Abstract：
BACKGROUND: The administration of 5-fluorouracil (5FU) in the treatment of gastrointestinal (GI) malignancies is associated with common side effects such as mucositis, diarrhoea, and myelosuppression, which are easily managed with supportive measures and dose adjustments. Cardiotoxicity and neurotoxicity are rare but reversible side effects of 5-FU and are treated with withdrawal of the drug and conservative measures. The presenting symptoms of 5-FU-induced leukoencephalopathy are often confusing and pose a diagnostic dilemma in routine clinical practice.
METHODS: We report a series of five patients with GI malignancies who developed 5-FU-induced leukoencephalopathy.
RESULTS: All (n = 5) had Naranjo scores of 6-7, predictive of 5-FU-related adverse effects, with clinical and radiological findings suggestive of 5-FU-induced encephalopathy as described in prior literature. The median time to onset of symptoms from initiation of 5FU was 3 days (range: 2-4 days). All patients improved after conservative management with complete neurological recovery.
CONCLUSIONS: Prompt recognition of this rare yet severe adverse effect of 5-FU-based chemotherapy aids early withdrawal of the offending agent (5-FU) and timely initiation of supportive measures and helps plan alternative oncological interventions.
METHODS: We report a series of five patients with GI malignancies who developed 5-FU-induced leukoencephalopathy.
RESULTS: All (n = 5) had Naranjo scores of 6-7, predictive of 5-FU-related adverse effects, with clinical and radiological findings suggestive of 5-FU-induced encephalopathy as described in prior literature. The median time to onset of symptoms from initiation of 5FU was 3 days (range: 2-4 days). All patients improved after conservative management with complete neurological recovery.
CONCLUSIONS: Prompt recognition of this rare yet severe adverse effect of 5-FU-based chemotherapy aids early withdrawal of the offending agent (5-FU) and timely initiation of supportive measures and helps plan alternative oncological interventions.
摘要：
背景：在胃肠道（GI）恶性肿瘤的治疗中使用5-氟尿嘧啶（5FU）与常见的副作用有关，例如粘膜炎，腹泻,和骨髓抑制，通过支持性措施和剂量调整可以轻松管理。心脏毒性和神经毒性是5-FU的罕见但可逆的副作用，并通过停药和保守措施进行治疗。5-FU引起的白质脑病的症状通常令人困惑，并在常规临床实践中构成诊断难题。
方法：我们报告了5例发生5-FU诱导的脑白质病变的胃肠道恶性肿瘤患者。
结果：所有（n=5）的Naranjo评分为6-7，可预测5-FU相关的不良反应，如先前文献所述，临床和放射学发现提示5-FU诱导的脑病。从5FU开始到症状发作的中位时间为3天(范围:2-4天)。保守治疗后，所有患者均得到改善，神经功能完全恢复。
结论：迅速认识到以5-FU为基础的化疗的这种罕见但严重的不良反应有助于尽早戒除不良药物（5-FU）和及时启动支持措施，并有助于计划替代肿瘤干预措施。
方法：我们报告了5例发生5-FU诱导的脑白质病变的胃肠道恶性肿瘤患者。
结果：所有（n=5）的Naranjo评分为6-7，可预测5-FU相关的不良反应，如先前文献所述，临床和放射学发现提示5-FU诱导的脑病。从5FU开始到症状发作的中位时间为3天(范围:2-4天)。保守治疗后，所有患者均得到改善，神经功能完全恢复。
结论：迅速认识到以5-FU为基础的化疗的这种罕见但严重的不良反应有助于尽早戒除不良药物（5-FU）和及时启动支持措施，并有助于计划替代肿瘤干预措施。
