Background Venous thromboembolism (VTE) is a common problem in cancer patients and the incidence is increasing, especially for patients with lung cancer. Common features of these patients, like advanced stage, male gender, old age and chemotherapy, are risk factors of VTE. Here we reported a case in which the patient with lung cancer developed deep vein thrombosis (DVT) when receiving chemotherapy. Case presentation A 53-year-old male who was diagnosed with lung cancer with multiple metastasis developed severe DVT during chemotherapy. Despite the use of aspirin, warfarin and low molecular weight heparin (LMWH) for anticoagulant and thrombolytic therapy, the condition was still deteriorating, resulting in amputation finally. Conclusions It’s rare that the conditions of cancer patients who develop venous thromboembolism (VTE) keep deteriorating despite the administration of aspirin, warfarin and low weight molecular heparin. Both early diagnosis and prophylactic use of anticoagulants are suggested for cancer patients to improve the prognosis.

Although elevated neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been reported to be inverse prognostic predictors of survival in patients with pancreatic cancer (PC), the comparison of their prognostic roles in patients with PC undergoing gemcitabine-based chemotherapy and 5-fluorouracil (5-FU) remains unclear. This study was designed and performed to determine the predictive roles of NLR and PLR in patients diagnosed with PC who underwent one of these two regimens. We retrospectively enrolled 95 patients diagnosed with PC undergoing supportive care, gemcitabine-based chemotherapy or 5-FU therapy from January 2015 to October 2018. Univariate and multivariate Cox regression analyses were done to identify clinicopathological predictors of time to treatment failure (TTF) and overall survival (OS), including pretreatment NLR and PLR. The statistical data showed that pretreatment NLR was significantly associated with metastasis. Among all analyzed variables, pretreatment NLR was an independent prognostic predictor of both TTF and OS of patients with PC, with NLR>4.0 predicting worse survival. PLR, however, didn't independently predict TTF or OS. There were no significant difference in the OS of patients undergoing gemcitabine-based regimens and 5-FU regimens when divided into two subgroups: NLR ≤4.0 and >4.0. In conclusion, pretreatment NLR is a promising independent outcome predictor for patients with PC, while NLR might not be a suitable factor in the selection of regimens for patients with PC.

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