Prophylaxis of catheter-related deep vein thrombosis in cancer patients with low-dose warfarin, low molecular weight heparin, or control: a randomized, controlled, phase III study.
Cancer Chemother Pharmacol
; 72(1): 65-73, 2013 Jul.
Article
em En
| MEDLINE
| ID: mdl-23636449
ABSTRACT
PURPOSE:
Whether an anticoagulant prophylaxis is needed for patients with cancer with a central venous catheter is a highly controversial subject. We designed a study to compare different prophylactic strategies over 3 months of treatment.METHODS:
We performed a phase III prospective, open-label randomized trial. After the insertion of a central venous access device, consecutive patients with planned chemotherapy for cancer were randomized to no anticoagulant prophylaxis, low molecular weight heparin [low molecular weight heparin (LMWH); with isocoagulation doses], or warfarin 1 mg/day. Treatments were given over the first 3 months. Doppler ultrasound and venographies were performed on days 1 and 90, respectively, or sooner in case of clinical presumption of thrombosis.RESULTS:
A total of 420 patients were randomized, and 407 were evaluable. Forty-two catheter-related deep vein thrombosis (DVT) occurred (10.3 %), 20 in those with no anticoagulation, 8 in those receiving warfarin, and 14 in those receiving LMWH. Nine additional non-related catheter deep vein thrombosis (CDVT) occurred. Anticoagulation significantly reduced the incidence of catheter-related DVT (p = 0.035) and catheter non-related DVT (p = 0.007), with no difference between warfarin and LMWH. Safety was good (3.4 % of attributable events) but compliance with randomized prophylaxis was lower than expected.CONCLUSIONS:
Prophylaxis showed a benefit regarding catheter-related and non-catheter-related DVT with no increase in serious side effects.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Varfarina
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Heparina de Baixo Peso Molecular
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Trombose Venosa Profunda de Membros Superiores
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Cateteres Venosos Centrais
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Anticoagulantes
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Neoplasias
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Antineoplásicos
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Incidence_studies
/
Prognostic_studies
Limite:
Adult
/
Aged
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Aged80
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Female
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Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Cancer Chemother Pharmacol
Ano de publicação:
2013
Tipo de documento:
Article