Temporal Patterns and Risk Factors for Pulmonary Embolism Associated with Anti-Tumor Therapies in Patients with Lung Cancer.

Objective: This study aimed to characterize the association between pulmonary embolism (PE) onset and various anti-tumor therapeutic approaches in patients with lung cancer, with the goal of identifying potential high-risk populations.

Methods: A retrospective analysis was conducted on clinical records from 2019 to 2025, among the 84,000 inpatients with lung cancer, 106 patients developed PE during hospitalization for anti-tumor treatment, who were confirmed using spiral computed tomography (CT) or pulmonary angiography per CTS (2018) and NEJM (2010) criteria. Data were collected on patient demographics, cancer staging, treatment type, and time to PE onset.

Results: Among patients who developed PE during lung cancer treatment, the mean age was 66.82 ± 10.50 years. Females comprised 64.04% of cases, adenocarcinoma was identified in 60.38%, and stage IV lung cancer was present in 56.60%. First-line therapy was administered in 63.21% of cases, and 66.04% exhibited enlarged mediastinal lymph nodes. The mean D-dimer level among this cohort was 3.559 μg/mL, indicating a heightened thrombotic risk. Temporally, 50.95% of PE cases occurred within six months of lung cancer diagnosis. Onset within three months following therapy initiation was observed across multiple modalities: 46.15% for chemotherapy, 34.78% for targeted therapy, and 77.78% following surgical intervention. Notably, 16.98% of PE events occurred during the initial chemotherapy cycle. The mean time to PE onset was 1.81 ± 2.51 months for patients undergoing surgery alone, compared to 15.52 ± 12.88 months for those receiving surgery combined with other treatments (p < 0.05). Surgical intervention was identified as an independent risk factor for PE. In early-stage lung cancer, the mean time to PE onset was significantly shorter, with a mean time of 16.38 ± 21.07 months (p < 0.05).

Conclusion: The timing and incidence of PE vary according to the type of anti-tumor therapy administered in lung cancer treatment. These findings underscore the importance of vigilant monitoring, personalized risk assessment, and targeted anticoagulation strategies throughout the therapeutic course.