title: Sequential methotrexate and 5-fluorouracil therapy for gastric cancer patients with bone metastasis.
abstract: BACKGROUND: Patients with bone metastasis of gastric cancer occasionally experience disseminated intravascular coagulation (DIC), with a very poor prognosis.METHODS: We treated 18 gastric cancer patients with bone metastasis with sequential methotrexate and 5-fluorouracil (sequential MTX/5-FU therapy). The treatment schedule comprised weekly administration of methotrexate (MTX; 100 mg/m(2), i.v. bolus) followed by 5-fluorouracil (5-FU; 600 mg/m(2), i.v. bolus) after an interval of 3 h. Calcium leucovorin (10 mg/m(2), p.o. or i.v.) was administered six times, every 6 h starting 24 h after the administration of MTX.RESULTS: In 11 patients with measurable metastatic lesions, the response rate was 64% (7/11). Nine patients (50%) had DIC before the initiation of chemotherapy, and 8 of them (89%) recovered from it. Two of these 9 patients (22%) survived for more than 1 year. The median survival times for all patients and for the 9 with DIC were 186 and 113 days, respectively. Grade 4 leukopenia was observed in 3 patients (17%). No treatment-related deaths occurred.CONCLUSION: Sequential MTX/5-FU therapy may have palliative potential and may be a feasible treatment for gastric cancer patients with bone metastasis with or without DIC.
authors: Division of Digestive Endoscopy and GI Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
authors: Shu-Ichi
authors: SI
authors: Hironaka
authors: Narikazu
authors: N
authors: Boku
authors: Atsushi
authors: A
authors: Ohtsu
authors: Fumio
authors: F
authors: Nagashima
authors: Yasushi
authors: Y
authors: Sano
authors: Manabu
authors: M
authors: Muto
authors: Takahiro
authors: T
authors: Fujii
authors: Hisao
authors: H
authors: Tajiri
authors: Shigeaki
authors: S
authors: Yoshida