Chai-Adisaksopha Chatree, Linkins Lori-Ann, ALKindi Said Y, Cheah Matthew, Crowther Mark A, Iorio Alfonso
Alfonso Iorio, HIRU CRL-140, Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada, Tel.: +1 905 525 9140 ext 22421, E-mail:
Thromb Haemost. 2017 Feb 28;117(3):589-594. doi: 10.1160/TH16-09-0680. Epub 2017 Jan 12.
Venous thromboembolism (VTE) is one of the most common complications in patients with brain tumours. There is limited data available in the literature on VTE treatment in these patients. We conducted a matched retrospective cohort study of patients with primary or metastatic brain cancer who were diagnosed with cancer-associated VTE. Patients were selected after a retrospective chart review of consecutive patients who were diagnosed with cancer-associated VTE between January 2010 and January 2014 at the Juravinski Thrombosis Clinic, Hamilton, Canada. Controls were age- and gender-matched patients with cancer-associated VTE from the same cohort, but without known brain tumours. A total of 364 patients with cancer-associated VTE were included (182 with primary or metastatic brain tumours and 182 controls). The median follow-up duration was 6.7 (interquartile range 2.5-15.8) months. The incidence rate of recurrent VTE was 11.0 per 100 patient-years (95 % CI; 6.7-17.9) in patients with brain tumours and 13.5 per 100 patient-years (95 % CI; 9.3-19.7) in non-brain tumour group. The incidence of major bleeding was 8.6 per 100 (95 % CI; 4.8-14.7) patient-years in patients with brain tumours versus 5.0 per 100 patient-years (95 % CI; 2.8-9.2) in controls. Rate of intracranial bleeding was higher in brain tumour patients (4.4 % vs 0 %, p-value=0.004). In summary, rates of recurrent VTE and major bleeding were not significantly different in patients with cancer-associated VTE in the setting of primary or metastatic brain tumours compared those without known brain tumours. However, greater numbers of intracranial bleeds were observed in patients with brain tumours.
静脉血栓栓塞症（VTE）是脑肿瘤患者最常见的并发症之一。关于这些患者VTE治疗的文献资料有限。我们对诊断为癌症相关VTE的原发性或转移性脑癌患者进行了一项配对回顾性队列研究。在对2010年1月至2014年1月在加拿大汉密尔顿朱拉温斯基血栓诊所连续诊断为癌症相关VTE的患者进行回顾性病历审查后选择患者。对照组为来自同一队列的年龄和性别匹配的癌症相关VTE患者，但无已知脑肿瘤。总共纳入了364例癌症相关VTE患者（182例原发性或转移性脑肿瘤患者和182例对照）。中位随访时间为6.7（四分位间距2.5 - 15.8）个月。脑肿瘤患者复发性VTE的发生率为每100患者年11.0（95％CI；6.7 - 17.9），非脑肿瘤组为每100患者年13.5（95％CI；9.3 - 19.7）。脑肿瘤患者严重出血的发生率为每100患者年8.6（95％CI；4.8 - 14.7），而对照组为每100患者年5.0（95％CI；2.8 - 9.2）。脑肿瘤患者颅内出血率更高（4.4％对0％，p值 = 0.004）。总之，与无已知脑肿瘤的患者相比，原发性或转移性脑肿瘤患者中癌症相关VTE患者的复发性VTE和严重出血率无显著差异。然而，脑肿瘤患者观察到更多的颅内出血。
