572P - Cardiotoxicity in Chinese cancer patients treated with 5-fluorouracil or capecitabine: A multicenter prospective observational study

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Cytotoxic agents
Complications/Toxicities of treatment
Presenter Gong Chen
Citation Annals of Oncology (2016) 27 (suppl_9): ix184-ix189. 10.1093/annonc/mdw603
Authors G. Chen1, J.J. Peng2, C. Dong3, M. Qiu4, C. Wang5, H.W. Li6, H. Yu7, M. Zhang8, Q. Zhao9, B. Zhu10, J. Zhang11, L.W. Li12, H.F. Wang13, Q. Wu14, Y. Yuan15, H.W. Zhou1
  • 1Colorectal, Cancer Centre Sun Yat-Sen University, 510060 - Guangzhou/CN
  • 2Gastrointestinal-pancreatic Surgery, 1st Affiliated Hospital of Sun Yat-sen University, 510080 - Guangzhou/CN
  • 3Yunnan Cancer Hospital, Yunnan Tumour Hospital (3rd Affiliated Hospital Affiliated to Kunming Medical College), 650118 - Kunming/CN
  • 4Oncology, West China Hospital, Huaxi, Sichuan University, 610041 - Chengdu/CN
  • 5Hematology Oncology, The First Bethune Hospital of Jilin university, 130021 - Changchun/CN
  • 6Surgical Oncology, Fujian Provincial Hospital, 350001 - Fuzhou/CN
  • 7Biological Statistics, Nanjing Medical University, 211166 - Nanjing/CN
  • 8Cardiology, Shanghai Chest Hospital, 200000 - Shanghai/CN
  • 9Surgical Oncology, Hebei Cancer Hospital, 50011 - Shijiazhuang/CN
  • 10Oncology, Xinqiao Hospital, 3rd Military Medical University, 400037 - Chongqing/CN
  • 11Oncology, Shanghai Ruijin Hospital, Shanghai Jiao Tong University, College of Medicine, 200025 - Shanghai/CN
  • 12Oncology, 1st Affiliated Hospital of Kunming Medical University, 650032 - Kunming/CN
  • 13Internal Medicine, Cancer Centre Sun Yat-Sen University, 510060 - Guangzhou/CN
  • 14Medical Oncology, The First Affiliated Hospital of Bengbu Medical College, 233004 - Bengbu/CN
  • 15Medical Oncology, 2nd Affiliated Hospital of Zhejiang University University School of Medicine, 310009 - Hangzhou/CN



Although the cardiotoxicity associated with 5-Fluorouracil (5-FU) or capecitabine administration has been well addressed in literature, there is still a lack of data from prospective clinical trials in Chinese population.The aim of this study was to evaluate the incidence, manifestations and predisposing factors for the cardiotoxicity in Chinese cancer patients treated 5-FU or capecitabine.


A multicenter prospective observational study was performed in 527 patients with various solid tumors from 12 cancer centers in china . Of these patients,196 received 5-FU-based and 331 received oral capecitabine-based chemotherapy as either first-line or adjuvant therapy. Outcome measures including electrocardiogram(ECG), myocardial enzymes, cardiac troponin(cTn), BNP and echocardio- graphy(UCG) etc. Univariate analysis and the logistic regression were performed for subgroup analysis and identification of the significant independent variables that are associated with cardiotoxicity of both agents.


In total, 161 of 527 patients (30.55%) experienced cardiotoxicity. The incidence of cardiotoxicity was 33.84% (112 out of 331) in the capecitabine-treated population, significantly higher than 25% (49 out of 196) in the 5-FU treated population (P = 0.0042). 110 out of 527 patients (20.87%) suffered arrhythmia, 105/527 (19.92%) developed ischemic changes, 20/527(3.80%) heart failure and 6/527 (1.14%) myocardial infarction. Among the factors evaluated with univariate analysis and the logistic regression, a history of cardiac disease, chemotherapy agent, duration of treatment and hypertension were significant with cardiotoxicity occurrence. The odds ratio were 15.447(with a history of cardiac history vs without), 2.118 (capecitabine group vs 5-FU group), 1.079(5-8 vs 1-4 cycles) and 1.698 (with hypertension vs without) respectively.


Cardiotoxicity induced by fluoropyrimidines in Chinese population may be underestimated in clinical practice. Possible risk factors are duration of treatment, chemotherapy agents, preexisting cardiac disease and hypertension.

Clinical trial indentification

No clinical Register

Legal entity responsible for the study

Sun Yat-sen University Cancer Center, China




All authors have declared no conflicts of interest.