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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/m2, i.v. bolus) followed by 5-fluorouracil (5-FU; 600 mg/m2, i.v. bolus) after an interval of 3 h. Calcium leucovorin (10 mg/m2, 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.

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Received: December 10, 1999 / Accepted: January 28, 2000

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Hironaka, Si., Boku, N., Ohtsu, A. et al. Sequential methotrexate and 5-fluorouracil therapy for gastric cancer patients with bone metastasis. Gastric Cancer 3, 19–23 (2000). https://doi.org/10.1007/PL00011684

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  • DOI: https://doi.org/10.1007/PL00011684

  • Key words Methotrexate
  • 5-Fluorouracil
  • Gastric cancer
  • Bone metastasis
  • Disseminated intravascular coagulation