Department of Hematology, Takeda General Hospital, 28-1 Ishida-Moriminami-cho, Fushimi-ku, Kyoto 601-1495, Japan.
Int J Clin Oncol. 2010 Apr;15(2):172-8. doi: 10.1007/s10147-010-0039-8. Epub 2010 Mar 2.
Although subcutaneous implantable ports have been indicated as venous access for chemotherapy, these devices have not been used routinely for hematological tumors.
Between May 2006 and April 2009, 39 ports were implanted in 37 patients with hematological tumors and 16 ports were implanted in 14 patients with nonhematological tumors. The patients were treated with standard/first-line and/or salvage/second-line or greater chemotherapy, and were prospectively followed until port removal, death, or the end of the study.
Thirty-five (96%) patients with hematological tumors developed grade 4 hematological toxicity, while 1 (7%) patient with nonhematological tumors showed grade 4 neutropenia. The actual duration of the port in situ ranged from 14 to 719 days (mean, 271.4 days) in the hematology group, and from 50 to 955 days (mean, 419.5 days) in the nonhematology group (P = 0.039). The Kaplan-Meier-estimated median duration of port in situ in the hematology group was 364 days, which was significantly shorter than that in the nonhematology group (P = 0.009). When patient death and port removal for the end of treatment were censored, the rate of port functioning at 1 year was estimated to be 83% in the hematology group. Bloodstream infection (BSI) occurred in 7 patients with hematological tumors and in 1 patient with metastatic colorectal cancer; however, microbiological confirmation that the implantable port was the source of the BSI was inconclusive.
The duration of port functioning in patients with hematological tumors was comparable to that in patients with nonhematological tumors. The higher rate of BSI in the hematology group was primarily attributable to profound neutropenia.
尽管皮下植入式输液港已被推荐作为化疗的静脉通路,但这些装置尚未常规用于血液系统肿瘤。
2006 年 5 月至 2009 年 4 月,在 37 例血液系统肿瘤患者中植入了 39 个输液港,在 14 例非血液系统肿瘤患者中植入了 16 个输液港。患者接受标准/一线和/或挽救/二线或以上化疗,并前瞻性随访至输液港取出、死亡或研究结束。
35 例(96%)血液系统肿瘤患者发生 4 级血液学毒性,而 1 例(7%)非血液系统肿瘤患者出现 4 级中性粒细胞减少症。血液组输液港原位实际使用时间为 14-719 天(平均 271.4 天),非血液组为 50-955 天(平均 419.5 天)(P=0.039)。血液组输液港原位的 Kaplan-Meier 估计中位时间为 364 天,明显短于非血液组(P=0.009)。当患者死亡和因治疗结束而取出输液港时,血液组 1 年时输液港功能的估计率为 83%。7 例血液系统肿瘤患者和 1 例转移性结直肠癌患者发生血流感染(BSI);然而,植入式输液港是 BSI 来源的微生物学证实不确定。
血液系统肿瘤患者输液港的使用时间与非血液系统肿瘤患者相当。血液组 BSI 发生率较高主要归因于严重中性粒细胞减少症。