Anticoagulants in patients with central nervous system tumors
Keywords:
BRAIN NEOPLASMS, ANTICOAGULANTS, THROMBOSIS
Abstract
Background: thromboembolic complications are seen in 15% of patients with cancer. Patients with primary or secundary tumors of the central nervous system add to usual risk factors for oncologic patients, specific factors for thromboembolic complications.
Since associated-risk to anticoagulant administration in patients with central nervous system injuries is usually overvalued, it is not usually recommended as prophylactic criteria. On the other way, once tromboembolic complications are proved, a therapeutic dosage must be indicated.
Objective: to assess risk/benefit of anticoagulant administration to patients with central nervous system tumors according to prophylactic and therapeutic criteria.
Methods: a ten-years old specific bibliography was reviewed.
Conclusions: low dosage of anticoagulant administration with warfarine based on risk-benefit assessment and paramedical follow up is indicated in ambulatory patients with encephalic tumors.
Thromboembolic prophylaxis benefit in surgery with low molecular weight heparine overtake haemorragic risk better than neurosurgery.
Patients with thromboembolic complications benefited from anticoagulant administration as far as dosage follow up ranged therapeutic average.
References
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2) Levine M, Rickles F, Kakkar A. Thrombosis in cancer patients. In: Educational Book. Alexandria: ASCO, 2002: 57-60.
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6) Bern M, Lokich J, Wallach S, Bothe A Jr, Benotti P, Arkin C, et al. Very low doses of warfarin can prevent thrombosis in central venous catheters: a randomised prospective trial. Ann Intern Med 1990; 112: 423-8.
7) Abdulwadud O, Centre for Clinical Effectiveness. Anticoagulation therapy as prophylaxis for prevention of DVT or pulmonary embolism in neurosurgery. Melbourne: Southern Health/Monash Institute of Public Health, 2002. [consulta: 20 ago 2003].
8) Iorio A, Agneli G. Low-molecular-weight and unfractionated heparin for prevention of venous thromboembolism in neurosurgery: a meta-analysis. Arch Intern Med 2000; 160(15): 2327-32.
9) Raabe A, Gerlach R, Zimmermann M, Seifert V. The risk of haemorrhage associated with early postoperative heparin administration after intracranial surgery. Acta Neurochir 2001; 243(1): 1-7.
10) Chan A, Atiemo A, Diran L, Licholai G, McLaren Black P, Creager M. Venous thromboembolism occurs frequently in patients undergoing brain surgery despite prophylaxis. J Thromb Thrombolysis 1999; 8(2): 139-42.
11) Constantini S, Kanner A, Friednan A, Shoshan Y, Israel Z, Ashkenazi Even A, et al. Safety of perioperative minidose heparin in patients undergoing brain tumor surgery. A prospective, randomised, double-blind study. J Neurosurgery 2001; 94(6): 918-21.
12) Goldhaber S, Dunn K, Gerhard-Herman M, Park J, Black P. Low rate of venous thromboembolism after craniotomy for brain tumor with multimodality prophylaxis. Chest 2002; 122(6): 1933-7.
13) Bona R, Hickey A, Wallace D. Efficacy and safety of oral anticoagulation in patients with cancer. Thromb Haemost 1997; 78: 137-40.
14) Sack G, Levin J, Bell W. Trousseau’s syndrome and other manifestations of chronic disseminated coagulaopathy in patients with neoplasms: clinical, pathologic, and therapeutica features. Medicine 1977; 56: 1-37.
15) Lee A, Levine M, Baker R, Bowden C, Kakkar A, Prins M, et al. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med 2003; 349(2): 146-53.
16) Gould M, Dembitzer A, Sanders G, Garber A. Low-molecular-weight heparins compared with unfractionated heparin for treatment of acute deep venous thrombosis. Ann Intern Med 1999; 130: 789-99.
17) Rodgers G, Spiro T. Treatment of cancer-associated deep vein trombosis with enoxaparin: comparison with unfractionated heparin therapy. Proc Am Soc Clin Oncol 1999; 18: 193a.
18) Green D, Hull R, Brant R, Pineo G. Lower mortality in cancer patients treated with low-molecular weight versus standard heparin. Lancet 1992; 339: 1476.
19) Prandoni P, Lensing A, Cogo A, Cuppini S, Villalta S, Carta M, et al. The long term clinical course of acute deep venous thrombosis. Ann Intern Med 1996; 125: 1-7.
20) Zacharski L, Henderson W, Rickles F, Forman W, Cornell C Jr, Forcier R, et al. Effect of warfarin anticoagulation on survival in small cell carcinoma of the lung. JAMA 1981; 245: 831-5.
21) Zacharski L, Henderson W, Rickles F, Forman W, Cornel C Jr, Forcier R, et al. Effect of warfarin anticoagulation on survival in carcioma of the lung, colon, head and neck, and prostate. Cancer 1984; 53: 2046-52.
22) Maurer L, Herndon J, Hollis D, Aisner J, Carey R, Skarin A, et al. Randomized trial of chemotherapy and radiation therapy with or without warfarin for limited-stage small-cell lung cancer: a CALGB study. J Clin Oncol 1997; 15: 3378-87.
23) Calligaro K, Bergen W, Haut M, Savarese R, De Laurentis D. Thromboembolic complications in patients with advanced cancer: anticoagulation versus Greenfield filter placement. Ann Vasc Surg 1991; 5: 186-9.
24) Schiff D, DeAngelis L. Therapy of venous thromboembolism in patients with brain metastases. Cancer 1994; 73: 493-8.
25) Burrows E, Centre for Clinical Effectiveness. In patients with cerebral metastases is anticoagulation therapy for thromboembolic disease associated with an increased risk of cerebral haemorrhage?, Melbourne: Southern Health/Monash Institute of Public Health, 2001. [consulta: 20 ago 2003].
26) Levin J, Schiff D, Loeffler J, Fine H, Black P, Wen P. Complications of therapy for venous thromboembolic disease in patients with brain tumors. Neurology 1993; 43: 1111-4.
27) Olin J, Young J, Graor R, Ruschhaupt W, Beven E, Bay J. Treatment of deep vein thrombosis and pulmonary emboli in patients with primary and metastatic brain tumors: Anticoagulants of inferior vena cava filter?. Arch Intern Med 1987; 147: 2177-9.
28) Schwarz R, Marrero A, Conlon K, Burt M. Inferior vena cava filters in cancer patients: indications and outcome. J Clin Oncol 1996; 14: 652-7.
29) Jarret B, Dougherty M, Calligaro K. Inferior vena cava filtres in malignant disease. J Vasc Surg 2002; 36(4): 704-7.
30) Tiscornia, E. Filtros en vena cava. In: Enfermedad trombo-embólica venosa. Montevideo: Oficina del Libro, 2000: 95-7.
31) Morales A, Adelstein D. Should a patient with a brain tumor receive anticoagulation for a thromboembolic event? Cleve Clin J Med 2001; 68(1): 13-6.
2) Levine M, Rickles F, Kakkar A. Thrombosis in cancer patients. In: Educational Book. Alexandria: ASCO, 2002: 57-60.
3) Magga D. Factores de riesgo adquiridos de enfermedad tromboembólica venosa. In: Enfermedad traomboembólica venosa. Montevideo: Oficina del Libro, 2000: 11-23.
4) Letai A, Kuter D. Cancer, coagulation and anticoagulation. Oncologist 1999; 4: 443-9.
5) Levine M, Hirsh J, Gent M, Arnold A, Warr K, Falanga A, et al. Double blind randomised trial of very-low-dose warfarin for the prevention of thromboembolism in stage IV breast cancer. Lancet 1994; 343: 886-9.
6) Bern M, Lokich J, Wallach S, Bothe A Jr, Benotti P, Arkin C, et al. Very low doses of warfarin can prevent thrombosis in central venous catheters: a randomised prospective trial. Ann Intern Med 1990; 112: 423-8.
7) Abdulwadud O, Centre for Clinical Effectiveness. Anticoagulation therapy as prophylaxis for prevention of DVT or pulmonary embolism in neurosurgery. Melbourne: Southern Health/Monash Institute of Public Health, 2002.
8) Iorio A, Agneli G. Low-molecular-weight and unfractionated heparin for prevention of venous thromboembolism in neurosurgery: a meta-analysis. Arch Intern Med 2000; 160(15): 2327-32.
9) Raabe A, Gerlach R, Zimmermann M, Seifert V. The risk of haemorrhage associated with early postoperative heparin administration after intracranial surgery. Acta Neurochir 2001; 243(1): 1-7.
10) Chan A, Atiemo A, Diran L, Licholai G, McLaren Black P, Creager M. Venous thromboembolism occurs frequently in patients undergoing brain surgery despite prophylaxis. J Thromb Thrombolysis 1999; 8(2): 139-42.
11) Constantini S, Kanner A, Friednan A, Shoshan Y, Israel Z, Ashkenazi Even A, et al. Safety of perioperative minidose heparin in patients undergoing brain tumor surgery. A prospective, randomised, double-blind study. J Neurosurgery 2001; 94(6): 918-21.
12) Goldhaber S, Dunn K, Gerhard-Herman M, Park J, Black P. Low rate of venous thromboembolism after craniotomy for brain tumor with multimodality prophylaxis. Chest 2002; 122(6): 1933-7.
13) Bona R, Hickey A, Wallace D. Efficacy and safety of oral anticoagulation in patients with cancer. Thromb Haemost 1997; 78: 137-40.
14) Sack G, Levin J, Bell W. Trousseau’s syndrome and other manifestations of chronic disseminated coagulaopathy in patients with neoplasms: clinical, pathologic, and therapeutica features. Medicine 1977; 56: 1-37.
15) Lee A, Levine M, Baker R, Bowden C, Kakkar A, Prins M, et al. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med 2003; 349(2): 146-53.
16) Gould M, Dembitzer A, Sanders G, Garber A. Low-molecular-weight heparins compared with unfractionated heparin for treatment of acute deep venous thrombosis. Ann Intern Med 1999; 130: 789-99.
17) Rodgers G, Spiro T. Treatment of cancer-associated deep vein trombosis with enoxaparin: comparison with unfractionated heparin therapy. Proc Am Soc Clin Oncol 1999; 18: 193a.
18) Green D, Hull R, Brant R, Pineo G. Lower mortality in cancer patients treated with low-molecular weight versus standard heparin. Lancet 1992; 339: 1476.
19) Prandoni P, Lensing A, Cogo A, Cuppini S, Villalta S, Carta M, et al. The long term clinical course of acute deep venous thrombosis. Ann Intern Med 1996; 125: 1-7.
20) Zacharski L, Henderson W, Rickles F, Forman W, Cornell C Jr, Forcier R, et al. Effect of warfarin anticoagulation on survival in small cell carcinoma of the lung. JAMA 1981; 245: 831-5.
21) Zacharski L, Henderson W, Rickles F, Forman W, Cornel C Jr, Forcier R, et al. Effect of warfarin anticoagulation on survival in carcioma of the lung, colon, head and neck, and prostate. Cancer 1984; 53: 2046-52.
22) Maurer L, Herndon J, Hollis D, Aisner J, Carey R, Skarin A, et al. Randomized trial of chemotherapy and radiation therapy with or without warfarin for limited-stage small-cell lung cancer: a CALGB study. J Clin Oncol 1997; 15: 3378-87.
23) Calligaro K, Bergen W, Haut M, Savarese R, De Laurentis D. Thromboembolic complications in patients with advanced cancer: anticoagulation versus Greenfield filter placement. Ann Vasc Surg 1991; 5: 186-9.
24) Schiff D, DeAngelis L. Therapy of venous thromboembolism in patients with brain metastases. Cancer 1994; 73: 493-8.
25) Burrows E, Centre for Clinical Effectiveness. In patients with cerebral metastases is anticoagulation therapy for thromboembolic disease associated with an increased risk of cerebral haemorrhage?, Melbourne: Southern Health/Monash Institute of Public Health, 2001.
26) Levin J, Schiff D, Loeffler J, Fine H, Black P, Wen P. Complications of therapy for venous thromboembolic disease in patients with brain tumors. Neurology 1993; 43: 1111-4.
27) Olin J, Young J, Graor R, Ruschhaupt W, Beven E, Bay J. Treatment of deep vein thrombosis and pulmonary emboli in patients with primary and metastatic brain tumors: Anticoagulants of inferior vena cava filter?. Arch Intern Med 1987; 147: 2177-9.
28) Schwarz R, Marrero A, Conlon K, Burt M. Inferior vena cava filters in cancer patients: indications and outcome. J Clin Oncol 1996; 14: 652-7.
29) Jarret B, Dougherty M, Calligaro K. Inferior vena cava filtres in malignant disease. J Vasc Surg 2002; 36(4): 704-7.
30) Tiscornia, E. Filtros en vena cava. In: Enfermedad trombo-embólica venosa. Montevideo: Oficina del Libro, 2000: 95-7.
31) Morales A, Adelstein D. Should a patient with a brain tumor receive anticoagulation for a thromboembolic event? Cleve Clin J Med 2001; 68(1): 13-6.
Published
2005-03-31
How to Cite
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Roldán G, Sosa A, Rodríguez R. Anticoagulants in patients with central nervous system tumors. Rev. Méd. Urug. [Internet]. 2005Mar.31 [cited 2024Nov.15];21(1):23-9. Available from: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/824
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