Jahanzeb Mohammad, Wu Ching-Yang, Lim Howard, Muro Kei, Xu Lichao, Somashekhar Manjiri, Sampige Prasannakumar Somashekhar S P, Zhang Xiaotao, Qiu Xiaoxia, Fu Ying, Pittiruti Mauro
Creative Precision Oncology, an OncAdvisor Practice, Boca Raton, FL, USA.
Chang Gung Memorial Hospital, Linkou, Taiwan.
J Vasc Access. 2025 Sep;26(5):1447-1458. doi: 10.1177/11297298241300792. Epub 2024 Dec 2.
In patients with cancer, the choice of an appropriate venous access device is crucial for effective treatment, minimizing complications, and reducing healthcare costs. Key management decisions, such as the timing of device removal post-therapy, can impact clinical outcomes. As current international guidelines lack specific directives for these issues, a global consensus of experts, representing different countries, was deemed appropriate.
A panel of 11 experts from three continents, including oncologists and healthcare professionals, was chosen. After a comprehensive review of clinical trials and guidelines on central venous access devices (CVAD) in oncology published between January 2013 and December 2023, the panel developed and voted on specific recommendations for the selection and management of CVADs in patients with cancer, during a 2-day meeting.
The panel reached consensus on 10 issues concerning (a) indications for a CVAD, (b) available options for CVADs, (c) role of the staff and patients in the choice of CVAD, (d) factors influencing the selection of a port over an external catheter, (e) logistical requirements for port and external catheter insertion, (f) stakeholders responsible for port and external catheter insertion, (g) factors determining the removal of a port after completing the definitive therapy, and (h) recommended frequency of flushing when the CVAD is not in use.
The results of the consensus may offer healthcare professionals a global view of some critical issues concerning CVADs for cancer therapy, helping to establish recommendations for local clinical practice.
对于癌症患者而言，选择合适的静脉通路装置对于有效治疗、将并发症降至最低以及降低医疗成本至关重要。关键的管理决策，如治疗后装置移除的时机，会影响临床结果。由于当前国际指南缺乏针对这些问题的具体指导方针，因此认为有必要达成代表不同国家的全球专家共识。
挑选了一个由来自三大洲的11名专家组成的小组，其中包括肿瘤学家和医疗保健专业人员。在全面回顾了2013年1月至2023年12月期间发表的关于肿瘤学中中心静脉通路装置（CVAD）的临床试验和指南后，该小组在为期两天的会议期间制定并投票通过了关于癌症患者CVAD选择和管理的具体建议。
该小组就10个问题达成了共识，这些问题涉及（a）CVAD的适应症，（b）CVAD的可用选项，（c）工作人员和患者在CVAD选择中的作用，（d）影响选择植入式静脉输液港而非外部导管的因素，（e）植入式静脉输液港和外部导管插入的后勤要求，（f）负责植入式静脉输液港和外部导管插入的利益相关者，（g）确定在完成确定性治疗后移除植入式静脉输液港的因素，以及（h）CVAD未使用时推荐的冲洗频率。
共识结果可能为医疗保健专业人员提供有关癌症治疗中CVAD一些关键问题的全球视角，有助于为当地临床实践制定建议。
