Introduction
Nasopharyngeal carcinoma (NPC) is a very rare tumor in children.
Although enormous differences exist among races and geographical groups,
nasopharyngeal carcinoma makes up 1–5% of all pediatric cancers and
20–50% of all primary malignant nasopharyngeal tumors in children.
This disease has been linked to etiological factors such as Epstein Barr
virus, consumption of food rich in nitrosamines, and genetic and
epigenetic factors that are still unclear. Current treatment protocols
use induction with Cisplatin-based chemotherapy and 5-FU with
concomitant chemoradiotherapy. Prognosis with current protocols treating
pediatric nasopharyngeal carcinoma is excellent with an overall survival
higher than 85%
[1].
5-FU is a known inducer of cardiotoxicity in adult patients,
particularly those with underlying cardiovascular disease. The
cardiotoxic effects of 5-FU in the pediatric population are not well
described. Previous studies of adults with 5-FU-mediated cardiotoxicity
described events of myocardial infarction, coronary vasospasm,
arrhythmias or cardiomyopathy
[2]. The
mechanism is not fully understood; however, may be due to a combination
of ischemia related to coronary vasospasm and direct myocardial cell
toxicity [3].
Uridine triacetate was FDA approved in December of 2015 as a 5-FU
reversal agent for the emergency treatment of patients with
life-threatening toxicity.