肺癌治疗手段相关静脉血栓栓塞的风险评估研究进展

Research progress on the risk assessment of anticancer treatment-related venous thromboembolic events in hospitalized patients with lung cancer

目前肺癌多学科综合治疗手段主要包括手术、化放疗、靶向治疗、免疫治疗等。近年来,新型分子靶向治疗药物及免疫检查点抑制剂(ICIs)的应用更是大放异彩。然而,治疗手段相关风险不容忽视,其中静脉血栓栓塞(VTE)是重要风险之一。对于临床而言,需进一步提高对肺癌治疗手段相关VTE的警惕及认识,特别须警惕个体化分子靶向治疗及免疫治疗相关VTE的发生。本文就肺癌干预措施相关VTE的风险评估及其作用机制相关研究进展予以综述,以期为临床实践中肺癌治疗相关VTE的风险预警及精准治疗提供参考,权衡治疗益处与VTE形成风险的平衡点,进而实现治疗增益最大化。

Current treatments for lung cancer included surgery,traditional chemotherapy,radiotherapy,targeted therapy and immunotherapy.Therapeutic efficacy in lung cancer treatment has recently been improved by molecular targeted drugs and immune checkpoint inhibitors(ICIs).However,the risk of treatment-related factors should not be neglected and venous thromboembolism(VTE)has become a common and important complication of anticancer treatments.Therefore,there is a great need for clinicians to improve their understanding of treatment-associated VTE events.Specially,the society should increase its vigilance against individualized treatment-associated VTE,including molecular targeted therapy and ICIs.This review evaluates the advances in research regarding the risk and prevention of anticancer treatment-related VTE and the underlying mechanisms,which is crucial and provides practical reference for the early warning of treatment-related VTE and individualized precision treatment.The implementation of individualized precision therapy strategies are based upon balancing the treatment benefits against the risk of VTE,thus realizing maximised treatment gains.