Thromboembolic events with estramustine phosphate-based chemotherapy in patients with hormone-refractory prostate carcinoma results of a meta-analysis
Combinations of cytotoxic chemotherapy with estramustine phosphate (EMP), a nornitrogen mustard-estrogen conjugate, are used to treat patients with hormone-refractory prostate carcinoma (HRPC). However, thromboembolic events (TE), including deep venous thrombosis (DVT), pulmonary embolism, stroke, m...
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| Veröffentlicht in: | Cancer 2004-12, Vol.101 (12), p.2755-2759 |
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| creator | LUBINIECKI, Gregory M BERLIN, Jesse A WEINSTEIN, Rachel B VAUGHN, David J |
| description | Combinations of cytotoxic chemotherapy with estramustine phosphate (EMP), a nornitrogen mustard-estrogen conjugate, are used to treat patients with hormone-refractory prostate carcinoma (HRPC). However, thromboembolic events (TE), including deep venous thrombosis (DVT), pulmonary embolism, stroke, myocardial infarction, and arterial thrombosis, are significant toxicities of these regimens. The current study sought to establish the rate of TE and to determine risk factors for TE.
A MEDLINE-based search identified EMP-based clinical trials published in the English-language peer-reviewed literature after 1990 in which > or = 20 patients with HRPC were enrolled and TE were clearly documented. Patient characteristics and the dose of EMP given were analyzed to determine their association with the rate of TE.
Twenty-three studies, enrolling a total of 896 patients, were included in the analysis. The overall risk of TE was 0.07 (95% confidence interval [95% CI], 0.05-0.11). The risk of DVT was 0.06 (95% CI, 0.04-0.09). The risks of all other types of TE were |
| doi_str_mv | 10.1002/cncr.20673 |
| format | Article |
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A MEDLINE-based search identified EMP-based clinical trials published in the English-language peer-reviewed literature after 1990 in which > or = 20 patients with HRPC were enrolled and TE were clearly documented. Patient characteristics and the dose of EMP given were analyzed to determine their association with the rate of TE.
Twenty-three studies, enrolling a total of 896 patients, were included in the analysis. The overall risk of TE was 0.07 (95% confidence interval [95% CI], 0.05-0.11). The risk of DVT was 0.06 (95% CI, 0.04-0.09). The risks of all other types of TE were <0.01. Using univariate logistic regression analysis, the dose of EMP administered, baseline patient age, and baseline prostate-specific antigen level were not found to be associated with the total risk of TE. The rates of total TE and DVT may be inflated because one of the analyzed studies initially had a very high rate of DVT (25%) when compared with the others.
The rate of TE in men with HRPC who are treated with EMP-based regimens is significant, but it does not appear to be related to the dose of EMP. Whether TE can be prevented with anticoagulant prophylaxis remains to be determined.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.20673</identifier><identifier>PMID: 15536625</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>New York, NY: Wiley-Liss</publisher><subject>Antineoplastic Agents, Hormonal - therapeutic use ; Biological and medical sciences ; Blood and lymphatic vessels ; Carcinoma - complications ; Carcinoma - drug therapy ; Cardiology. Vascular system ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Drug Resistance, Neoplasm ; Estramustine - administration & dosage ; Estramustine - adverse effects ; Humans ; Male ; Medical sciences ; Prostatic Neoplasms - complications ; Prostatic Neoplasms - drug therapy ; Risk Factors ; Thromboembolism - chemically induced ; Tumors ; Venous Thrombosis - chemically induced</subject><ispartof>Cancer, 2004-12, Vol.101 (12), p.2755-2759</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c204t-4bc5a25b62ac15e7e1daf35310c8a2ab1dcd8577ee29ebb405634f99073ef48b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>309,310,314,780,784,789,790,23928,23929,25138,27922,27923</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16318597$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15536625$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LUBINIECKI, Gregory M</creatorcontrib><creatorcontrib>BERLIN, Jesse A</creatorcontrib><creatorcontrib>WEINSTEIN, Rachel B</creatorcontrib><creatorcontrib>VAUGHN, David J</creatorcontrib><title>Thromboembolic events with estramustine phosphate-based chemotherapy in patients with hormone-refractory prostate carcinoma results of a meta-analysis</title><title>Cancer</title><addtitle>Cancer</addtitle><description>Combinations of cytotoxic chemotherapy with estramustine phosphate (EMP), a nornitrogen mustard-estrogen conjugate, are used to treat patients with hormone-refractory prostate carcinoma (HRPC). However, thromboembolic events (TE), including deep venous thrombosis (DVT), pulmonary embolism, stroke, myocardial infarction, and arterial thrombosis, are significant toxicities of these regimens. The current study sought to establish the rate of TE and to determine risk factors for TE.
