Complications associated with erythropoietin-stimulating agents in patients with metastatic breast cancer: a Surveillance, Epidemiology, and End Results-Medicare study.
Complications associated with erythropoietin-stimulating agents in patients with metastatic breast cancer: a Surveillance, Epidemiology, and End Results-Medicare study.
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DOI：
10.1002/cncr.25972
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发表时间：
2011-08-15
期刊：
影响因子：
6.2
通讯作者：
Giordano, Sharon H.
中科院分区：
文献类型：
--
作者：
Chavez-MacGregor, Mariana;Zhao, Hui;Fang, Shenying;Srokowski, Tomasz P.;Hortobagyi, Gabriel N.;Giordano, Sharon H.
关键词：
目的：评价老年转移性乳腺癌化疗患者中促红细胞生成素刺激剂(ESA)的使用模式和血栓栓塞性事件(TEE)的风险。使用SEER-Medicare链接数据库进行的回溯性研究。纳入1995年至2005年确诊的接受化疗的IV期乳腺癌患者，≥年龄66岁，完全覆盖医疗保险A和B。ICD-9和HCPCS编码用于识别ESA的使用、化疗和治疗的并发症。分析包括描述性统计和Logistic回归。包括2266名妇女，980名(43.3%)接受了ESA，1286名(56.7%)没有接受ESA。1999年后确诊的患者或接受紫杉烷、蒽环类或长春瑞滨治疗的患者更有可能接受ESA。接受ESA治疗的患者有更高的中风(18.5%比15.1%，p=0.031)、深静脉血栓(21.3%比14.4%，p<；0.001)、其他/未指定TEE(19.8%比14.7%；p=0.001)和任何血栓(31.3%比23.4%，p<；0.0001)。在多变量分析中，接受ESA治疗的患者发生深静脉血栓(OR=1.36；1.05-1.75)和任何血栓(OR=1.26；1.02-1.57)的风险增加。对于中风、深静脉血栓、其他TEE和任何血栓，剂量依赖效应明显。在这组患者中，ESA的使用增加了TEE的风险，对中风、DVT、其他TEE和任何血栓都有剂量依赖性的影响。我们的数据显示，在接受化疗和ESA治疗的转移性乳腺癌患者中，TES是常见的事件。因此，建议在使用这些代理时要谨慎。
To evaluate the patterns of use and the risk of thromboembolic events (TEE) associated with Erythropoietin Stimulating Agents (ESAs) in older patients with metastatic breast cancer receiving chemotherapy. Retrospective study using the SEER-Medicare linked database. Stage IV breast cancer patients diagnosed from 1995–2005, treated with chemotherapy, ≥66 years old, with full coverage of Medicare A and B were included. ICD-9 and HCPCS codes were used to identify the use of ESAs, chemotherapy, and complications of therapy. Analyses included descriptive statistics and logistic regression. 2,266 women were included, 980 (43.3%) received ESAs and 1,286 (56.7%) did not. Patients diagnosed after 1999 or who received treatment with taxanes, anthracyclines or vinorelbine were more likely to receive ESAs. Patients receiving ESAs had higher rates of stroke (18.5% vs 15.1%, p=0.031); DVT (21.3% vs. 14.4%, p<0.001), other/unspecified TEE (19.8% vs 14.7%; p=0.001) and any clot (31.3% vs. 23.4%, p<0.0001). In multivariable analysis, patients receiving ESAs had increased risk for DVT (OR=1.36; 1.05–1.75), and any clot (OR=1.26; 1.02–1.57). A dose-dependent effect was evident for stroke, DVT, other TEE and any clot. In this cohort of patients, the use of ESAs increased the risk of TEEs, with a dose-dependent effect for stroke, DVT, other TEE and any clot. Our data shows that among patients treated with chemotherapy and ESAs for metastatic breast cancer, TEEs are a common event. Therefore caution is recommended when using these agents.
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影响因子：
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