Title: Clinical study of anticoagulant combination with chemotherapy in the treatment of advanced non-small cell lung cancer
Abstract: Objective To observe whether abnormal coagulation existed or not and to explore the effects of anticoagulant therapy and the safety of LMWHdow molecular weight heparin) in advanced non-small-cell lung cancer (NSCLC). Methods This study applied a prospective randomized controlled clinical trail. Fifty nine chemotherapeutic cases with stageⅢ-Ⅳ NSCLC were randomized into anticoagulanr group——chemotherapy combined with LMWH and control group——chemotherapy alone. LMWH of 5000 IU was subcutaneously administered twice daily ×7 days (from the third day before chemotherapy up to 10 days). The response rate,survival time, bleeding and thrombosis, toxic side effect, blood coagulation test were observed in two groups. Results Thirty nine point one percent cases had elevated blood platelat counting (BPC). The highest BPC was 715 × 109. Fourteen point one percent cases had abnormal APTT(active part of thrombin time). The highest APTT was 76. 4 seconds. Forty three point one percent patients had increased TT(thrombin time) while 2. 8% patients had decreased TT. The highest TT was 45. 2 seconds and the lowest was 15. 3 seconds. Elevated Fbg (fibrinogen) accounted for 48. 5% of all the cases and the highest Fbg was 7. 08 g/L. Abnormal AT-Ⅲ(antithrombin-Ⅲ ) occurred in 63. 2% cases. The elevated rate on DD (D dimer) was 25. 4%. The highest DD was 4 391μg/L. After anticoagulant therapy, AT-Ⅲ was significantly increased from 119. 86% ± 19. 84% to 128. 08%±18. 88%(P0. 05). Meanwhile AT-Ⅲ of the control group had no difference. APTT of the both groups was significantly shorter after chemotherapy in comparison with that before chemotherapy(P0. 05). One case with deep venous thrombosis (DVT) was detected in control group, but there was no case in anticoagulant group. The major bleeding event that was related to LMWH was not observed. Overall response rate was 33. 3% in anticoagulant group and 25. 0% in control group, but there was no statistically significant difference (P0. 05). It was found that both groups had no significant difference in myelosuppression, vomit and liver and renal impairment. Conclusion There are abnormal blood coagulation in NSCLC. Anticoagulant prolong AT-Ⅲ and improve hypercoagulant state. The LMWH is safe. But anticoagulant therapy is needed to further investigation in chemotherapy response and survival time.
Publication Year: 2005
Publication Date: 2005-01-01
Language: en
Type: article
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Cited By Count: 1
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