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Thromboembolism Linked to Cytotoxic Cancer Treatment

Last Updated: April 30, 2009.

Cisplatin may be more thrombogenic than oxaliplatin in patients with advanced gastroesophageal cancer, and thromboembolism may shorten patients' survival, according to research published online April 27 in the Journal of Clinical Oncology.

THURSDAY, April 30 (HealthDay News) -- Cisplatin may be more thrombogenic than oxaliplatin in patients with advanced gastroesophageal cancer, and thromboembolism may shorten patients' survival, according to research published online April 27 in the Journal of Clinical Oncology.

Naureen Starling, of the Royal Marsden Hospital National Health Service Foundation Trust in London, U.K., and colleagues analyzed data from 964 adults with advanced gastroesophageal cancer. Patients were treated with four epirubicin/platinum/fluoropyrimidine triplet regimens.

The incidence of any thromboembolic event was 12.1 percent; incidence of venous thromboembolic event was 10.1 percent and incidence of arterial thromboembolic event was 2.2 percent, the investigators found. Those receiving oxaliplatin had fewer thromboembolic events than those receiving cisplatin (7.6 versus 15.1 percent). Multivariate analysis also found cisplatin to be a risk factor for thromboembolic events. Overall survival was lower in patients with thromboembolic events compared with those free of the event (median survival 7.4 versus 10.5 months), the researchers report.

"Thromboembolic complications of cytotoxic treatment, frequently overlooked in randomized trials, lead to morbidity and mortality and should form part of the risk/benefit assessment for cytotoxic regimens. We have documented the incidence of thromboembolism in a large trial of patients with advanced gastroesophageal cancer who are undergoing chemotherapy," the authors write. "Future disease-specific, prospective documentation of these events will help to define and refine treatment-associated risks."

The study was supported by Hoffmann-La Roche and sanofi-aventis. Several co-authors disclosed a variety of relationships with these companies.

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