在接受免疫检查点抑制剂治疗的肺癌患者中，体能状态评分预测静脉血栓栓塞的价值。

The value of performance status in predicting venous thromboembolism in lung cancer patients treated with immune checkpoint inhibitors.

机构信息

Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.

West China School of Medicine, Sichuan University, Chengdu, Sichuan Province, China.

出版信息

Eur J Oncol Nurs. 2024 Apr;69:102527. doi: 10.1016/j.ejon.2024.102527. Epub 2024 Feb 5.

DOI:10.1016/j.ejon.2024.102527

PMID:38377652

Abstract

INTRODUCTION

The incidence of venous thromboembolism (VTE) is notably high in lung cancer patients, particularly among those treated with immune checkpoint inhibitors (ICIs). Previous studies have focused on the relationship between Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) and VTE risk in immune checkpoint inhibitor therapy, but available evidence is inconsistent.

METHODS

The clinical data of lung cancer patients treated with ICIs were collected and analyzed from West China Hospital between January 2018 and March 2022. ECOG PS score was measured on admission. The primary outcome was the incidence of VTE, encompassing both deep vein thrombosis (DVT) and pulmonary embolism (PE). Multivariate logistic regression analysis was conducted to calculate the odds ratio (OR) and 95% confidence interval (95% CI).

RESULTS

A total of 1115 lung cancer patients receiving ICIs were eligible for this study, VTE developed in 105 (9.4%) during the 12-month follow-up, of which 95 (8.5%) had DVT,14 (1.3%) had definite PE. Poor ECOG PS (PS ≥ 2) was associated with an increased risk for VTE (OR = 5.405, 95% CI = 3.067-9.525, P < 0.001), DVT (OR = 4.669, 95% CI = 2.588-8.427, P < 0.001) and PE (OR = 8.413, 95% CI = 2.565-27.600, P < 0.001) after multivariable adjustment in the study cohort.

CONCLUSION

VTE occurred in 9.4% of lung cancer patients treated with ICIs, and poor performance status was associated with an increased risk of VTE.

摘要

简介

静脉血栓栓塞症（VTE）在肺癌患者中的发病率显著较高，尤其是在接受免疫检查点抑制剂（ICI）治疗的患者中。先前的研究主要集中在东部肿瘤协作组（ECOG）表现状态（PS）与免疫检查点抑制剂治疗中 VTE 风险之间的关系，但现有证据并不一致。

方法

收集并分析了 2018 年 1 月至 2022 年 3 月在华西医院接受 ICI 治疗的肺癌患者的临床数据。入院时测量 ECOG PS 评分。主要结局是 VTE 的发生率，包括深静脉血栓形成（DVT）和肺栓塞（PE）。采用多变量逻辑回归分析计算比值比（OR）和 95%置信区间（95%CI）。

结果

共纳入 1115 例接受 ICI 治疗的肺癌患者，在 12 个月的随访期间，105 例（9.4%）发生 VTE，其中 95 例（8.5%）发生 DVT，14 例（1.3%）发生明确的 PE。较差的 ECOG PS（PS≥2）与 VTE（OR=5.405，95%CI=3.067-9.525，P<0.001）、DVT（OR=4.669，95%CI=2.588-8.427，P<0.001）和 PE（OR=8.413，95%CI=2.565-27.600，P<0.001）风险增加相关，在研究队列中进行多变量调整后。