Article Text
Abstract
Introduction Gynaecological malignancies are treated using external beam radiotherapy and brachytherapy. There is an increased risk of venous thromboembolism (VTE) for patients receiving these treatments. This study assesses rates of VTE in women who underwent brachytherapy for cervical, vaginal and vulval cancers, in addition to associated risk factors and suitability of the Caprini score (CS) in this cohort.
Methods Data for women who underwent brachytherapy from January 2022 to January 2024 was collected, including age, body mass index (BMI), comorbidities, tumour properties (table 1). CS was used to indicate VTE risk at brachytherapy. Patients who developed deep vein thrombosis (DVT) or pulmonary embolism (PE) during their treatment were identified.
Results Out of 139 patients, 9 patients developed VTE (6.5%). Two developed DVT prior to brachytherapy during chemoradiotherapy, whilst 7 developed PE during brachytherapy. Three of the PE group patients required thrombolysis. Within the VTE group (table 1), 5 had adenocarcinoma (56%) versus 33 in the non-VTE group (34%, p=0.05). Eight patients in the VTE group received chemotherapy (89%) versus 81 in the non-VTE group (74%). The PE group scored CS 8 or above (Median age (68 vs. 60), BMI >25 (89% vs 52%) and chemotherapy use (86% vs. 74%) scoring), with significantly higher CS (median 9) than the non-PE group (median 7, p<0.007).
Conclusion/Implications CS performs well in this cohort, with a score of 8 as a potential threshold for consideration of anticipatory thromboprophylaxis. Age, BMI and chemotherapy were factors contributing to higher CS.