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Anticoagulation in the Setting of Primary and Metastatic Brain Tumors.
Cancer Treat Res ; 179: 179-189, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31317488
ABSTRACT
Venous thromboembolism is commonly diagnosed in patients with primary and secondary brain tumors. Anticoagulation management in the setting of brain tumors is complicated by the high background rate of spontaneous intracranial hemorrhage. Until recently, there was limited evidence to support the decision to administer therapeutic anticoagulation in the setting of brain metastases or primary brain tumors. The current evidence suggests that the safety profile of therapeutic low molecular weight heparin for the treatment of venous thromboembolism is contingent on whether the origin of brain tumor is primary (i.e., glioma) versus secondary. In patients with brain metastases, the rate of intracranial hemorrhage often exceeds 20% but is not influenced by the administration of low molecular weight heparin. In contrast, in primary brain tumors such as glioma, therapeutic anticoagulation is associated with an increased risk of intracranial hemorrhage that can negatively impact survival. This chapter reviews the underlying mechanisms contributing to thrombosis and hemorrhage in brain tumors and summarizes the current evidence and approaches in anticoagulation to treat venous thromboembolism.
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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Neoplasias Encefálicas / Hemorragias Intracranianas / Tromboembolia Venosa / Anticoagulantes Aspecto clínico: Etiologia / Terapia Limite: Humanos Idioma: Inglês Revista: Cancer Treat Res Ano de publicação: 2019 Tipo de documento: Artigo País de afiliação: Estados Unidos