Retrospective analysis of the bleeding risk induced by oral antiplatelet drugs during radiotherapy

摘要

We conducted this retrospective analysis to assess whether oral antiplatelet drugs (APDs) during radiotherapy increase bleeding risk. Patients who underwent radiotherapy for esophageal cancer (EC) in the Third Affiliated Hospital of Soochow University from January 2015 to December 2019 were screened. After the differences in clinical parameters were eliminated by a propensity-score matched (PSM) analysis at a 1:1 ratio, the thrombocytopenia, consumption of platelet-increasing drugs, suspension of radiotherapy, and bleeding in patients taking APDs were compared with those in the control group. A total of 986 patients were included in the original dataset. Of these, 34 patients took APDs during radiotherapy. After matching, the APD and control groups each retained 31 patients. There was no significant difference in platelet concentrations between the two groups before radiotherapy (P=.524). The lowest platelet concentration during radiotherapy in the APD group was significantly lower (P=.033). The consumption of platelet-increasing drugs in the APD group was higher than that in the control group (P.05). However, there was no significant difference in the average number of days of radiotherapy suspension because of thrombocytopenia (P=.933) and no significant difference in the incidence of bleeding between the two groups (P=.605). Oral APDs during radiotherapy lead to a further decrease in platelet concentration, but timely and adequate application of plateletincreasing drugs can avoid the increased risk of bleeding and the reduced efficacy of radiotherapy. Abbreviations: ADP = adenosine diphosphate, APD = antiplatelet drug, APDs = oral antiplatelet drugs, APTT = activated partial thromboplastin time, CFRT = conventional fractionated radiotherapy, EC = esophageal cancer, PSM = propensity-score matched, PT = prothrombin time, rhlL-11 = recombinant human interleukin-11, TPIAO = recombinant human thrombopoietin injection, TPO = thrombopoietin, VMAT = volumetric modulated arc therapy.