A MEDLINE-based search identified EMP-based clinical trials published in the English-language peer-reviewed literature after 1990 in which > or = 20 patients with HRPC were enrolled and TE were clearly documented. Patient characteristics and the dose of EMP given were analyzed to determine their association with the rate of TE.
Twenty-three studies, enrolling a total of 896 patients, were included in the analysis. The overall risk of TE was 0.07 (95% confidence interval [95% CI], 0.05-0.11). The risk of DVT was 0.06 (95% CI, 0.04-0.09). The risks of all other types of TE were <0.01. Using univariate logistic regression analysis, the dose of EMP administered, baseline patient age, and baseline prostate-specific antigen level were not found to be associated with the total risk of TE. The rates of total TE and DVT may be inflated because one of the analyzed studies initially had a very high rate of DVT (25%) when compared with the others.
The rate of TE in men with HRPC who are treated with EMP-based regimens is significant, but it does not appear to be related to the dose of EMP. Whether TE can be prevented with anticoagulant prophylaxis remains to be determined.</description><subject>Antineoplastic Agents, Hormonal - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Carcinoma - complications</subject><subject>Carcinoma - drug therapy</subject><subject>Cardiology. Vascular system</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Drug Resistance, Neoplasm</subject><subject>Estramustine - administration & dosage</subject><subject>Estramustine - adverse effects</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Prostatic Neoplasms - complications</subject><subject>Prostatic Neoplasms - drug therapy</subject><subject>Risk Factors</subject><subject>Thromboembolism - chemically induced</subject><subject>Tumors</subject><subject>Venous Thrombosis - chemically induced</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkEtLxDAQx4Mo7vq4-AEkFy9C1zyaPo4ivkDwouCtTNIpjbRNSbLKfhE_r9Fd2MMwDPz-w8yPkAvOVpwxcWMm41eCFaU8IEvO6jJjPBeHZMkYqzKVy48FOQnhM42lUPKYLLhSsiiEWpKft967UTtMNVhD8QunGOi3jT3FED2M6xDthHTuXZh7iJhpCNhS0-PoYo8e5g21E50h2n20d350E2YeOw8mOr-hs3chpjw14I2d3AjUY1gPKeI6CnTECBlMMGyCDWfkqIMh4Pmun5L3h_u3u6fs5fXx-e72JTOC5THLtVEglC4EGK6wRN5CJ5XkzFQgQPPWtJUqS0RRo9Y5U4XMu7pmpcQur7Q8JdfbvSZdF9K1zeztCH7TcNb8yW3-5Db_chN8uYXntR6x3aM7mwm42gEQDAzp9cnYsOcKyStVl_IX21SIHw</recordid><startdate>20041215</startdate><enddate>20041215</enddate><creator>LUBINIECKI, Gregory M</creator><creator>BERLIN, Jesse A</creator><creator>WEINSTEIN, Rachel B</creator><creator>VAUGHN, David J</creator><general>Wiley-Liss</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20041215</creationdate><title>Thromboembolic events with estramustine phosphate-based chemotherapy in patients with hormone-refractory prostate carcinoma results of a meta-analysis</title><author>LUBINIECKI, Gregory M ; BERLIN, Jesse A ; WEINSTEIN, Rachel B ; VAUGHN, David J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c204t-4bc5a25b62ac15e7e1daf35310c8a2ab1dcd8577ee29ebb405634f99073ef48b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Antineoplastic Agents, Hormonal - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Carcinoma - complications</topic><topic>Carcinoma - drug therapy</topic><topic>Cardiology. Vascular system</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Drug Resistance, Neoplasm</topic><topic>Estramustine - administration & dosage</topic><topic>Estramustine - adverse effects</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Prostatic Neoplasms - complications</topic><topic>Prostatic