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Crit Rev Oncol Hematol. 2017 May;113:83-89. doi: 10.1016/j.critrevonc.2017.03.006. Epub 2017 Mar 9.

Venous thromboembolism in radiation therapy cancer patients: Findings from the RIETE registry.

Author information

1
Département de Radiothérapie, Institut de cancérologie de la Loire - Lucien Neuwirth, Saint-Priest en Jarez, France.
2
Université Jean-Monnet, UdL, SAINBIOSE U1059, St-Etienne, France; Inserm, CIC1408, F- 42055 Saint-Etienne, France; Centre Hospitalier Universitaire, Service de Médecine Vasculaire et Thérapeutique, St-Etienne, France. Electronic address: laurent.bertoletti@chu-st-etienne.fr.
3
Department of Internal Medicine, Hôpital Louis Mourier, Colombes (APHP), University Paris 7, France.
4
Department of Medical Oncology, Hospital Clínic de Barcelona, Barcelona, Spain.
5
Department of Internal Medicine, Hospital Universitario de Gran Canaria Dr. Negrín. Las Palmas, Spain.
6
Department of Haemostasis and Thrombosis, Hospital Río Carrión, Palencia, Spain.
7
Department of Medicina d'Urgenza, Ospedale San Camilo, Rome, Italy.
8
Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain.
9
Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Universidad Católica de Murcia, Badalona, Barcelona, Spain.

Abstract

BACKGROUND:

Cancer patients are at high risk of venous thromboembolism, particularly during cancer treatment. Conversely to chemotherapy, data on the epidemiology and clinical features of venous thromboembolism during radiation therapy are scarce. There is lack of evidence on the influence of radiation therapy (RT) on outcome in cancer patients with acute venous thromboembolism (VTE).

METHODS:

We used the RIETE (Registro Informatizado de Enfermedad ThromboEmbolica) database to assess the clinical characteristics and outcome of prospectively-collected consecutive patients with cancer-associated thrombosis occurred during the course of radiation therapy for cancer. Death, venous thromboembolism recurrences and major bleeding rates during long-term follow-up according to cancer site and treatment were compared RESULTS: 9284 Patients with active cancer and VTE were enrolled in RIETE: 4605 with pulmonary embolism (PE) and 4679 with deep vein thrombosis (DVT). In all, 1202 (13%) were receiving RT. This last sub-population had a higher rate of PE recurrences and a similar rate of DVT recurrences or major bleeding than those not receiving RT. Patients on RT had a higher rate of cerebral bleeding.

CONCLUSIONS:

In this cohort of cancer patients with VTE, a significant proportion of them received RT before VTE, the latter experienced a higher risk of cerebral bleeding.

KEYWORDS:

Anticoagulant therapy; Cancer; Pulmonary embolism; Radiation therapy; Venous thromboembolism

[Indexed for MEDLINE]

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