Background: Antiangiogenetic therapy and lung cancer, per se, are associated with an increased risk of thromboembolic events (TE). We aim to evaluate the pattern and outcome of TE as well as its influence on survival time of advanced non-small cell lung cancer (NSCLC) patients receiving antiangiogenic therapy.
Methods: This was a retrospective cohort study, which included advanced NSCLC patients receiving antiangiogenic therapy. All TE were confirmed by objective image studies. We disclosed the presentation and risk factors of TE and evaluated its influence on outcome.
Results: A total of 427 patients were included. TE occurred in 43 patients (10.1%). Deep vein thrombosis (DVT) was the most common TE (n = 20). Up to 46.2% of DVT did not occur in the typical lower extremities. Two patients died of TE. Among patients with continuous use or reuse of antiangiogenetic therapy, 18.2% had recurrent TE events. At the occurrence of TE, 28 patients experienced progressive disease (TE with PD), while tumor status remained stable in another 15 patients (TE without PD). The post-TE survival of patients without and with PD were 8.9 months (95% CI 3.9– 13.9) vs 2.2 months (95% CI 0.1– 4.3), P = 0.012. As compared with patients without TE (31.4 months [95% CI 27.1– 35.7]), TE with PD patients experienced a significantly shorter overall survival (20.1 months [95% CI 15.5– 24.6]), but TE without PD patients had comparable survival time (32.7 months [95% CI 7.4– 28.1]) (P = 0006). The use of hormone analogue and proteinuria predicted the events among TE with PD group (aOR 2.79 [95% CI 1.13=6.92]; P = 0.027) and TE without PD group (aOR 4.30 [95% CI 1.13– 16.42]; P = 0.033), respectively.
Conclusion: Owing to the different risk factors and influences on the survival time, TE with and without PD may be two different disease entities.



中文翻译：

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接受抗血管生成治疗的晚期NSCLC患者血栓栓塞事件的结局及其对生存时间的影响

背景：抗血管生成治疗和肺癌本身与血栓栓塞事件（TE）风险增加相关。我们的目的是评估 TE 的模式和结果及其对接受抗血管生成治疗的晚期非小细胞肺癌 (NSCLC) 患者生存时间的影响。
方法：这是一项回顾性队列研究，其中包括接受抗血管生成治疗的晚期 NSCLC 患者。所有 TE 均通过客观图像研究得到证实。我们披露了 TE 的表现和风险因素，并评估了其对结果的影响。
结果：共纳入 427 名患者。43 名患者（10.1%）发生 TE。深静脉血栓 (DVT) 是最常见的 TE (n = 20)。高达 46.2% 的 DVT 并未发生在典型下肢。两名患者死于 TE。在连续使用或重复使用抗血管生成治疗的患者中，18.2%的患者出现复发性TE事件。发生 TE 时，28 名患者出现疾病进展（TE 伴有 PD），而另外 15 名患者的肿瘤状态保持稳定（TE 不伴有 PD）。没有和患有 PD 的患者的 TE 后生存期分别为 8.9 个月 (95% CI 3.9–13.9) vs 2.2 个月 (95% CI 0.1–4.3)，P = 0.012。与未发生 TE 的患者（31.4 个月 [95% CI 27.1–35.7]）相比，发生 TE 的 PD 患者的总生存期显着缩短（20.1 个月 [95% CI 15.5–24.6]），但未发生 PD 的 TE 患者的生存期相当时间（32.7 个月 [95% CI 7.4–28.1]）（P = 0006）。使用激素类似物和蛋白尿可预测 TE 伴 PD 组（aOR 2.79 [95% CI 1.13=6.92]；P = 0.027）和 TE 无 PD 组（aOR 4.30 [95% CI 1.13–16.42]；P = 0.027）的事件。 0.033），分别。
结论：由于危险因素和对生存时间的影响不同，伴有PD和不伴有PD的TE可能是两种不同的疾病实体。