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放射治疗——癌症相关静脉血栓形成的重要促成因素。

Radiotherapy-the not-so-insignificant contributor to cancer-associated venous thrombosis.

作者信息

Gurumurthy Gerard, Miller Jacob, Carrier Marc, Khorana Alok, Thachil Jecko

机构信息

The University of Manchester, Manchester, UK.

Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA.

出版信息

Res Pract Thromb Haemost. 2025 Jul 23;9(5):102985. doi: 10.1016/j.rpth.2025.102985. eCollection 2025 Jul.

Abstract

Venous thromboembolism is a well-established complication in patients with cancer and a leading cause of morbidity and mortality in these subjects. However, the role of radiotherapy in cancer-associated venous thromboembolism (CAT) remains less clearly defined. The incidence of CAT in this population varies widely, with several large-scale studies suggesting an association. Although management of CAT in this population follows standard guidelines, less is known about the appropriateness of thromboprophylaxis in patients with different types of cancer. Patients with cancer undergoing radiotherapy may also be at increased risk of bleeding, which may be further worsened by anticoagulation. A multidisciplinary approach integrating hematology and oncology expertise is essential in this setting. Further research is needed to establish standardized protocols and predictive models to identify those at risk of thrombosis and bleeding while on anticoagulation.

摘要

静脉血栓栓塞是癌症患者中一种公认的并发症,也是这些患者发病和死亡的主要原因。然而,放疗在癌症相关静脉血栓栓塞(CAT)中的作用仍不太明确。该人群中CAT的发病率差异很大,多项大规模研究表明存在关联。尽管该人群中CAT的管理遵循标准指南,但对于不同类型癌症患者血栓预防的适宜性了解较少。接受放疗的癌症患者出血风险也可能增加,抗凝可能会使情况进一步恶化。在这种情况下,整合血液学和肿瘤学专业知识的多学科方法至关重要。需要进一步研究以建立标准化方案和预测模型,以识别抗凝时存在血栓形成和出血风险的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce46/12362088/bb002ea6270c/gr1.jpg

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