铂类双联化疗用于伴弥散性血管内凝血的晚期胃癌

Platinum-based Doublet Chemotherapy for Advanced Gastric Cancer with Disseminated Intravascular Coagulation.

作者信息

Sugiyama Keiji, Narita Yukiya, Kadowaki Shigenori, Ura Takashi, Tajika Masahiro, Muro Kei

机构信息

Department of Clinical Oncology, Aichi Cancer Center Hospital, Aichi, Japan.

Department of Clinical Oncology, Aichi Cancer Center Hospital, Aichi, Japan

出版信息

Anticancer Res. 2017 Jan;37(1):309-313. doi: 10.21873/anticanres.11322.

DOI:10.21873/anticanres.11322

PMID:28011507

Abstract

BACKGROUND

Disseminated intravascular coagulation (DIC) is a rare complication of advanced gastric cancer (AGC). Despite reports of the efficacy of chemotherapy for AGC with DIC, little is known of platinum-based doublet therapy.

PATIENTS AND METHODS

We conducted a single-institute, retrospective chart review of 500 consecutive chemotherapy-naïve patients with advanced gastric adenocarcinoma (recurrent or metastatic) from November 2010 to November 2015.

RESULTS

Six patients were diagnosed with AGC with DIC (1.2%); five (1.0%; 3 men, 2 women) received platinum-based doublet chemotherapy. All patients exhibited improved DIC and thrombocytopenia and survived for >100 days (range=114-313) with no therapy-related mortality. Grade ≥3 adverse effects included neutropenia, anemia, hyponatremia, catheter-related infection and diarrhea (maximum: 2 patients each).

CONCLUSION

Fluoropyrimidine plus platinum combination therapy was effective against DIC and yielded acceptable survival outcomes. Combination chemotherapy should be considered as a primary therapy for AGC with DIC.

摘要

背景

弥散性血管内凝血（DIC）是晚期胃癌（AGC）的一种罕见并发症。尽管有报道称化疗对合并DIC的AGC有效，但对于铂类双联疗法知之甚少。

患者与方法

我们对2010年11月至2015年11月期间500例未经化疗的晚期胃腺癌（复发或转移）患者进行了单机构回顾性病历审查。

结果

6例患者被诊断为合并DIC的AGC（1.2%）；5例（1.0%；3例男性，2例女性）接受了铂类双联化疗。所有患者的DIC和血小板减少均有所改善，存活时间超过100天（范围=114 - 313天），且无治疗相关死亡。≥3级不良反应包括中性粒细胞减少、贫血、低钠血症、导管相关感染和腹泻（最多各2例患者）。