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[Complications due to high-dose OK-432 administration into tumors and the peritoneal cavity in patients with advanced gastric cancer].

It has been assumed that a high dose of OK-432 can be safely injected into tumor tissues or intraperitoneally under general anesthesia. Among 40 patients with advanced carcinoma of the stomach, high doses of OK-432 were injected into the tumor in six and intraperitoneally in 34. Circulatory shock associated with subsequent disseminated intravascular coagulation (DIC) developed within 3 days in one of the former and in two of the latter group. Hypovolemic shock was initially considered to indicate that hypovolemia actually existed in these three patients. However, the shock state with DIC persisted even after the blood volume had been corrected. Gram-negative bacteremia was verified in two of the patients. The shock and DIC seen in these patients could have been attributed to septicemia through either the necrotic tumor or the intestinal wall showing increased permeability as a result of the drug. When and if a high dose of OK-432 is administered locally, the prophylaxis of infection seems to be of crucial importance in order to avoid such complications as those reported above.