Fluorouracil was scarcely described, being characterized as rare adverse effect of this drug. The objective of this study is to report a 5-Fluorouracil induced late peripheral neuropathy case treated at the Pain Clinic, with standard care for neuropathic main. CASE REPORT: Female patient, 62 years old, undergoing 5-Fluorouracil chemotherapy 2520mg/week in 5 cycles of 360mg/day continuous infusion to treat colorectal cancer. Three months after the end of the cycle she reported burning pain and hand and foot dysesthesia with proximal irradiation and allodynia. She was referred to the Pain Clinic 2 years after the symptoms onset. The treatment started with gabapentin and she was advised to have psychiatric follow-up and physical exercises. The Visual Numeric Scale was used to assed pain. In less than 6 months the patient reported pain improvement with values reduced from 10 to 2. CONCLUSION: Although uncommon, peripheral neuropathy can occur as permanent toxicity due to 5-Fluorouracil chemotherapy and should be early identified and treated to improve patient's quality of life.
Highlights
The vast majority of the reported cases of neurotoxicity caused by 5-FU alone are central and reversible neuropathic conditions after treatment discontinuation[6]. Probably due to these reasons, the diagnosis of persistent late peripheral neuropathy associated with 5-FU chemotherapy was long neglected, which aggravated the condition
Through documented bibliographic review and after ruling out other causes of peripheral neuropathy, we thought about the possibility of the case in question be a rare secondary condition to the chemotherapy used
These findings suggest the 5-FU participation in the development of peripheral neurotoxicity induced by combination chemotherapy[7]
Summary
AND OBJECTIVES: Peripheral neuropathy caused by chemotherapeutic drugs is today one of the major limiting factors in cancer pharmacological therapy due to its negative influence in the cancer patient’s quality of life. The objective of this study is to report a 5-Fluorouracil induced late peripheral neuropathy case treated at the Pain Clinic, with standard care for neuropathic main. Three months after the end of the cycle she reported burning pain and hand and foot dysesthesia with proximal irradiation and allodynia. She was referred to the Pain Clinic 2 years after the symptoms onset. O objetivo deste estudo foi relatar um caso de neuropatia periférica tardia induzida por 5-Fluorouracil atendido na Clínica de Dor com tratamento padrão para dor neuropática. CONCLUSÃO: Apesar de incomum, a neuropatia periférica pode ocorrer como toxicidade permanente da quimioterapia com 5-Fluorouracil e deve ser precocemente identificada e tratada para proporcionar melhora da qualidade de vida do paciente.
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