Short summary

Patients with Glioma are at increased risk of venous thromboembolism (VTE), but the prophylactic treatment is challenged by an increased risk of intracranial bleeding. Existing studies have yet to identify high-risk patients, and this study therefore seeks to identify the incidence of VTE in Danish patients with Glioma based on registry data and investigate characteristics of patients in high risk of VTE.

Rationale

Every year in Denmark, 1200 persons are diagnosed with a primary brain tumor called Glioma. The tumor manifests by focal neurological deficit, convulsions, cognitive deficit and/or headache depending on which part of the brain it affects. There are several types of brain tumors, and the prognosis depends on the tumor subtype. However, all types typically include a harsh course of treatment involving surgery, chemotherapy, and radiotherapy. The most common and aggressive type of Glioma is called Glioblastoma (GBM) with a median survival of 15 months.

An additional issue for patients with Glioma is an increased risk of venous thromboembolism (VTE), which results in sequelae, interruption of treatment, reduced survival and quality of life. Prophylactic treatment of VTE is challenged since patients with Glioma are at increased risk of intracranial bleeding. Therefore, the anticoagulant treatment used to prevent VTE further increases the risk of bleeding creating even more complications.

In 2008 Khorana et al. developed a model to assess the risk of VTE at the start of a new chemotherapy regime, but the study did not include enough patients to validate the applicability on patients with primary brain tumors. Therefore, clinicians still have a hard time weighing the risk of VTE against the risk of bleeding.

This study seeks to determine the incidence of VTE in Danish patients with Glioma and investigate characteristics of high-risk patients.

Description of the cohort

This study includes Danish patients with Glioma from 2010 to 2019.

VTE includes deep vein thrombosis, pulmonary embolism and cerebral venous sinus thrombosis.

Data and biological material

The Danish Neuro-Oncology Registry.

The National Patient Registry.

Collaborating researchers and departments

Department of Oncology, OUH.

• Rikke Hedegaard Dahlrot
• Steinbjørn Hansen