title: Platinum-based Doublet Chemotherapy for Advanced Gastric Cancer with Disseminated Intravascular Coagulation.
abstract: 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.
authors.affiliation: Department of Clinical Oncology, Aichi Cancer Center Hospital, Aichi, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Sugiyama
authors.affiliation: Department of Clinical Oncology, Aichi Cancer Center Hospital, Aichi, Japan yukiya.narita@aichi-cc.jp.
authors.forename: Yukiya
authors.initials: Y
authors.lastname: Narita
authors.affiliation: Department of Clinical Oncology, Aichi Cancer Center Hospital, Aichi, Japan.
authors.forename: Shigenori
authors.initials: S
authors.lastname: Kadowaki
authors.affiliation: Department of Clinical Oncology, Aichi Cancer Center Hospital, Aichi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ura
authors.affiliation: Department of Endoscopy, Aichi Cancer Center Hospital, Aichi, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tajika
authors.affiliation: Department of Clinical Oncology, Aichi Cancer Center Hospital, Aichi, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Muro
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000627:therapeutic use*; D004211:Disseminated Intravascular Coagulation / Q000188:drug therapy*; D004338:Drug Combinations; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D010094:Oxonic Acid / Q000627:therapeutic use; D017239:Paclitaxel / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000188:drug therapy*; D005641:Tegafur / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; D009944:Organoplatinum Compounds; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D017239:Paclitaxel; D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil
keywords: 5-fluorouracil; Chemotherapy; S-1; cisplatin; disseminated intravascular coagulopathy; fluoropyrimidine; gastric cancer; oxaliplatin