Despite the occurrence of various hemorrhagic events during advanced lung cancer treatment, few researchers have reported on their risk factors. Moreover, the development of cancer-related thromboembolism indicates anticoagulant use. However, adverse events such as bleeding should be monitored. In this study, we aimed to identify factors that influence the onset of hemorrhagic events in patients with lung cancer. The Rising-VTE/NEJ037 study was a multicenter, prospective, observational study. A total of 1008 patients with lung cancer who were unsuitable for radical resection or radiation were enrolled and followed up for 2 years. Multivariate analysis using a Cox proportional hazard model was performed to compare the outcomes of the time to the onset of hemorrhagic events for 2 years after registration. Hemorrhagic events occurred in 115 patients (11.4%), with 35 (30.4%) experiencing major bleeding. Significant risk factors included venous thromboembolism (VTE) (hazard ratio [HR]: 4.003,p< 0.001) and an Eastern Cooperative Oncology Group Performance Status score of 1 (HR: 2.476,p< 0.001). Factors that significantly reduced hemorrhagic event risk were female sex (HR: 0.454,p= 0.002) and M1a status (HR: 0.542,p= 0.038). VTE is a risk factor for hemorrhagic events in patients with advanced lung cancer, and risks associated with anticoagulant therapy should be considered.
尽管晚期肺癌治疗过程中常发生各类出血事件，但鲜有研究者报道其风险因素。此外，癌症相关血栓栓塞的发生提示需使用抗凝治疗，但应监测出血等不良事件。本研究旨在识别影响肺癌患者出血事件发生的因素。Rising-VTE/NEJ037研究是一项多中心、前瞻性、观察性研究，共纳入1008例不适合根治性切除或放疗的肺癌患者，并进行了为期2年的随访。采用Cox比例风险模型进行多变量分析，比较患者入组后2年内出血事件发生时间的结果。115例患者（11.4%）发生出血事件，其中35例（30.4%）为大出血。显著风险因素包括静脉血栓栓塞（风险比[HR]：4.003，p<0.001）和美国东部肿瘤协作组体能状态评分为1分（HR：2.476，p<0.001）。显著降低出血事件风险的因素为女性（HR：0.454，p=0.002）和M1a分期（HR：0.542，p=0.038）。静脉血栓栓塞是晚期肺癌患者出血事件的风险因素，应考虑抗凝治疗相关风险。
肿瘤(癌症)患者之家