Oncology Department, San Filippo Neri Hospital, via Martinotti 20, Rome, 00135, Italy.
J Transl Med. 2011 Oct 20;9:179. doi: 10.1186/1479-5876-9-179.
Cancer patients receiving chemotherapy are at increased risk of thrombosis. Nadroparin has been demonstrated to reduce the incidence of venous and arterial thrombotic events (TEs) by about 50% in cancer outpatients receiving chemotherapy. The aims of this retrospective analysis were to evaluate the thromboembolic risk and the benefit of thromboprophylaxis according to type of chemotherapy.
Cancer outpatients were randomly assigned to receive subcutaneous injections of nadroparin or placebo. The incidence of symptomatic TEs was assessed according to the type of chemotherapy. Results were reported as risk ratios with associated 95% CI and two-tailed probability values.
769 and 381 patients have been evaluated in the nadroparin and placebo group, respectively. In the absence of thromboprophylaxis, the highest rate of TEs was found in patients receiving gemcitabine- (8.1%) or cisplatin-based chemotherapy (7.0%). The combination of gemcitabine and cisplatin or carboplatin increased the risk to 10.2%. Thromboprophylaxis reduced TE risk by 68% in patients receiving gemcitabine; with a further decrease to 78% in those receiving a combination of gemcitabine and platinum.
This retrospective analysis confirms that patients undergoing chemotherapy including gemcitabine, platinum analogues or their combination are at higher risk of TEs. Our results also suggest that outpatients receiving chemotherapy regimens including these agents might achieve an increased benefit from thromboprophylaxis with nadroparin.
NCT 00951574.
接受化疗的癌症患者发生血栓的风险增加。那屈肝素已被证明可使接受化疗的门诊癌症患者静脉和动脉血栓事件（TE）的发生率降低约 50%。本回顾性分析的目的是评估根据化疗类型血栓栓塞风险和血栓预防的获益。
癌症门诊患者随机接受那屈肝素或安慰剂皮下注射。根据化疗类型评估症状性 TE 的发生率。结果以风险比（RR）及相关 95%置信区间（CI）和双侧概率值报告。
分别有 769 例和 381 例患者纳入那屈肝素组和安慰剂组。未进行血栓预防时，接受吉西他滨-（8.1%）或顺铂为基础的化疗患者（7.0%）TE 发生率最高。吉西他滨联合顺铂或卡铂增加至 10.2%。接受吉西他滨治疗的患者中，血栓预防可降低 TE 风险 68%；而接受吉西他滨联合铂类治疗的患者中，该风险进一步降低至 78%。
本回顾性分析证实，接受包含吉西他滨、铂类类似物或其联合化疗的患者发生 TE 的风险更高。我们的结果还提示，接受包含这些药物的化疗方案的门诊患者可能会从那屈肝素预防血栓中获得更大获益。
NCT 00951574。
