{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T18:40:55Z","timestamp":1779302455661,"version":"3.51.4"},"reference-count":28,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T00:00:00Z","timestamp":1733184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"BTG International"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Objectives: We aimed to determine whether the occurrence of early-onset toxicities due to 5-fluorouracil (5-FU) in treatment-naive patients undergoing their first cycle of FOLFOX\/FOLFIRINOX was associated with decreased overall survival, increased risk of treatment cessation, and hospitalization. Methods: This was a retrospective cohort study using patient information from community oncology practices. Patients who received their first dose of 5-FU from 1 January 2015 through 1 August 2023 were included. The occurrence of an early-onset 5-FU-related toxicity (during 5-FU infusion or up to 96 h after infusion completion) in the first cycle of FOLFOX\/FOLFIRINOX was the explanatory variable. The primary endpoint was overall survival (OS); secondary endpoints included early treatment cessation and early hospital admission. Results: In total, 3988 patients were included; the median age was 62.9 years and 57.5% were male. Early-onset toxicities were observed in 19.1%, with vomiting, thrombocytopenia, and diarrhea being most common. Patients with early-onset toxicities had a median OS of 2.5 years [95% CI 2.2 to 2.9] compared with 5.3 years [95% CI 4.7 to 5.8] in patients without early-onset toxicities (p &lt; 0.001). The occurrence of early-onset toxicities was associated with an adjusted hazard ratio of 1.61 [95% CI 1.44 to 1.80] and was also significantly associated with early treatment cessation (odds ratio [OR] 1.53, 95% CI 1.30 to 1.80) and early hospital admission (OR 8.69, 95% CI 3.45 to 24.18). Conclusions: Early-onset toxicities related to 5-FU during the first cycle of FOLFOX\/FOLFIRINOX treatment were associated with poor outcomes. Early recognition and prompt intervention are pertinent to improve outcomes in patients receiving fluoropyrimidine chemotherapy.<\/jats:p>","DOI":"10.3390\/cancers16234050","type":"journal-article","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T04:04:04Z","timestamp":1733198644000},"page":"4050","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Long-Term Outcomes of 5-Fluorouracil-Related Early-Onset Toxicities: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9402-5086","authenticated-orcid":false,"given":"Nicol\u00e1s","family":"Tentoni","sequence":"first","affiliation":[{"name":"Resonance, Memphis, TN 38104, USA"},{"name":"Laboratory of Applied Statistics in the Health Sciences, Faculty of Medicine, University of Buenos Aires, Buenos Aires C1121 ABG, Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Combs","sequence":"additional","affiliation":[{"name":"Resonance, Memphis, TN 38104, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0685-4352","authenticated-orcid":false,"given":"Miriam","family":"Hwang","sequence":"additional","affiliation":[{"name":"Resonance, Memphis, TN 38104, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Ward","sequence":"additional","affiliation":[{"name":"BTG International Inc., West Conshohocken, PA 19428, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"McCracken","sequence":"additional","affiliation":[{"name":"Guardian Research Network, Spartanburg, SC 29303, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Lowe","sequence":"additional","affiliation":[{"name":"Resonance, Memphis, TN 38104, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott C.","family":"Howard","sequence":"additional","affiliation":[{"name":"Resonance, Memphis, TN 38104, USA"},{"name":"Sant Joan de D\u00e9u Hospital Barcelona, 08950 Barcelona, Spain"},{"name":"Yeolyan National Hematology Center, Yerevan 0014, Armenia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,3]]},"reference":[{"key":"ref_1","unstructured":"Pratt, V.M., Scott, S.A., Pirmohamed, M., Esquivel, B., Kattman, B.L., and Malheiro, A.J. 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