Mellema Wouter W, van der Hoek Dorien, Postmus Pieter E, Smit Egbert F
Department of Pulmonary Diseases, VU University Medical Center, de Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Department of Pulmonary Diseases, VU University Medical Center, de Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Lung Cancer. 2014 Oct;86(1):73-7. doi: 10.1016/j.lungcan.2014.07.017. Epub 2014 Aug 2.
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.
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.
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).
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.
血栓栓塞事件（TE）在癌症患者中很常见，且可能危及生命。在肺癌患者中，对于化疗期间的血栓形成情况了解甚少。本研究的目的是描述非小细胞肺癌（NSCLC）患者在铂类化疗治疗期间发生TE的发生率。
我们回顾性选取了2000年至2012年期间在阿姆斯特丹VU大学医学中心接受铂类化疗的NSCLC患者。近期接受过手术的患者被排除。纳入所有从化疗开始至最后一次给药后30天内发生的TE。
在784例纳入患者中，63例（8.0%）患者在治疗期间发生了69次TE。45次为静脉血栓栓塞（VTE），24次为动脉血栓栓塞（ATE）。6例患者在治疗期间发生了多次事件，其中3例同时发生了ATE和VTE。总共有613例患者接受了顺铂治疗，119例患者接受了卡铂治疗，52例患者在一线或二线治疗中同时接受了两者。在接受顺铂治疗的患者中，8%（55/665）发生了TE，而接受卡铂治疗的患者中这一比例为5%（8/171）（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的发生相关（p<0.01）。有TE和无TE的患者的中位无进展生存期相似（分别为6.2个月和7.2个月；p=0.10）。有TE的患者的中位总生存期明显较短（分别为9.5个月和12.9个月；p=0.03）。
在我们的研究系列中，ATE和VTE在化疗期间均很常见。TE是一个不良预后因素。接受顺铂或卡铂治疗的患者在TE发生率上未发现差异。
