[Effect of sequential MTX/5-FU therapy for a case of disseminated intravascular coagulation syndrome associated with recurrence of gastric cancer--a case report].
Although a 39-year-old male received the curative operation of total gastrectomy for advanced scirrhous carcinoma of the stomach, recurrence of cancer was occurred soon after the surgery, accompanied by hemorrhagic diathesis from DIC. The abdominal CT scan examination revealed the rapid enlargement in the size of the several lymphnodes around the abdominal aorta, and the blood chemistry tests showed marked increase of the serum CEA value. The sequential chemotherapy with intermediate dose of MTX and 5-FU in conjunction with OK-432 was started to treat the case. This chemotherapy was carried out once a week for 5 times and consequently DIC was led to the perfect remission. Furthermore, CEA level decreased within normal range, and the size of the enlarged lymphnodes at paraaortic area diminished remarkably. Although he complained of nausea and loss of appetite during the treatment, no severe adverse effects such as granulocytopenia, diarrhea, or loss of hair were observed. The successful result in this patient suggests that sequential therapy of intermediate dose of MTX and 5-FU with administration of OK-432 may be effective in the treatment of advanced scirrhous carcinoma of the stomach.
Koike
H
H
2nd Dept. of Surgery, Faculty of Medicine, University of Tokyo, Japan.
Konishi
T
T
Mafune
K
K
Hirata
T
T
Miyama
T
T
Hiraishi
M
M
Idezuki
Y
Y
D002293:Adenocarcinoma, Scirrhous / Q000150:complications / Q000188:drug therapy; D000328:Adult; D004211:Disseminated Intravascular Coagulation / Q000188:drug therapy / Q000209:etiology*; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use*; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000188:drug therapy*; D013274:Stomach Neoplasms / Q000150:complications / Q000188:drug therapy*
D005472:Fluorouracil; D008727:Methotrexate