title: Risk of venous thromboembolism in patients with cancer treated with Cisplatin: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Several reports suggest that cisplatin is associated with an increased risk of thromboembolism. However, because the excess risk of venous thromboembolic events (VTEs) with cisplatin-based chemotherapy has not been well described, we conducted a systemic review and meta-analysis of randomized controlled trials evaluating the incidence and risk of VTEs associated with cisplatin-based chemotherapy.
  
  
  METHODS
  PubMed was searched for articles published from January 1, 1990, to December 31, 2010. Eligible studies included prospective randomized phase II and III trials evaluating cisplatin-based versus non-cisplatin-based chemotherapy in patients with solid tumors. Data on all-grade VTEs were extracted. Study quality was calculated using Jadad scores. Incidence rates, relative risks (RRs), and 95% CIs were calculated using a random effects model.
  
  
  RESULTS
  A total of 8,216 patients with various advanced solid tumors from 38 randomized controlled trials were included. The incidence of VTEs was 1.92% (95% CI, 1.07 to 2.76) in patients treated with cisplatin-based chemotherapy and 0.79% (95% CI, 0.45 to 1.13) in patients treated with non-cisplatin-based regimens. Patients receiving cisplatin-based chemotherapy had a significantly increased risk of VTEs (RR, 1.67; 95% CI, 1.25 to 2.23; P = .01). Exploratory subgroup analysis revealed the highest RR of VTEs in patients receiving a weekly equivalent cisplatin dose > 30 mg/m(2) (2.71; 95% CI, 1.17 to 6.30; P = .02) and in trials reported during 2000 to 2010 (1.72; 95% CI, 1.27 to 2.34; P = .01).
  
  
  CONCLUSIONS
  Cisplatin is associated with a significant increase in the risk of VTEs in patients with advanced solid tumors when compared with non-cisplatin-based chemotherapy.
authors.affiliation: Southcoast Centers for Cancer Care, Fairhaven, MA, USA.
authors.forename: Sonia
authors.initials: S
authors.lastname: Seng
authors.forename: Ziyue
authors.initials: Z
authors.lastname: Liu
authors.forename: Sophia K
authors.initials: SK
authors.lastname: Chiu
authors.forename: Tracy
authors.initials: T
authors.lastname: Proverbs-Singh
authors.forename: Guru
authors.initials: G
authors.lastname: Sonpavde
authors.forename: Toni K
authors.initials: TK
authors.lastname: Choueiri
authors.forename: Che-Kai
authors.initials: CK
authors.lastname: Tsao
authors.forename: Menggang
authors.initials: M
authors.lastname: Yu
authors.forename: Noah M
authors.initials: NM
authors.lastname: Hahn
authors.forename: William K
authors.initials: WK
authors.lastname: Oh
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Galsky
mesh_terms: D000368:Aged; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000139:chemically induced*
chemical_list: D002945:Cisplatin