Verso Melina, Agnelli Giancarlo
Division of Internal and Cardiovascular Medicine - Stroke Unit, University of Perugia, Perugia, Italy.
Division of Internal and Cardiovascular Medicine - Stroke Unit, University of Perugia, Perugia, Italy.
Thromb Res. 2014 May;133 Suppl 2:S128-32. doi: 10.1016/S0049-3848(14)50022-9.
Venous thromboembolism (VTE) is a common complication in patients with cancer. VTE is a main cause of morbidity and mortality in patients with cancer and has a significant impact on their quality of life. Preventing VTE in cancer patients reduces both morbidity and mortality. The level of evidence for antithrombotic prophylaxis of VTE in patients with cancer varies for hospitalized and ambulatory patients. Hospitalized patients with active cancer (for both medical or surgical indication) and reduced mobility should receive thromboprophylaxis throughout hospital stay. Prophylaxis of VTE is not routinely recommended for outpatients with cancer on chemotherapy. For these patients, current guidelines suggest that clinicians should consider antithrombotic prophylaxis on a case-by-case basis in highly selected outpatients. Different strategies for identification of high-risk outpatients with cancer who could benefit of thromboprophylaxis are under consideration. The new oral anticoagulants could have a role for VTE prevention in ambulatory patients with cancer who are on chemotherapy, as they are administered at a fixed dose without routine laboratory monitoring and may have fewer drug interactions with anticancer agents.
静脉血栓栓塞症（VTE）是癌症患者常见的并发症。VTE是癌症患者发病和死亡的主要原因，对其生活质量有重大影响。预防癌症患者的VTE可降低发病率和死亡率。癌症患者VTE抗血栓预防的证据水平因住院患者和门诊患者而异。患有活动性癌症（因内科或外科指征）且活动能力下降的住院患者在整个住院期间应接受血栓预防。对于接受化疗的癌症门诊患者，通常不建议进行VTE预防。对于这些患者，当前指南建议临床医生应在高度选择的门诊患者中逐案考虑抗血栓预防。正在考虑采用不同策略来识别可能从血栓预防中获益的癌症高危门诊患者。新型口服抗凝剂可能在接受化疗的癌症门诊患者的VTE预防中发挥作用，因为它们以固定剂量给药，无需常规实验室监测，并且与抗癌药物的药物相互作用可能较少。
