Severe central nervous system toxicity associated with continuous infusion of 5-fluorouracil

Objectives To observe severe central nervous system(CNS) toxicity associated with continuous infusion of 5-fluorouracil and to search for the therapeutic programmes designed for it. Methods The source material of the patients treated with folinic acid plus 5-fluorouracil continuous infusion for 48 hours during April 1999 to November 2002 in our department was reviewed and analysed,including the main side effects, particularly CNS toxicity associated with 5-fluorouracil continuous infusion and the therapeutic programmes designed for it. Results 242 patients were treated with folinic acid plus 5-fluorouracil continuous infusion for 48 hours and the total cycles of treatment were 750.Two (0.8%) patients experienced superficial coma (CNS toxicity, grade 4) within 48 hours after treatment with 5-fluorouracil continuous infusion. The patients were treated with good supporting treatment, and perfectly recovered in one or two day. Conclusions The results suggest that severe CNS toxicity is one of the side-effects of 5-fluorouracil, and is reversible and uncommon.It is related with the dosage of 5-fluorouracil and individual variation.