Yamane H, Matsubara M, Umemura S, Suwaki T, Kamei H, Takigawa N, Kiura K, Tanimoto M. Variant angina pectoris associated with FOLFOX4 therapy. World J Gastrointest Oncol 2011; 3(11): 165-168 [PMID: 22110843 DOI: 10.4251/wjgo.v3.i11.165]
Corresponding Author of This Article
Hiromichi Yamane, MD, PhD, Director, Division of Clinical Oncology, Sumitomo-Besshi Hospital Cancer Center, 3-1 Ohji-cho, Niihama, Ehime 792-8543, Japan. hiromichi_yamane@ni.sbh.gr.jp
Article-Type of This Article
Case Report
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Hiromichi Yamane, Shigeki Umemura, Toshimitsu Suwaki, Haruhito Kamei, Division of Clinical Oncology, Sumitomo-Besshi Hospital Cancer Center, 3-1Ohji-cho, Niihama, Ehime 792-8543, Japan
Hiromichi Yamane, Nagio Takigawa, Department of General Internal Medicine 4, Kawasaki Medical School, 2-1-80 Nakasange, Okayama 700-8505, Japan
Minoru Matsubara, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Okayama 700-8558, Japan
Nagio Takigawa, Katsuyuki Kiura, Department of Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan
Mitsune Tanimoto, Department of Hematology, Oncology and Respiratory Medicine, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Okayama 700-8558, Japan
Author contributions: Yamane H and Matsubara M analyzed the bibliographical reports; Yamane H, Matsubara M, Umemura S, Suwaki T and Kamei H were involved in the patient’s case; Yamane H, Takigawa N, Kiura K and Tanimoto M wrote the paper.
Correspondence to: Hiromichi Yamane, MD, PhD, Director, Division of Clinical Oncology, Sumitomo-Besshi Hospital Cancer Center, 3-1 Ohji-cho, Niihama, Ehime 792-8543, Japan. hiromichi_yamane@ni.sbh.gr.jp
Telephone: +81-897-377111 Fax: +81-897-377121
Received: March 14, 2011 Revised: October 3, 2011 Accepted: October 10, 2011 Published online: November 15, 2011
Abstract
The patient was a 71-year-old man who underwent a right hemicolectomy for ascending colon cancer (pT3, pN1, pM0) and who opted not to receive adjuvant chemotherapy. Eight months later, multiple liver metastases occurred. He therefore received FOLFOX4 (5-fluorouracil/leucovorin and 85 mg/m2 oxaliplatin) therapy, up to a total of 5 courses, and showed a partial response. While receiving the sixth course of FOLFOX4, he complained of chest pain and systemic itching approximately 15 min after the start of chemotherapy. An electrocardiogram revealed typical signs of ischemia. Coronary arteriography showed that the coronary arteries were intact. Believing the chest pain to be merely coincidental, we continued with the same therapy. However, he again developed the same chest pain during the seventh cycle of FOLFOX4 and treatment was stopped. We concluded that the patient’s symptoms were due to acute coronary syndrome (ACS) associated with the FOLFOX4 regimen. Variant angina as a type of ACS is a rare adverse effect of FOLFOX4. Clinicians should be aware of this potential adverse effect when monitoring patients receiving FOLFOX4.
