Retrospective evaluation of thromboembolic events in patients with non-small cell lung cancer treated with platinum-based chemotherapy
Retrospective evaluation of thromboembolic events in patients with non-small cell lung cancer treated with platinum-based chemotherapy
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DOI：
10.1016/j.lungcan.2014.07.017
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发表时间：
2014-10-01
期刊：
影响因子：
5.3
通讯作者：
Smit, Egbert F.
中科院分区：
文献类型：
--
作者：
Mellema, Wouter W.;van der Hoek, Dorien;Smit, Egbert F.
目的：血栓栓塞事件（TE）在癌症患者中很常见，可能危及生命。在肺癌中，对化疗治疗期间的血栓形成知之甚少。本研究的目的是描述TE的发病率与非小细胞肺癌（NSCLC），发生在治疗过程中与铂为基础的chemotherapy.Methods：我们回顾性地选择了与铂为基础的化疗在VU大学医学中心阿姆斯特丹2000年至2012年治疗的NSCLC患者。排除了近期接受手术的患者。结果：在784例患者中，63例（8.0%）患者在化疗期间发生TE 69次，TE发生率为100%（63/784）。45例静脉TE（VTE）和24例动脉TE（ATE）。6例患者在治疗期间发生多起事件，其中3例同时发生ATE和VTE。共有613例患者接受顺铂治疗，119例患者接受卡铂治疗，52例患者接受一线或二线治疗。8%（55/665）的顺铂暴露患者发生TE，而5%（8/171）的卡铂暴露患者发生TE（p = 0.42）。大多数TE发生在前2个周期（70%）。TE病史与化疗期间TE的发生有关（p < 0.01）。有和无TE患者的中位PFS相似（分别为6.2 vs. 7.2个月; p = 0.10）。TE患者的中位OS显著较短（分别为9.5 vs. 12.9个月; p = 0.03）。结论：在我们的系列中，ATE和VTE是化疗期间的常见结果。TE是一个不良预后因素。在接受顺铂或卡铂治疗的患者中，TE发生率无差异。(C)2014爱思唯尔爱尔兰有限公司版权所有。
Objectives: Thromboembolic events (TE) are common in patients with cancer and are potentially life-threatening. In lung cancer, little is known about thrombosis during chemotherapy treatment. The aim of this study was to describe the incidence of TE in patients with non-small cell lung cancer (NSCLC), occurring during treatment with platinum-based chemotherapy.Methods: We retrospectively selected patients with NSCLC treated with platinum-based chemotherapy at the VU University Medical Center Amsterdam between 2000 and 2012. Patients who underwent recent surgery were excluded. All TE were included that occurred from start of chemotherapy treatment until 30 days after last administration.Results: Among 784 included patients, 63 (8.0%) patients had 69 TE during treatment. Forty-five venous TE (VTE) and 24 arterial TE (ATE). Six patients had multiple events within treatment period, 3 of which had simultaneous ATE and VTE. In total, 613 patients were treated with cisplatin, 119 patients received carboplatin and 52 patients received both in first- or second-line treatment. In 8% (55/665) of the patients exposed to cisplatin a TE had occurred vs. 5% (8/171) in patients exposed to carboplatin (p = 0.42). The majority of TE occurred in the first 2 cycles (70%). History of TE was related to occurrence of TE during chemotherapy (p < 0.01). Median PFS was similar in patients with and without TE (6.2 vs. 7.2 months, respectively; p = 0.10). Median OS was significantly shorter in patients with TE (9.5 vs. 12.9 months, respectively; p = 0.03).Conclusion: In our series, both ATE and VTE were a common finding during chemotherapy. TE was a poor prognostic factor. No difference in TE incidence was found between patients treated with cisplatin or carboplatin. (C) 2014 Elsevier Ireland Ltd. All rights reserved.