Sugiyama Keiji, Narita Yukiya, Kadowaki Shigenori, Ura Takashi, Tajika Masahiro, Muro Kei
Department of Clinical Oncology, Aichi Cancer Center Hospital, Aichi, Japan.
Department of Clinical Oncology, Aichi Cancer Center Hospital, Aichi, Japan
Anticancer Res. 2017 Jan;37(1):309-313. doi: 10.21873/anticanres.11322.
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.
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.
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).
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.
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。
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。
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）。
氟嘧啶加铂类联合疗法对DIC有效，并产生了可接受的生存结果。联合化疗应被视为合并DIC的AGC的主要治疗方法。
