Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update 2014

被引：543

作者：

Lyman, Gary H. ^{[1
,2
]}

Bohlke, Kari ^{[3
]}

Khorana, Alok A. ^{[4
]}

Kuderer, Nicole M. ^{[2
]}

Lee, Agnes Y. ^{[5
]}

Arcelus, Juan Ignacio ^{[7
]}

Balaban, Edward P. ^{[8
]}

Clarke, Jeffrey M. ^{[9
]}

Flowers, Christopher R. ^{[11
]}

Francis, Charles W. ^{[12
,13
]}

Gates, Leigh E.

Kakkar, Ajay K. ^{[14
]}

Key, Nigel S. ^{[10
]}

Levine, Mark N. ^{[6
]}

Liebman, Howard A. ^{[15
,16
]}

Tempero, Margaret A. ^{[17
]}

Wong, Sandra L. ^{[18
]}

Somerfield, Mark R. ^{[3
]}

Falanga, Anna ^{[19
]}

机构：

[1] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA

[2] Univ Washington, Seattle, WA 98195 USA

[3] Amer Soc Clin Oncol, Alexandria, VA USA

[4] Cleveland Clin, Cleveland, OH 44106 USA

[5] Univ British Columbia, Vancouver, BC V5Z 1M9, Canada

[6] McMaster Univ, Hamilton, ON, Canada

[7] Univ Granada, Hosp Univ Virgen Nieves, Granada, Spain

[8] Mt Nittany Hlth & Penn State Hershey Canc Inst, Canc Care Partnership, State Coll, PA USA

[9] Duke Univ, Med Ctr, Durham, NC USA

[10] Univ N Carolina, Lineberger Comprehens Canc Ctr, Chapel Hill, NC 27599 USA

[11] Emory Univ, Sch Med, Atlanta, GA USA

[12] James P Wilmot Canc Ctr, Rochester, NY USA

[13] Univ Rochester, Rochester, NY USA

[14] Thrombosis Res Inst, London SW3 6LR, England

[15] Univ So Calif, Keck Sch Med, Los Angeles, CA 90033 USA

[16] Norris Comprehens Canc Ctr, Los Angeles, CA USA

[17] Univ Calif San Francisco, Pancreas Ctr, San Francisco, CA 94143 USA

[18] Univ Michigan, Ann Arbor, MI 48109 USA

[19] Hosp Papa Giovanni XXIII, Bergamo, Italy

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2015年 / 33卷 / 06期

关键词：

D O I：

10.1200/JCO.2014.59.7351

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose To provide current recommendations about the prophylaxis and treatment of venous thromboembolism (VTE) in patients with cancer. Methods PubMed and the Cochrane Library were searched for randomized controlled trials, systematic reviews, meta-analyses, and clinical practice guidelines from November 2012 through July 2014. An update committee reviewed the identified abstracts. Results Of the 53 publications identified and reviewed, none prompted a change in the 2013 recommendations. Recommendations Most hospitalized patients with active cancer require thromboprophylaxis throughout hospitalization. Routine thromboprophylaxis is not recommended for patients with cancer in the outpatient setting. It may be considered for selected high-risk patients. Patients with multiple myeloma receiving antiangiogenesis agents with chemotherapy and/or dexamethasone should receive prophylaxis with either low-molecular weight heparin (LMWH) or low-dose aspirin. Patients undergoing major surgery should receive prophylaxis starting before surgery and continuing for at least 7 to 10 days. Extending prophylaxis up to 4 weeks should be considered in those undergoing major abdominal or pelvic surgery with high-risk features. LMWH is recommended for the initial 5 to 10 days of treatment for deep vein thrombosis and pulmonary embolism as well as for long-term secondary prophylaxis (at least 6 months). Use of novel oral anticoagulants is not currently recommended for patients with malignancy and VTE because of limited data in patients with cancer. Anticoagulation should not be used to extend survival of patients with cancer in the absence of other indications. Patients with cancer should be periodically assessed for VTE risk. Oncology professionals should educate patients about the signs and symptoms of VTE. (C) 2015 by American Society of Clinical Oncology

引用

页码：654 / U174

页数：5

共 1 条

[1] Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update [J].

Lyman, Gary H. ;

Khorana, Alok A. ;

Kuderer, Nicole M. ;

Lee, Agnes Y. ;

Ignacio Arcelus, Juan ;

Balaban, Edward P. ;

Clarke, Jeffrey M. ;

Flowers, Christopher R. ;

Francis, Charles W. ;

Gates, Leigh E. ;

Kakkar, Ajay K. ;

Key, Nigel S. ;

Levine, Mark N. ;

Liebman, Howard A. ;

Tempero, Margaret A. ;

Wong, Sandra L. ;

Prestrud, Ann Alexis ;

Falanga, Anna .

JOURNAL OF CLINICAL ONCOLOGY, 2013, 31 (17) :2189-+

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