Document Detail


Management of venous thromboembolism in colorectal cancer patients treated with bevacizumab.
MedLine Citation:
PMID:  19697164     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Venous thromboembolism associated with use of a central venous access system is an urgent problem in patients treated with bevacizumab (bev). We investigated the effectiveness of Doppler ultrasound imaging (DUS) in the early detection of catheter-related thrombosis for avoidance of severe venous thromboembolism. Patients with metastatic colorectal cancer received either FOLFOX-4 + bev or FOLFIRI + bev. DUS was performed on the deep venous system for detection of thrombus formation during the initial cycle of treatment, followed by re-evaluation after the third cycle in patients with asymptomatic thrombus formation. All patients were followed up until treatment was interrupted. Median duration of follow-up was 484 days (range 72-574). Among 41 enrolled patients, curable symptomatic thrombosis occurred in one, and asymptomatic thrombosis in 21 (51.2%). Of 21 patients undergoing re-evaluation, thrombi remained without progression in 17 patients, and enlargement in 4 patients. In two of the patients in whom there was progression, pulmonary embolism occurred after the sixth cycle. In the asymptomatic group, no thrombi developed as far as the superior vena cava in any patient. In the cases of progression, thrombotic enlargement was observed in all the 4 patients, with decreased vascular flow in 2. Using DUS, we were able to detect asymptomatic thrombosis in the early cycles of treatment, indicating its potential in the monitoring of venous thrombi. In the event of an enlarging asymptomatic thrombosis developing into the superior vena cava along with decreased vascular flow, careful follow-up and appropriate anticoagulant therapy may be recommended without increased risk of bleeding.
Authors:
Mitsukuni Suenaga; Nobuyuki Mizunuma; Kokoro Kobayashi; Eiji Shinozaki; Satoshi Matsusaka; Keisho Chin; Yasutoshi Kuboki; Takashi Ichimura; Masato Ozaka; Mariko Ogura; Yoshimasa Fujiwara; Kiyoshi Matsueda; Fumio Konishi; Kiyohiko Hatake
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2009-08-21
Journal Detail:
Title:  Medical oncology (Northwood, London, England)     Volume:  27     ISSN:  1559-131X     ISO Abbreviation:  Med. Oncol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-20     Completed Date:  2010-12-30     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  9435512     Medline TA:  Med Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  807-14     Citation Subset:  IM    
Affiliation:
Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan. m.suenaga@jfcr.or.jp
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / complications,  drug therapy*
Adolescent
Adult
Aged
Angiogenesis Inhibitors / administration & dosage,  adverse effects*
Antibodies, Monoclonal / administration & dosage,  adverse effects*
Antibodies, Monoclonal, Humanized
Anticoagulants / therapeutic use
Antineoplastic Combined Chemotherapy Protocols / administration & dosage,  adverse effects,  therapeutic use*
Camptothecin / administration & dosage,  analogs & derivatives
Catheterization, Central Venous / adverse effects*
Colorectal Neoplasms / complications,  drug therapy*
Disease Progression
Early Diagnosis
Female
Fluorouracil / administration & dosage
Follow-Up Studies
Humans
Leucovorin / administration & dosage
Male
Middle Aged
Organoplatinum Compounds / administration & dosage
Prospective Studies
Pulmonary Embolism / etiology,  prevention & control
Risk Factors
Thrombophilia / drug therapy,  etiology*,  ultrasonography
Ultrasonography, Doppler*
Vena Cava, Superior
Venous Thromboembolism / drug therapy,  etiology,  prevention & control,  ultrasonography*
Young Adult
Chemical
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Anticoagulants; 0/Organoplatinum Compounds; 2S9ZZM9Q9V/bevacizumab; 51-21-8/Fluorouracil; 58-05-9/Leucovorin; 7689-03-4/Camptothecin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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