Yeh K H, Cheng A L
Department of Oncology, National Taiwan University Hospital, and Cancer Research Centre, Taipei, ROC.
Br J Haematol. 1998 Mar;100(4):769-72. doi: 10.1046/j.1365-2141.1998.00613.x.
Acute disseminated intravascular coagulation (DIC) is a severe complication of gastric adenocarcinoma, and most of the patients die within 1-3 weeks. We have treated five such patients with an empirical non-myelosuppressive HDFL regimen (weekly 24h infusion of high-dose 5-fluorouracil 2600 mg/m2 and leucovorin 300 mg/m2). Within 2 weeks of starting the treatment the clinical and laboratory evidence of acute DIC quickly resolved in all five patients. HDFL not only caused no further myelosuppression, but also resulted in normalization of the patient's haemogram within a few weeks. Other anti-cancer drugs could then be safely added. Three patients had a survival time of more than 6 months. We suggest that HDFL is an ideal initial treatment for gastric cancer complicated by acute DIC.
急性弥散性血管内凝血（DIC）是胃腺癌的一种严重并发症，大多数患者在1 - 3周内死亡。我们用经验性非骨髓抑制性HDFL方案（每周24小时输注高剂量5-氟尿嘧啶2600 mg/m²和亚叶酸钙300 mg/m²）治疗了5例此类患者。在开始治疗的2周内，所有5例患者急性DIC的临床和实验室证据迅速消失。HDFL不仅未引起进一步的骨髓抑制，还使患者的血常规在几周内恢复正常。随后可以安全地添加其他抗癌药物。3例患者存活时间超过6个月。我们认为HDFL是胃癌合并急性DIC的理想初始治疗方法。
