Derin Ventrombozu/Pulmoner Emboli
Özet
Kanser ilişkili venöz tromboemboli (VTE), kanser hastalarında önemli bir mortalite ve morbidite nedenidir. Derin ven trombozu (DVT) ve pulmoner emboliyi (PE) kapsayan bu durum, kanserin kendisinden sonra ikinci en yaygın ölüm sebebidir. Kanserin biyolojik özellikleri, tümör medyatörlerinin prokoagülan etkisi ve antikanser tedavilerin endotel üzerindeki aktivasyonu nedeniyle, kanser hastalarında VTE riski genel popülasyona göre dokuz kat daha fazladır. Tanı sürecinde, Wells skoru ve Modifiye Geneva skoru gibi klinik değerlendirme araçları önemli bir yer tutar. Tedavide akut, uzun dönem ve genişletilmiş fazlar için düşük molekül ağırlıklı heparin (LMWH), doğrudan oral antikoagülanlar (DOAK) ve gerektiğinde vena kava filtreleri kullanılabilir. Tedavi seçiminde hastanın trombotik ve kanama riski, kanser türü ve hasta tercihleri dikkate alınmalıdır. Doğru tedavi ve kişiselleştirilmiş takip protokolleri, VTE rekürrensini önlemede ve yaşam kalitesini artırmada kritik öneme sahiptir.
Cancer-associated venous thromboembolism (VTE) is a significant cause of mortality and morbidity among cancer patients, comprising deep vein thrombosis (DVT) and pulmonary embolism (PE). It is the second leading cause of death in cancer patients after the malignancy itself. Due to the procoagulant effects of tumor mediators, endothelial activation by anticancer treatments, and the biological nature of cancer, VTE risk is nine times higher in cancer patients compared to the general population. Clinical assessment tools like the Wells score and Modified Geneva score play a vital role in diagnosis. Treatment strategies include low molecular weight heparin (LMWH), direct oral anticoagulants (DOACs), and vena cava filters during the acute, long-term, and extended phases of treatment. Individualized therapy, considering the patient’s thrombotic and bleeding risks, cancer type, and personal preferences, is essential. Effective treatment and personalized follow-up protocols are critical in preventing VTE recurrence and improving quality of life.
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