Neoplasms - drug therapy</topic><topic>Risk Factors</topic><topic>Thromboembolism - chemically induced</topic><topic>Tumors</topic><topic>Venous Thrombosis - chemically induced</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LUBINIECKI, Gregory M</creatorcontrib><creatorcontrib>BERLIN, Jesse A</creatorcontrib><creatorcontrib>WEINSTEIN, Rachel B</creatorcontrib><creatorcontrib>VAUGHN, David J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>LUBINIECKI, Gregory M</au><au>BERLIN, Jesse A</au><au>WEINSTEIN, Rachel B</au><au>VAUGHN, David J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thromboembolic events with estramustine phosphate-based chemotherapy in patients with hormone-refractory prostate carcinoma results of a meta-analysis</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2004-12-15</date><risdate>2004</risdate><volume>101</volume><issue>12</issue><spage>2755</spage><epage>2759</epage><pages>2755-2759</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>Combinations of cytotoxic chemotherapy with estramustine phosphate (EMP), a nornitrogen mustard-estrogen conjugate, are used to treat patients with hormone-refractory prostate carcinoma (HRPC). However, thromboembolic events (TE), including deep venous thrombosis (DVT), pulmonary embolism, stroke, myocardial infarction, and arterial thrombosis, are significant toxicities of these regimens. The current study sought to establish the rate of TE and to determine risk factors for TE.
A MEDLINE-based search identified EMP-based clinical trials published in the English-language peer-reviewed literature after 1990 in which > or = 20 patients with HRPC were enrolled and TE were clearly documented. Patient characteristics and the dose of EMP given were analyzed to determine their association with the rate of TE.
Twenty-three studies, enrolling a total of 896 patients, were included in the analysis. The overall risk of TE was 0.07 (95% confidence interval [95% CI], 0.05-0.11). The risk of DVT was 0.06 (95% CI, 0.04-0.09). The risks of all other types of TE were <0.01. Using univariate logistic regression analysis, the dose of EMP administered, baseline patient age, and baseline prostate-specific antigen level were not found to be associated with the total risk of TE. The rates of total TE and DVT may be inflated because one of the analyzed studies initially had a very high rate of DVT (25%) when compared with the others.
The rate of TE in men with HRPC who are treated with EMP-based regimens is significant, but it does not appear to be related to the dose of EMP. Whether TE can be prevented with anticoagulant prophylaxis remains to be determined.</abstract><cop>New York, NY</cop><pub>Wiley-Liss</pub><pmid>15536625</pmid><doi>10.1002/cncr.20673</doi><tpages>5</tpages></addata></record> |
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| subjects | Antineoplastic Agents, Hormonal - therapeutic use Biological and medical sciences Blood and lymphatic vessels Carcinoma - complications Carcinoma - drug therapy Cardiology. Vascular system Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Drug Resistance, Neoplasm Estramustine - administration & dosage Estramustine - adverse effects Humans Male Medical sciences Prostatic Neoplasms - complications Prostatic Neoplasms - drug therapy Risk Factors Thromboembolism - chemically induced Tumors Venous Thrombosis - chemically induced |
| title | Thromboembolic events with estramustine phosphate-based chemotherapy in patients with hormone-refractory prostate carcinoma results of a meta-analysis |
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