Weekly 24-hour infusional 5-fluorouracil as initial treatment for advanced gastric cancer with acute disseminated intravascular coagulation.
BACKGROUND
Acute disseminated intravascular coagulation (DIC) occurring in patients with advanced gastric cancer (AGC) is a rare entity with a dismal prognosis. Conventional cytotoxic chemotherapy is usually not possible. Preliminary reports have suggested that non-myelosuppressive weekly 24-h infusion of high-dose 5-fluorouracil (5-FU) and leucovorin (HDFL) may be helpful.


METHODS
Between 1994 and 2005, AGC patients who presented with acute DIC and were initially treated with HDFL (5-FU 2600 mg/m2 plus leucovorin 300 mg/m2, 24-h infusion weekly) were reviewed.


RESULTS
Nineteen such patients were identified. After treatment with HDFL for a median of 4 weeks, 14 patients showed a response of the acute DIC. Eight of them subsequently received HDFL-based combination chemotherapy. The median survivals for the whole group, the DIC responders, and the 8 patients receiving subsequent combination chemotherapy were 3, 6, and 8 months, respectively.


CONCLUSIONS
HDFL, as a safe initial treatment for AGC patients with acute DIC, provides the opportunity for further aggressive chemotherapy.
Huang
Ta-Chen
TC
Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan, ROC.
Yeh
Kun-Huei
KH
Cheng
Ann-Lii
AL
Hsu
Chih-Hung
CH
D000328:Adult; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D015331:Cohort Studies; D004211:Disseminated Intravascular Coagulation / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D015996:Survival Rate
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil