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Prophylactic anti-coagulation in cancer palliative care: a prospective randomised study

Merminod, Thierry
Published in Supportive care in cancer. 2008, vol. 16, no. 7, p. 847-52
Collection Open Access - Licence nationale Springer
Abstract GOALS: The objective of this study was to determine utility of prophylactic anti-coagulation in cancer patients hospitalised for palliative care in a specialised centre. MATERIALS AND METHODS: Prospective 1:1 open randomised study was designed. Twenty patients aged 55 to 88 years with advanced cancer and an estimated life expectancy of less than 6 months were assigned to either receive treatment with 2,850/3,800 U (<70/>70 kg) of daily subcutaneous nadroparin or no treatment. Suspicion of venous thrombo-embolism (deep vein thrombosis and pulmonary embolism) was confirmed by echo-Doppler examination of the lower limbs and/or by spiral computed tomography scan of the lungs. Bleeding episodes were recorded. Platelet count was measured on days 7 and 14. Survival time from study entry was determined. MAIN RESULTS: One venous thrombo-embolism and one major bleeding occurred in the group receiving nadroparin, whereas two minor bleedings occurred in the control group. At 3 months, nine of ten participants had died in the control group vs five of ten in the group receiving nadroparin (P = 0.141). Five participants could be discharged home (P = 0.141). CONCLUSIONS: Decision to administer prophylactic nadroparin in hospitalised cancer patients under palliative care remains a challenge. Better mobility score at admission and the likelihood to be discharged home may be useful for practical purposes. The observation of a potential influence of prophylactic nadroparin on survival deserves further studies.
Keywords AgedAged 80 and overAnticoagulants/therapeutic useFemaleHumansMaleMiddle AgedNadroparin/therapeutic useNeoplasms/complications/mortality/pathology/physiopathologyPalliative Care/methodsProspective StudiesSurvivalVenous Thromboembolism/prevention & control/ultrasonography
PMID: 17940809
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Research group Médecine palliative (709)
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WEBER, Catherine et al. Prophylactic anti-coagulation in cancer palliative care: a prospective randomised study. In: Supportive care in cancer, 2008, vol. 16, n° 7, p. 847-52. doi: 10.1007/s00520-007-0339-3 https://archive-ouverte.unige.ch/unige:822

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Deposited on : 2009-02-17

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