Cisplatin chemotherapy (without erythropoietin) and risk of life-threatening thromboembolic events in carcinoma of the uterine cervix: the tip of the iceberg? A review of the literature
| Autor: | Perry W. Grigsby, Anurag K. Singh, Jon C Anders |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
medicine.medical_specialty lcsh:R895-920 medicine.medical_treatment Uterine Cervical Neoplasms Antineoplastic Agents Review lcsh:RC254-282 Cohort Studies Thromboembolism Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Prospective cohort study Erythropoietin Retrospective Studies Cervical cancer Clinical Trials as Topic Chemotherapy business.industry Incidence Incidence (epidemiology) Retrospective cohort study lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease Combined Modality Therapy Thrombosis Surgery Treatment Outcome Oncology Embolism Research Design Female Cisplatin business Cohort study |
| Zdroj: | Radiation Oncology (London, England) Radiation Oncology, Vol 1, Iss 1, p 14 (2006) |
| ISSN: | 1748-717X |
| DOI: | 10.1186/1748-717x-1-14 |
| Popis: | Background The risk of severe cardiovascular toxicity, specifically thromboembolic events (TE), in patients with cervical cancer receiving concurrent irradiation and cisplatin chemotherapy is reported to be less than 1% in several large prospective trials. However, the anecdotal risk appears to be far higher. Results and discussion A review of several prospective trials demonstrates no treatment related grade 4 cardiovascular toxicities and only two grade 5 toxicities in 1424 (0.1%) collective patients. A recent publication and our own unpublished experience finds 6 of 128 (4.7%) patients developed grade 4 to 5 cardiovascular (thrombosis/embolism) toxicity. The differenc in incidence of severe or life threatening cardiovascular toxicity of 0.1 versus 4.7% is highly statistically significant (p < 0.00001.) Conclusion This dramatic difference in incidence of cardiovascular toxicity raises the possibility that cardiovascular toxicities were inadequately reported on the listed prospective trials. For those patients enrolled in prospective trials, we suggest that thromboses should be diligently documented and reported. Only after the true incidence of thromboses is established can we implement appropriate levels of early screening and intervention that may prevent life threatening complications. |
| Databáze: | OpenAIRE |
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