Lefebvre L, Noyon E, Georgescu D, Proust V, Alexandru C, Leheurteur M, Thery J C, Savary L, Rigal O, Di Fiore F, Veyret C, Clatot F
Department of Radiation Oncology, Centre Henri Becquerel, 1 rue d'Amiens, 76038, Rouen, France.
Department of Anesthesiology, Centre Henri Becquerel, 1 rue d'Amiens, 76038, Rouen, France.
Support Care Cancer. 2016 Mar;24(3):1397-403. doi: 10.1007/s00520-015-2901-8. Epub 2015 Sep 5.
We aimed to compare the complication rate between port catheters (PC) and peripherally inserted central catheters (PICC) for the administration of postoperative chemotherapy for breast cancer.
All patients treated from January 2010 to August 2012 at the Centre Henri Becquerel for early breast cancer requiring postoperative chemotherapy were retrospectively screened. The primary endpoint was the occurrence of a major complication related to the central venous catheter. Major complications were defined as any grade 3 event according to CTCAE 4.0, delay in chemotherapy >7 days, change of the device, life-threatening event, event requiring a hospitalization, or a prolongation of hospitalization.
A total of 448 patients were included; 290 had a PC and 158 a PICC. Overall, 31 major complications related to the central venous catheter were observed: 13 for patients with a PC (4.5%) and 18 for patients with a PICC (11.4%). In univariate analysis, having a PICC was the only factor significantly associated with a higher risk of major complications (HR = 2.83, p = 0.0027). We observed a trend for a higher risk of major complications for patients older than 60 years or with BMI >25 (p = 0.06). In multivariate analysis, having a PICC was the only predictive factor of major complications (HR = 2.89, p = 0.004).
In univariate and multivariate analysis, having a PICC instead of a PC was the only predictive factor of device-related major complication. If confirmed prospectively by the NCT02095743 ongoing trial, this result might modify the management of adjuvant chemotherapy administration.
我们旨在比较用于乳腺癌术后化疗的植入式静脉输液港(PC)和外周静脉穿刺中心静脉导管(PICC)之间的并发症发生率。
对2010年1月至2012年8月在亨利·贝克勒尔中心接受早期乳腺癌术后化疗的所有患者进行回顾性筛查。主要终点是与中心静脉导管相关的严重并发症的发生情况。严重并发症根据CTCAE 4.0被定义为任何3级事件、化疗延迟>7天、装置更换、危及生命的事件、需要住院治疗的事件或住院时间延长。
共纳入448例患者;290例使用PC,158例使用PICC。总体而言,观察到31例与中心静脉导管相关的严重并发症:PC患者中有13例(4.5%),PICC患者中有18例(11.4%)。单因素分析中,使用PICC是与严重并发症风险较高显著相关的唯一因素(HR = 2.83,p = 0.0027)。我们观察到年龄>60岁或BMI>25的患者发生严重并发症的风险有升高趋势(p = 0.06)。多因素分析中,使用PICC是严重并发症的唯一预测因素(HR = 2.89,p = 0.004)。
在单因素和多因素分析中,使用PICC而非PC是与装置相关的严重并发症的唯一预测因素。如果正在进行的NCT02095743试验前瞻性地证实了这一结果,该结果可能会改变辅助化疗给药的管理方式。