Ikeda Masakazu, Matsuzuka Takashi, Kakamu Takeyasu, Nakaegawa Yuta, Kawase Tomotaka, Saito Yukiko, Kubota Satoshi, Imaizumi Mitsuyoshi, Murono Shigeyuki
Department of Otolaryngology, Fukushima Medical University, Fukushima City, Japan.
Department of Head and Neck Surgery and Otolaryngology, Asahi University Hospital, Gifu, Japan.
J Vasc Access. 2025 Sep;26(5):1489-1494. doi: 10.1177/11297298241279623. Epub 2024 Sep 26.
With recent developments in chemotherapy, the prognosis of head and neck cancer patients has been prolonged, and it is expected that totally implantable venous access devices will be developed for use as feasible and safe chemotherapy routes. We investigated the feasibility of implanting totally implantable venous access ports in the upper arms of head and neck cancer patients in this modern era of chemotherapy.
Relevant data of a cohort of 210 patients with head and neck cancer who had had totally implantable venous access devices implanted between January 2013 and December 2022 were investigated retrospectively. The totally implantable venous access ports were used for chemoradiotherapy, chemotherapy, radiotherapy, and palliative treatment. Adverse events related to totally implantable venous access devices were investigated and the associated variables subjected to statistical analysis.
There were 22 (10.5%) adverse events, representing 0.201 adverse events per 1000 catheter days. Non-ultrasound-guided puncture ( = 0.015) and forearm implantation ( = 0.005) were associated with higher risk of adverse events according to univariate analysis. According to multiple logistic analysis, non-ultrasound-guided puncture was significantly associated with age and sex (OR = 2.89; 95% CI, 1.14, 7.36; = 0.026).
Peripherally implanted totally implantable venous access devices in the upper arm are feasible and safe for head and neck cancer patients. Ultrasound-guided implantation of totally implantable venous access ports into the upper arms of head and neck cancer patients may reduce the adverse event rate.
随着化疗技术的最新进展，头颈癌患者的预后得到了延长，预计将开发完全植入式静脉通路装置，作为可行且安全的化疗途径。在这个化疗的现代时代，我们研究了在头颈癌患者上臂植入完全植入式静脉通路端口的可行性。
回顾性调查了2013年1月至2022年12月期间植入完全植入式静脉通路装置的210名头颈癌患者队列的相关数据。完全植入式静脉通路端口用于放化疗、化疗、放疗和姑息治疗。调查了与完全植入式静脉通路装置相关的不良事件，并对相关变量进行了统计分析。
发生22例（10.5%）不良事件，每1000导管日不良事件发生率为0.201。单因素分析显示，非超声引导穿刺（P = 0.015）和前臂植入（P = 0.005）与不良事件风险较高相关。多因素逻辑分析显示，非超声引导穿刺与年龄和性别显著相关（OR = 2.89；95%CI，1.14，7.36；P = 0.026）。
对于头颈癌患者，在上臂外周植入完全植入式静脉通路装置是可行且安全的。对头颈癌患者上臂进行超声引导下完全植入式静脉通路端口植入术可能会降低不良事件发生率。
