JCO:顺铂治疗与晚期实体瘤患者VTE发生风险增高相关

2012-12-10 JCO JCO

  美国一项荟萃分析显示,使用顺铂治疗与晚期实体肿瘤患者出现静脉血栓栓塞(VTE)风险显著增加有关。文章11月13日在线发表于《临床肿瘤学杂志》(J Clin Oncol)。   研究共纳入38项随机对照试验中患不同类型的晚期实体瘤患者。使用顺铂与不使用顺铂的患者,VTE的发生率分别为1.92%和0.79%。接受以顺铂为基础的化疗,可显著增加VTE的发生风险(RR=1.67,

  美国一项荟萃分析显示,使用顺铂治疗与晚期实体肿瘤患者出现静脉血栓栓塞(VTE)风险显著增加有关。文章11月13日在线发表于《临床肿瘤学杂志》(J Clin Oncol)。

  研究共纳入38项随机对照试验中患不同类型的晚期实体瘤患者。使用顺铂与不使用顺铂的患者,VTE的发生率分别为1.92%和0.79%。接受以顺铂为基础的化疗,可显著增加VTE的发生风险(RR=1.67,P=0.01);亚组分析显示,每周顺铂剂量>30 mg/m2的患者(RR=2.71)及2000~2010年入选试验的受试者(RR=1.72)出现VTE的相对风险最高。

  


Purpose
Several reports suggest that cisplatin is associated with an increased risk of thromboembolism. However, because the excess risk of venous thromboembolic events (VTEs) with cisplatin-based chemotherapy has not been well described, we conducted a systemic review and meta-analysis of randomized controlled trials evaluating the incidence and risk of VTEs associated with cisplatin-based chemotherapy.
Methods 
PubMed was searched for articles published from January 1, 1990, to December 31, 2010. Eligible studies included prospective randomized phase II and III trials evaluating cisplatin-based versus non–cisplatin-based chemotherapy in patients with solid tumors. Data on all-grade VTEs were extracted. Study quality was calculated using Jadad scores. Incidence rates, relative risks (RRs), and 95% CIs were calculated using a random effects model.
Results 
A total of 8,216 patients with various advanced solid tumors from 38 randomized controlled trials were included. The incidence of VTEs was 1.92% (95% CI, 1.07 to 2.76) in patients treated with cisplatin-based chemotherapy and 0.79% (95% CI, 0.45 to 1.13) in patients treated with non–cisplatin-based regimens. Patients receiving cisplatin-based chemotherapy had a significantly increased risk of VTEs (RR, 1.67; 95% CI, 1.25 to 2.23; P = .01). Exploratory subgroup analysis revealed the highest RR of VTEs in patients receiving a weekly equivalent cisplatin dose > 30 mg/m2 (2.71; 95% CI, 1.17 to 6.30; P = .02) and in trials reported during 2000 to 2010 (1.72; 95% CI, 1.27 to 2.34; P = .01).
Conclusion 
Cisplatin is associated with a significant increase in the risk of VTEs in patients with advanced solid tumors when compared with non–cisplatin-based chemotherapy.

    

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    2013-11-11 lidong40
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    2012-12-12 liuxiaona
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    2012-12-12 liuxiaona