Huang Ta-Chen, Yeh Kun-Huei, Cheng Ann-Lii, Hsu Chih-Hung
Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan, ROC.
Anticancer Res. 2008 Mar-Apr;28(2B):1293-7.
Acute disseminated intravascular coagulation (DIC) occurring in patients with advanced gastric cancer (AGC) is a rare entity with a dismal prognosis. Conventional cytotoxic chemotherapy is usually not possible. Preliminary reports have suggested that non-myelosuppressive weekly 24-h infusion of high-dose 5-fluorouracil (5-FU) and leucovorin (HDFL) may be helpful.
Between 1994 and 2005, AGC patients who presented with acute DIC and were initially treated with HDFL (5-FU 2600 mg/m2 plus leucovorin 300 mg/m2, 24-h infusion weekly) were reviewed.
Nineteen such patients were identified. After treatment with HDFL for a median of 4 weeks, 14 patients showed a response of the acute DIC. Eight of them subsequently received HDFL-based combination chemotherapy. The median survivals for the whole group, the DIC responders, and the 8 patients receiving subsequent combination chemotherapy were 3, 6, and 8 months, respectively.
HDFL, as a safe initial treatment for AGC patients with acute DIC, provides the opportunity for further aggressive chemotherapy.
晚期胃癌（AGC）患者发生的急性弥散性血管内凝血（DIC）是一种罕见疾病，预后不佳。通常无法进行传统的细胞毒性化疗。初步报告表明，每周24小时输注非骨髓抑制性高剂量5-氟尿嘧啶（5-FU）和亚叶酸（HDFL）可能会有帮助。
回顾了1994年至2005年间出现急性DIC并最初接受HDFL治疗（5-FU 2600 mg/m²加亚叶酸300 mg/m²，每周24小时输注）的AGC患者。
确定了19例此类患者。接受HDFL治疗中位时间为4周后，14例患者的急性DIC有反应。其中8例随后接受了以HDFL为基础的联合化疗。整个组、DIC有反应者以及接受后续联合化疗的8例患者的中位生存期分别为3个月、6个月和8个月。
HDFL作为AGC合并急性DIC患者的一种安全初始治疗方法，为进一步积极化疗提供了机会。
