Adjuvant Treatment with 5-Fluorouracil and Oxaliplatin Does Not Influence Cardiac Function, Neurovascular Control, and Physical Capacity in Patients with Colon Cancer

Abstract

Background. Adjuvant chemotherapy with 5-fluorouracil (5-FU) and oxaliplatin increases recurrence-free and overall survival in patients with colon adenocarcinoma. It is known that these drugs have been associated with cardio-and neurotoxicity. We investigated the effects of 5-FU AE oxaliplatin on cardiac function, vascular responses, neurovascular control, and physical capacity in patients with colon cancer. Methods. Twenty-nine patients with prior colectomy for stage II-III adenocarcinoma and clinical indication for adjuvant chemotherapy were allocated to receive 5-FU (n = 12) or 5-FU + oxaliplatin (n = 17), according to the oncologist's decision. All the analyses were performed just before and after the end of chemotherapy. Cardiac function was assessed by echocardiography and speckle tracking, and cardiac autonomic control was assessed by heart rate variability (HRV). Vascular endothelial function was assessed by flowmediated dilation (FMD). Muscle sympathetic nerve activity (MSNA) was directly recorded by microneurography technique, and muscle blood flow by venous occlusion plethysmography. Physical capacity was evaluated by cardiopulmonary exercise test. Results. Chemotherapy (pooled data) did not significantly change left ventricular ejection fraction (58 AE 1 vs. 55 AE 2%, p = .14), longitudinal strain (−18 AE 1 vs. −18 AE 1%, p = .66), and HRV. Likewise, chemotherapy did not significantly change FMD, muscle blood flow, and MSNA (33 AE 2 vs. 32 AE 1 bursts/min, p = .31). Physical capacity was not significantly changed in both groups. Similar findings were observed when the patients were subdivided in 5-FU and 5-FU + oxaliplatin treatment groups. 5-FU and 5-FU + oxaliplatin did not significantly change cardiac function, HRV, vascular responses, MSNA, and physical capacity. Conclusion. This study provides evidence that adjuvant treatment with 5-FU AE oxaliplatin is well tolerated and does not promote changes compatible with long-term cardiotoxicity.

Assessments of Perfusion, Blood Flow, and Vascular Structure in Ambulatory Subjects: Guidance for Translational Research Scientists

“…A modified scoping review was performed according to accepted, published methodology for conducting scoping reviews [1]. The broad objective for this modified scoping review was to provide an overview of how FMD Cognitive function 2 [189,190] Investigate the association between dementia and EF Investigate the association between amyloid-β and white matter lesions and EF Neurological disease 2 [191,192] Use EF to assess the longitudinal changes in CVD risk in cerebral palsy Investigate the association between multiple sclerosis and endothelial function Stroke 2 [193,194] Investigate the effect of exercise treatment program on EF following ischemic stroke Investigate the effect of remote ischemic conditioning on EF in stroke survivors Cancer 2 [195,196] Determine the effect of different chemotherapy treatments on EF in stage II-III adenocarcinoma Sleep disorder 2 [197,198] Investigate the association between restless leg syndrome and EF Investigate the association between childhood primary snoring and EF Kidney disease 2 [199,200] Investigate role of ED in mediating elevated nocturnal BP in chronic kidney disease Investigate the association between end-stage renal disease and EF PE 1 [201] Investigate the association between development of PE and EF earlier in pregnancy Menopause 1 [202] Investigate the effect of resveratrol and estrogen on EF VTE 1 [203] Investigate the association between risk of venous thromboembolism and EF Lifestyle 1 [204] Investigate the effects of prolonged sitting on EF Diabetes 1 [205] Investigate the effect of remote ischemic preconditioning on EF BP, blood pressure; CAD, coronary artery disease; cIMT, carotid intima-media thickness; COPD, chronic obstructive pulmonary disease; CVD, cardiovascular disease; ED, endothelial dysfunction; EF, endothelial function; FMD, flow mediated dilation; PE, preeclampsia. DOI: 10.1159/000527765 has been used to characterize vascular function in previous research studies.…”

“…Brachial artery 47 [19,189,185,201,182,199,186,157,193,183,164,158,184,165,190,205,191,166,159,175,170,176,179,171,194,200,202,187,180,160,196,197,161,206,198,203,167,162,168,169,163,192,172,173,177,174,178] Femoral artery 2 [195,188] Posterior tibial artery 1 [204] Aspect of vasculature assessed Endothelial function 45…”

Coronary Artery Disease and Cancer: Treatment and Prognosis Regarding Gender Differences

“…Oxaliplatin can induce acute ST segment elevation without myocardial infarction [ 65 ]. However, as part of adjuvant treatment, oxaliplatin and 5-FU had no-effect on cardiac function [ 66 ].…”

HIF-1α Expression Increases Preoperative Concurrent Chemoradiotherapy Resistance in Hyperglycemic Rectal Cancer

“…In a study of hyperglycemic rectal cancer patients receiving chemotherapy, hyperglycemia significantly enhanced oxaliplatin chemotherapy resistance in patients receiving adjuvant infusional fluorouracil, leucovorin, and oxaliplatin (FOLFOX6) chemotherapy for stage III rectal cancer [ 18 , 19 , 20 ]. Hyperglycemia also affected the anti-tumor activity and survival rate of tumor-bearing or fibrosarcoma-bearing mice receiving oxaliplatin and 5-FU [ 21 , 22 ].…”