Rola weryfikacji histopatologicznej, trudności terapeutyczne i leczenie przeciwzakrzepowe w paliatywnej chemioterapii chorej z niedoborem antytrombiny oraz rakiem jelita grubego i rakiem macicy w wywiadzie

Abstract

Palliative chemotherapy in patients with thrombophilia is a challenge for clinical oncologists. On one hand the optimal treatment should be very safe for patient, on the other hand – as effective as possible. That therapy is also connected with proper thromboprophylaxis. The incidence of multiple cancers is a serious problem of modern oncology. In patients whose medical history includes two or more cancers, it is essential to obtain histopathological diagnosis before the administration of treatment of disseminated disease. It allows to avoid improper therapy which is often toxic. The article presents the case of a patient with antithrombin deficiency and two cancers in medical history: colon cancer and endometrial cancer. The treatment of the patient because of the metastatic cancer was started after the histopathological diagnosis. In metastatic lymph node the endometrial cancer was recognized. The carboplatin and paclitaxel were used in the therapy. The treatment was conducted in four course chemotherapy. It revealed considerable polyneuropathy and hematologic toxicity limiting from further therapy. Treatment allowed to obtain biochemical response, decrease of metastases and the condition of a patient improved. During the systemic therapy thromboprophylaxis with acenocumarol was used. The incidence of venous thromboembolism or bleeding complications were not noticed.