Petersen Lars J
Laboratory of Experimental Physiology and Inflammation, Department of Clinical Physiology, Viborg Hospital, Heibergs Alle 4, DK-8800 Viborg, Denmark.
Cancer Treat Rev. 2009 Dec;35(8):754-64. doi: 10.1016/j.ctrv.2009.08.009. Epub 2009 Sep 16.
Cancer patients in general have a high risk of venous thromboembolic events (VTE) driven not only by patient-related risk factors, but also risk factors related to the disease and anti-cancer therapies. Cancer patients with documented VTE have a notably worse outcome than non-cancer VTE patients. Since VTE is a highly preventable condition, it is striking that large surveys have shown significant underuse of VTE prophylaxis in surgical cancer patients and in medical cancer patients in particular. Recently, guidelines have been issued from European and American medical oncology societies and organizations for identification of cancer patients at risk, and the guidelines give recommendations for treatment of individual groups of cancer patients. This review summarizes the recommendations for VTE prophylaxis and treatment from the recent guidelines and reviews some outstanding issues in VTE prophylaxis and treatment of cancer patients.
一般来说,癌症患者发生静脉血栓栓塞事件(VTE)的风险很高,这不仅由患者相关的风险因素驱动,还与疾病和抗癌治疗相关的风险因素有关。有记录显示发生VTE的癌症患者的预后明显比非癌症VTE患者差。由于VTE是一种高度可预防的疾病,大型调查显示,外科癌症患者尤其是内科癌症患者对VTE预防措施的使用严重不足,这一点令人震惊。最近,欧美医学肿瘤学会和组织发布了关于识别有风险的癌症患者的指南,这些指南针对不同组别的癌症患者给出了治疗建议。本综述总结了近期指南中关于VTE预防和治疗的建议,并回顾了癌症患者VTE预防和治疗中的一些突出问题。