THE EFFECT OF WARFARIN ON SURVIVAL IN PATIENTS WITH LUNG CANCER

BACKGROUND: To assess the effects on survival of the low dose warfarin in patients with lung cancer. METHODS: In this single center, randomized study, patients with lung cancer were randomly assigned to warfarin or to control (no warfarin) in addition to their standard anticancer treatment. Warfarin was given orally starting on day 1 of chemotherapy at a dose of 5 mg/d to achieve a target interrnational normalized ratio (INR) of 1.5–2.5 for six months. RESULTS AND CONCLUSION: A total of 44 patients were allocated to warfarin group, and 47 were allocated to the control group. The overall median survival was statistically higher on the warfarin group (358 days, 95% CI 226–489 days), as compared with the control group (236 days, 95% CI 187–284 days) (p=0.03). There was no statistically significant difference in the response rates (complete+partial) between two groups (56.8 percent in warfarin group vs. 36.1 percent in the control group, p=0.09). No significant difference between the warfarin group and the control group was detected in the rate of bleeding (15.9 percent and 6.3 percent, respectively, p=0.18). Warfarin may be effective in improving survival without increasing the risk of bleeding in patients with lung cancer.