PULMONARY EMBOLISM: SOME ISSUES OF EPIDEMIOLOGY AND TREATMENT IN CANCER PATIENTS

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Abstract

The risk of pulmonary embolism (PE) in cancer patients  is 4–7-fold, compared to other  patient  categories. PE is the  second  most frequent  cause of death  in the first year after cancer diagnosis. PE is diagnosed in 7.5% of patients with malignant brain tumors, in 1 to 25% of those  with gastrointestinal tumors, in 4.5 to 17.5% of those with breast cancer and in 4 to 10% of lung cancer patients. The risk of PE is higher with surgical interventions and chemotherapy, as well as in metastatic tumors. In 13% of cases, PE may be the first symptom of cancer manifestation. For prevention and treatment of PE low molecular weight heparin (LMWH) and warfarin are   used. The risk of recurrent  PE is 2-fold lower with LMWH. The frequency of bleeding with LMWH and warfarin treatment is from 14 to 19%. Placement of a cava filter is indicated  only if anticoagulation is inefficient.  New oral anticoagulants,  which act as selective thrombin  or Factor Xa inhibitors, are not used in cancer patients. Thus, diagnostics and treatment of PE is a very urgent  problem in oncology that requires new approaches to be looked for.

About the authors

I. D. Rozanov

Moscow Regional Research and Clinical Institute

Author for correspondence.
Email: andreybalkanov@yandex.ru
Rozanov Ivan Dmitrievich – Doctor, Department of Radiology Russian Federation

A. E. Semashkova

Moscow Regional Research and Clinical Institute

Email: andreybalkanov@yandex.ru
Semashkova Anna Evgen'evna – Junior Research Fellow, Internal Disease Department No. 1 Russian Federation

A. S. Balkanov

Moscow Regional Research and Clinical Institute

Email: andreybalkanov@yandex.ru
Balkanov Andrey Sergeevich – MD, PhD, Head of Department of Radiology Russian Federation

S. A. Terpigorev

Moscow Regional Research and Clinical Institute

Email: andreybalkanov@yandex.ru
Terpigorev Stanislav Anatol'evich – MD, PhD, Head of Department of Occupational Diseases and Medi cal and Labour Expertise Russian Federation

E. A. Stepanova

Moscow Regional Research and Clinical Institute

Email: andreybalkanov@yandex.ru
Stepanova Elena Aleksandrovna – PhD, Roentgenologist, Department of X-ray Computed Tomography and Magnetic Resonance Imaging; Assistant Lecturer, Chair of Diagnostic Radiology, Postgraduate Training Faculty Russian Federation

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Copyright (c) 2015 Rozanov I.D., Semashkova A.E., Balkanov A.S., Terpigorev S.A., Stepanova E.A.

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