Hypercoagulability and Thrombosis in Patients with Gynecological Cancer Under Radiotherapy

Cancer patients often develop thromboembolic episodes and show laboratory signs of hypercoagulability. A randomised, controlled, prospective trial was performed in 30 patients which were treated by combined external ir-radation and intravaginal radium application. The incidence of deep vein thrombosis (DVT) diagnosed by 125 I-fibrinogen leg scanning was 43 % in the control group (age 62,9 years; weight 62,6 kg). The application of 2 χ 7.500 U Calciparin s. c/24 h reduced the incidence of DVT to less than 10% (age 61,9 years; weight 64,7 kg). Patients who developed DVT showed a significant increase in circulating soluble fibrin monomer complexes from 4.1 ± 0,8 to 6,7 ± 1,4 % estimated by agarose gel filtration and an increase of fibrinogen from 379 ± 58 to 444 ± 97 mg%. Raised serum FDP levels were found only in two patients with clinically symptomatic leg vein thrombosis. No correlation of AT III levels and DVT was observed. The study shows the efficiency of 2 χ 7.500 U Calciparin s.c.24/ h for the prevention of thromboembolic complications in patients with gynecological cancer under radiotherapy. Results of a continuing study in which the effect of Calciparin, is compared with the one of a semi-synthetic heparan analogue, a 73025 (SSHA) will be presented.