Vinorelbine plus 24-hour infusion of high-dose 5-fluorouracil and leucovorin as effective palliative chemotherapy for breast cancer patients with acute disseminated intravascular coagulation.

Abstract:

BACKGROUND:Cancer-related acute disseminated intravascular coagulation (DIC) is uncommon, but it is a severe complication resulting in a very dismal prognosis. Choosing the appropriate chemotherapy agents to treat the underlying cancer and stop the acute DIC process effectively, while avoiding chemotherapy-induced myelosuppression which may contribute to bleeding-related mortality, is difficult. Acute DIC in breast cancer is a rare condition and is not well studied. Therefore, we designed this study to determine the clinical characteristics and effective treatment for breast cancer patients with acute DIC. PATIENTS AND METHODS:From March 1996 to November 2008, patients with histologically proven breast cancer who presented with acute DIC at National Taiwan University Hospital were retrospectively analyzed. RESULTS:Sixteen patients were included in the study. Thirteen patients with breast cancer-related acute DIC were treated with various kinds of chemotherapy, one with tamoxifen, and two with supportive care only. Four patients responded to treatment; three of the responders received vinorelbine with high-dose 5-fluorouracil and leucovorin (HDFL), the other received vinorelbine with cisplatin. The median survival of the responders and non-responders was 13 months and 0.5 month (p<0.001). There were no grade 3 or 4 hematologic or non-hematologic toxicities in the patients receiving vinorelbine-HDFL. CONCLUSION:Vinorelbine plus HDFL is considered a safe and effective palliative treatment of choice for breast cancer patients with acute DIC. Further prospective study is warranted.

journal_name

Anticancer Res

journal_title

Anticancer research

authors

Lin PH,Lu YS,Lin CH,Chang DY,Huang CS,Cheng AL,Yeh KH

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

3087-91

issue

7

eissn

0250-7005

issn

1791-7530

pii

30/7/3087

journal_volume

30

pub_type

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