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辅助化疗的非小细胞肺癌患者血栓栓塞事件分析:单中心真实世界数据。

Analysis of thromboembolic events in patients with non-small cell lung cancer who received adjuvant chemotherapy: single-center real-world data.

机构信息

Department of Hematology-Oncology, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 16499, Gyeonggi-do, Korea.

Department of Pulmonology and Critical Care Medicine, Ajou University School of Medicine, Suwon, Korea.

出版信息

Sci Rep. 2022 May 10;12(1):7646. doi: 10.1038/s41598-022-11631-9.

Abstract

Thromboembolic events (TEEs) are common in cancer patients, with increased risk of TEE by chemotherapy in patients with lung cancer. However, TEEs in patients with non-small cell lung cancer (NSCLC) who received adjuvant chemotherapy have rarely been reported. This study retrospectively analyzed real-world data of 275 patients with NSCLC treated with adjuvant chemotherapy after surgery from October, 2005 to June, 2020, in a single institution. The incidence of TEEs during or within one year of completion of adjuvant chemotherapy was investigated, and factors related to TEEs were analyzed. TEEs were confirmed in nine patients (3.3%), without fatal event related to TEEs. None of the factors, including Khorana score, was significantly associated with the occurrence of TEEs. All patients with TEEs had pathologic stage IIB or higher and a history of smoking, except for one patient. In conclusion, TEEs occurred in a smaller proportion of patients with NSCLC treated with adjuvant chemotherapy in the real world compared with those treated with palliative chemotherapy in previous reports. Furthermore, prophylactic anticoagulation in patients with NSCLC receiving adjuvant chemotherapy may not be needed except for high-risk patients, although those patients should be informed about the possible risk of TEEs.

摘要

血栓栓塞事件(TEEs)在癌症患者中很常见,肺癌患者接受化疗会增加 TEE 的风险。然而,接受辅助化疗的非小细胞肺癌(NSCLC)患者的 TEE 很少有报道。本研究回顾性分析了 2005 年 10 月至 2020 年 6 月在一家机构接受辅助化疗的 275 例 NSCLC 术后患者的真实世界数据。调查了辅助化疗期间或完成后一年内 TEE 的发生率,并分析了与 TEE 相关的因素。9 例(3.3%)患者确诊 TEE,无 TEE 相关致死事件。包括 Khorana 评分在内的所有因素与 TEE 的发生均无显著相关性。除了一名患者外,所有 TEE 患者均为病理分期 IIB 期或更高,且有吸烟史。总之,与之前报道的接受姑息性化疗的 NSCLC 患者相比,在真实世界中接受辅助化疗的 NSCLC 患者发生 TEE 的比例较小。此外,除非是高危患者,否则接受辅助化疗的 NSCLC 患者可能不需要预防性抗凝,尽管应告知这些患者 TEE 的可能风险。

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