Servicio de Medicina Interna, Hospital Univeritario Santa María del Rosell, Cartagena, Spain.
Expert Opin Pharmacother. 2011 Feb;12(3):351-62. doi: 10.1517/14656566.2011.520703.
the development of venous thromboembolism (VTE) in patients with cancer adversely affects their prognosis. Several autopsy- and population-based studies have clearly shown a negative impact of VTE on patient outcome in cancer patients.
an up-to-date review of VTE prophylaxis and treatment in cancer patients is provided with some insights on areas of uncertainty to be answered in the near future. Particular attention is paid to recent cohort studies, randomized clinical trials and consensus guidelines.
cancer patients at a higher risk for VTE may be identified with five variables easily available before initiation of chemotherapy. Long-term treatment with low-molecular-weight heparin (LMWH) demonstrated a superior efficacy over vitamin K antagonists. The intensity and duration of anticoagulant therapy should be tailored to the risk of VTE recurrences or bleeding in an individual patient.
癌症患者发生静脉血栓栓塞(VTE)会对其预后产生不利影响。多项尸检和基于人群的研究清楚地表明,VTE 对癌症患者的生存结果有负面影响。
提供了最新的癌症患者 VTE 预防和治疗综述,并对未来需要解答的不确定领域提供了一些见解。特别关注了最近的队列研究、随机临床试验和共识指南。
在开始化疗之前,可通过 5 个易于获得的变量识别出 VTE 风险较高的癌症患者。与维生素 K 拮抗剂相比,长期使用低分子肝素(LMWH)的疗效更优。抗凝治疗的强度和时间应根据患者发生 VTE 复发或出血的风险来调整。