Risk of Vascular Toxicity with Platinum Based Chemotherapy in Elderly Patients with Bladder Cancer

The Journal of Urology
Amit GuptaRichard M Steingart

Abstract

Platinum based chemotherapy is widely used for bladder cancer but is associated with vascular toxicity, especially thromboembolism. We evaluated the short-term (less than 1 year) and intermediate-term (2 to 5 years) vascular toxicity of platinum agents in older patients with bladder cancer. We identified Medicare beneficiaries 66 to 94 years old diagnosed with stage II-III bladder cancer from 1998 to 2007 in the SEER-Medicare database. We measured the association between platinum based chemotherapy and vascular events (thromboembolic and nonthromboembolic) using Cox proportional hazard regression models. The sample included 5,057 patients, of whom 21.3% received platinum based chemotherapy. Patients receiving platinum based chemotherapy were more likely to be younger and male with less comorbidity than those not receiving any chemotherapy. During the first year after diagnosis the patients who received platinum based chemotherapy had a higher risk of a thromboembolic event (19.8% vs 11.6%, AHR 1.43, 95% CI 1.17-1.75) compared to those who did not receive chemotherapy. The likelihood of having a thromboembolic outcome was similar whether platinum chemotherapy was cisplatin based (21.1%, AHR 1.56, 95% CI 1.22-2.00) or carboplatin...Continue Reading

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Citations

Apr 5, 2016·Drug Development and Industrial Pharmacy·Donglin HeQingfei Liu
Apr 21, 2017·Current Opinion in Urology·Jathin BandariBruce L Jacobs
Mar 14, 2019·Journal of the National Comprehensive Cancer Network : JNCCN·Nikolai A PodoltsevXiaomei Ma
Aug 25, 2019·BMJ Case Reports·Sarah DerbyDavid McIntosh
May 8, 2018·Bladder Cancer·Piotr ZarebaJehonathan H Pinthus
Apr 4, 2021·Abdominal Radiology·Alfonso ReginelliSalvatore Cappabianca

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