Cisplatin-Based Chemotherapy Is a Strong Risk Factor for Thromboembolic Events in Small-Cell Lung Cancer
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Purpose Cisplatin-associated arterial and venous thromboembolic events (TEEs) are becoming anincreasing concern. In patients with small-cell lung cancer (SCLC) who are treated usingcisplatin-based chemotherapy, we assume that the overall risk of TEEs is high. However,cisplatin-associated vascular toxicity in patients with SCLC has been overlooked to date. The aim of this study was to determine the incidence of TEEs in patients with SCLC and toanalyze the predictors for TEE occurrence. Materials and MethodsWe retrospectively analyzed 277 patients who received chemotherapy for SCLC between2006 and 2012. As the influence of chemotherapy on TEE occurrence developed after itsinitiation, a time-dependent Cox regression analysis was used to estimate the significantpredictors for TEE. ResultsAmong the 277 patients, 30 patients (11%) developed a TEE. The 3-month, 6-month, and1-year cumulative incidences of TEEs were 5.0%, 9.1%, and 10.2%, respectively. Of 30 totalTEEs, 22 (73%) occurred between the time of initiation and 4 weeks after the last dose ofplatinum-based chemotherapy. Approximately 218 patients (79%) received cisplatin-basedchemotherapy. In multivariate analysis, cisplatin-based chemotherapy was an independentrisk factor for TEE occurrence (hazard ratio [HR], 4.36; p=0.05). Variables including smokingstatus (common HR, 2.14; p=0.01) and comorbidity index (common HR, 1.60; p=0.05) alsoshowed significant association with TEE occurrence. ConclusionThe 1-year cumulative incidence of TEE is 10.2% in Asian patients with SCLC. Cisplatinbasedchemotherapy in SCLC might be a strong predictor for the risk of TEE.
Abstract
Purpose Cisplatin-associated arterial and venous thromboembolic events (TEEs) are becoming anincreasing concern. In patients with small-cell lung cancer (SCLC) who are treated usingcisplatin-based chemotherapy, we assume that the overall risk of TEEs is high. However,cisplatin-associated vascular toxicity in patients with SCLC has been overlooked to date. The aim of this study was to determine the incidence of TEEs in patients with SCLC and toanalyze the predictors for TEE occurrence. Materials and MethodsWe retrospectively analyzed 277 patients who received chemotherapy for SCLC between2006 and 2012. As the influence of chemotherapy on TEE occurrence developed after itsinitiation, a time-dependent Cox regression analysis was used to estimate the significantpredictors for TEE. ResultsAmong the 277 patients, 30 patients (11%) developed a TEE. The 3-month, 6-month, and1-year cumulative incidences of TEEs were 5.0%, 9.1%, and 10.2%, respectively. Of 30 totalTEEs, 22 (73%) occurred between the time of initiation and 4 weeks after the last dose ofplatinum-based chemotherapy. Approximately 218 patients (79%) received cisplatin-basedchemotherapy. In multivariate analysis, cisplatin-based chemotherapy was an independentrisk factor for TEE occurrence (hazard ratio [HR], 4.36; p=0.05). Variables including smokingstatus (common HR, 2.14; p=0.01) and comorbidity index (common HR, 1.60; p=0.05) alsoshowed significant association with TEE occurrence. ConclusionThe 1-year cumulative incidence of TEE is 10.2% in Asian patients with SCLC. Cisplatinbasedchemotherapy in SCLC might be a strong predictor for the risk of TEE.
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