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一例接受西妥昔单抗治疗的结直肠癌患者在 peripherally inserted central catheter(外周中心静脉置管)置管部位发生 cetuximab(西妥昔单抗)诱导的皮肤毒性和接触性皮炎,导致 peripherally inserted central catheter(外周中心静脉置管)意外脱出:我们是否应该建议患者优先选择皮下端口?

A case of unexpected peripherally inserted central catheter removal from a colorectal cancer patient with cetuximab-induced skin toxicity and contact dermatitis at the peripherally inserted central catheter insertion site: Should we recommend the patient to choose subcutaneous port preferentially?

机构信息

Department of Gastrointestinal Surgery, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

J Vasc Access. 2021 Mar;22(2):310-313. doi: 10.1177/1129729820910880. Epub 2020 Mar 13.

Abstract

INTRODUCTION

Obtaining central venous access is one of the most commonly performed procedures in cancer patients. However, there are very limited data to guide clinicians when selecting a device for metastatic colorectal cancer patients who received cetuximab.

CASE DESCRIPTION

A 54-year-old male patient with metastatic colorectal cancer treated with cetuximab plus FOLFIRI used peripherally inserted central catheter as intravenous pathway. After eight cycles, the patient suffered cetuximab-induced grade 2 skin toxicity and grade 3 contact dermatitis at the peripherally inserted central catheter insertion site. Finally, he removed the peripherally inserted central catheter and accepted subcutaneous port instead for 2 years without implantation cutaneous complication.

CONCLUSIONS

We suggest that metastatic colorectal cancer patients treated with cetuximab should be recommended to choose subcutaneous port preferentially to avoid potential risk of unexpected peripherally inserted central catheter removal due to cetuximab-induced skin toxicity or contact dermatitis. Further clinical practices and researches are needed for more profound evidences for better practical suggestions.

摘要

简介

在癌症患者中,获取中心静脉通路是最常进行的操作之一。然而,当为接受西妥昔单抗治疗的转移性结直肠癌患者选择设备时,指导临床医生的相关数据非常有限。

病例描述

一名 54 岁男性转移性结直肠癌患者,接受西妥昔单抗联合 FOLFIRI 治疗,采用外周静脉置入中心静脉导管作为静脉通路。经过 8 个周期的治疗,患者出现西妥昔单抗诱导的 2 级皮肤毒性和外周静脉置入中心导管置管部位 3 级接触性皮炎。最终,他拔除了外周静脉置入中心导管,并接受皮下端口治疗,2 年期间未发生植入性皮肤并发症。

结论

我们建议接受西妥昔单抗治疗的转移性结直肠癌患者应优先选择皮下端口,以避免因西妥昔单抗诱导的皮肤毒性或接触性皮炎而意外拔除外周静脉置入中心导管的潜在风险。需要进一步的临床实践和研究,以提供更深入的证据,从而为更好的实际建议提供支持。

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