Venous thrombosis is the second leading cause of death in the vast majority of cancer patients, and it is worth paying attention to cancer patients with VTE.
The rate of
distant metastasis is higher and the one-year survival rate is lower, which leads to a significant increase in hospitalization days and economic burden of these patients, and increases the economic burden of patients, but also brings heavy economic burden and worse prognosis and complications
.
Let’s take a look at the clinical characteristics of patients with cancer-related thrombotic diseases? First of all, the incidence is high, and shows an upward trend year by year. From a number of studies at home and abroad, it can be seen that the later the tumor stage, the higher the risk of patients with thrombotic diseases, which is closely related to the characteristics of the disease, medication and the living habits of patients. At the same time, it is found that radiotherapy and surgery can increase the prevalence of patients with thrombotic diseases.
NCCN guidelines point out that the general risk factors of thrombotic diseases in cancer patients include: active cancer/advanced cancer/family heredity/acquired hypercoagulable state/medical complications: arterial thromboembolism/poor performance status and other factors
.
For the patients themselves, the factors that can be intervened are as follows: 1. Smoking; strictly control the amount of smoking, strive to quit smoking, improve the quality of life and reduce the occurrence of risk factors; 2. Obesity; adjust eating habits, pay attention to physical and mental health, control weight, properly increase the amount of exercise, improve the level of activity, regular diet, medication in accordance with medical supervision
. If
cancer patients have been diagnosed with thrombotic diseases, how should we further treat them? UFH/LMWH/Rivaroxaban
may be used for initial anticoagulation LMWH, edoxaban, or rivaroxaban are the first choice for
long-term anticoagulation for 6 months, which is more effective than VKA and reduces the cumbersome
monitoring of patients. Anticoagulation therapy
with LMWH, DOACs, or VKA should be continued after 6 months of initiation in patients with
certain active tumors, such as metastatic tumors or chemotherapy What are the medications for patients with
tumor venous thrombotic disease? Parenteral anticoagulants/anticoagulants, commonly used anticoagulants are low molecular weight heparin, but because of its inconvenient out-of-hospital medication, injection increases the pain of patients, expensive and other reasons are not preferred, warfarin because of the need to monitor INR during medication, bring a lot of inconvenience to patients, so more patients choose oral rivaroxaban, good safety, oral convenience and high compliance. Because of the particularity of cancer patients themselves, there are various differences and disadvantages in many aspects of physical fitness and healthy people, so we should pay more attention to the interaction between side effects and drugs in the selection of treatment options. Next, let’s take a look at the time of anticoagulation and individual treatment options
.
Based on the above considerations, for patients with tumor combined with thrombotic diseases, doctors should make decisions together with patients and formulate individualized anticoagulation programs to prevent the occurrence and development of thrombosis, reduce the pain of patients and reduce mortality
. How long is
the anticoagulation time more reasonable? Indefinite anticoagulant therapy is recommended for non-catheter-related thrombi if the cancer is active, under treatment, or if risk factors for recurrence persist.
For catheter-related venous thrombotic disease, the course of anticoagulation is the same as the catheter-in-place period. Overall treatment is recommended for at least 3 months.
Venous thromboembolic disease affects the treatment and survival of cancer patients, and anticoagulant therapy can effectively reduce the threat of VTE and provide more clinical benefits.
Anticoagulant therapy
for tumor-related venous thrombotic diseases has a long way to go, and colleagues attach great importance to it in order to bring more clinical benefits to patients.
