Abdel-Razeq Hikmat, Mansour Asem, Abdulelah Hazem, Al-Shwayat Anas, Makoseh Mohammad, Ibrahim Mohammad, Abunasser Mahmoud, Rimawi Dalia, Al-Rabaiah Abeer, Alfar Rozan, Abufara Alaa', Ibrahim Alaa, Bawaliz Anas, Ismael Yousef
1Department of Internal Medicine, King Hussein Cancer Center, 202 Queen Rania Al-Abdulla St., P.O. Box 1269, Amman, 11941 Jordan.
2Radiology, King Hussein Cancer Center, Amman, Jordan.
Thromb J. 2018 Mar 1;16:2. doi: 10.1186/s12959-018-0161-9. eCollection 2018.
The risk of thromboembolic events is higher among cancer patients, especially in patients undergoing chemotherapy. Cisplatin-based regimens claim to be associated with a very high thromboembolic rate. In this study, we report on our own experience with thrombosis among patients on active cisplatin-based chemotherapy.
Medical records and hospital databases were searched for all the patients treated with any cisplatin-based regimen for any kind of cancer. Thrombosis was considered cisplatin-related if diagnosed any time after the first dose and up to 4 weeks after the last. The Khorana risk assessment model was performed in all cases.
A total of 1677 patients (65.5% males, median age: 50 years) treated with cisplatin-based regimens were identified. Head and neck (22.9%), lung (22.2%), lymphoma and gastric (11.4% each) were the most common primary tumors. Thromboembolic events were reported in 110 (6.6%); the highest was in patients with gastric cancer (20.9%) and the lowest in patients with head and neck cancers (2.3%) and lymphoma (1.6%). Thrombosis included deep vein thrombosis (DVT) in 69 (62.7%), pulmonary embolism (PE) in 18 (16.9%) and arterial thrombosis in 17 (15.6%). A majority (51.1%) of the patients had stage IV disease and only 16% had stage I or II.In a multivariate analysis, significantly higher rates of thrombosis were associated with gastric as the primary tumor, advanced-stage disease, female sex but not age, and the Khorana risk score or type of cisplatin regimen. While the presence of CVC was significantly associated with the risk of thrombosis ( < 0.0001) in the univariate analysis, and such significance was lost in the multivariate analysis (odds ratio, 1.098; 95%CI, 0.603-1.999, = 0.7599).
Thromboembolic events in cancer patients on active cisplatin-based chemotherapy were commonly encountered. Gastric cancer, regardless of other clinical variables, was associated with the highest risk.
癌症患者发生血栓栓塞事件的风险较高，尤其是接受化疗的患者。基于顺铂的化疗方案据称与非常高的血栓栓塞发生率相关。在本研究中，我们报告了接受基于顺铂的积极化疗的患者发生血栓形成的自身经验。
检索病历和医院数据库，查找所有接受任何基于顺铂方案治疗的各类癌症患者。如果在首次给药后任何时间直至最后一剂后4周内诊断为血栓形成，则认为与顺铂相关。所有病例均采用科拉纳风险评估模型。
共确定1677例接受基于顺铂方案治疗的患者（男性占65.5%，中位年龄：50岁）。头颈部（22.9%）、肺癌（22.2%）、淋巴瘤和胃癌（各占11.4%）是最常见的原发性肿瘤。报告有110例（6.6%）发生血栓栓塞事件；其中胃癌患者发生率最高（20.9%），头颈部癌患者（2.3%）和淋巴瘤患者（1.6%）发生率最低。血栓形成包括69例（62.7%）深静脉血栓形成（DVT）、18例（16.9%）肺栓塞（PE）和17例（15.6%）动脉血栓形成。大多数（51.1%）患者为IV期疾病，仅16%为I期或II期。在多变量分析中，血栓形成发生率显著较高与以胃癌作为原发性肿瘤、晚期疾病、女性性别而非年龄以及科拉纳风险评分或顺铂方案类型相关。虽然在单变量分析中中心静脉导管（CVC）的存在与血栓形成风险显著相关（<0.0001），但在多变量分析中这种相关性消失（比值比，1.098；95%置信区间，0.603 - 1.999，P = 0.7599）。
接受基于顺铂的积极化疗的癌症患者中血栓栓塞事件较为常见。无论其他临床变量如何，胃癌的风险最高。
