Department of Oncology, Sha'are Zedek Medical Cente, Jerusalem, Israel.
Anticancer Drugs. 2010 Aug;21(7):704-7. doi: 10.1097/CAD.0b013e32833a5c51.
Indwelling central venous catheters and implantable port systems are widely used in the care of patients with cancer. Bevacizumab, a humanized monoclonal antibody against vascular endothelial growth factor, significantly prolongs survival when added to intravenous 5-fluorouracil-based chemotherapy as first-line treatment for metastatic colorectal cancer. It has also been shown to be of value in a range of other malignant diseases. Some elements of the toxicity profile of bevacizumab, however, such as bleeding and impaired wound healing, could interfere with surgical procedures involved in the treatment of the diseases. The aim of this study was to evaluate the possible effect of bevacizumab in increasing the morbidity associated with an indwelling central venous access port in patients currently receiving the drug, or those who had received it in the preoperative run-up to surgery. An analysis of the medical records of 57 patients with a variety of cancers, who had received an indwelling central venous access port, either during the course of treatment with bevacizumab or in the 4-week period before the commencement of therapy was carried out, with particular emphasis on periprocedural complications. Eight of the patients also had diabetes mellitus. There were no instances of delay in wound healing, abnormal bleeding, or wound infection in any of the patients and no episodes of skin ulceration during bevacizumab treatment. Although this is a relatively small study, and no definitive conclusions can be drawn at this stage, our data suggest that an indwelling central venous access port insertion may be carried out shortly before or during bevacizumab treatment without increasing periprocedural morbidity.
留置中央静脉导管和植入式港系统广泛应用于癌症患者的治疗中。贝伐单抗是人血管内皮生长因子的单克隆抗体，作为转移性结直肠癌的一线治疗方案，联合静脉氟尿嘧啶为基础的化疗可显著延长患者的生存时间。它在其他一些恶性疾病中也显示出了一定的价值。然而，贝伐单抗的一些毒性特征，如出血和伤口愈合受损，可能会干扰与治疗疾病相关的手术程序。本研究旨在评估贝伐单抗对正在接受该药治疗或在术前准备期间接受该药治疗的患者留置中央静脉通路港相关发病率增加的可能影响。对 57 名患有各种癌症的患者的医疗记录进行了分析，这些患者在接受贝伐单抗治疗期间或在治疗开始前的 4 周内接受了留置中央静脉通路港治疗，特别强调了围手术期并发症。其中 8 名患者还患有糖尿病。在任何患者中都没有出现伤口愈合延迟、异常出血或伤口感染的情况，也没有在贝伐单抗治疗期间出现皮肤溃疡的情况。尽管这是一项相对较小的研究，现阶段无法得出明确的结论，但我们的数据表明，在贝伐单抗治疗前或治疗期间进行留置中央静脉通路港插入可能不会增加围手术期发病率。
