Sakakida Tomoki, Fukahori Shinichiro, Mizuno Taro, Ishizuka Yasunobu, Wakabayashi Munehiro, Kodama Hiroyuki, Narita Yukiya, Masuishi Toshiki, Honda Kazunori, Kadowaki Shigenori, Ando Masashi, Muro Kei, Ogawa Akinobu, Kudo Chiho, Oze Isao, Taniguchi Hiroya
Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, 464-8681, Japan.
Department of Nursing, Aichi Cancer Center Hospital, Nagoya, 464-8681, Japan.
Oncologist. 2025 May 8;30(5). doi: 10.1093/oncolo/oyaf108.
Peripheral intravenous 5-fluorouracil (5-FU) administration often causes phlebitis and necessitates catheter replacement, imposing burdens on both patients and healthcare providers. Insertion of a midline catheter (MLC) into the upper arm with tip positioned in the axillary vein may reduce the incidence of phlebitis. This study evaluated the safety and effectiveness of MLC use for continuous 5-FU infusion in cancer patients.
This prospective study included patients with cancer requiring at least 4 days of continuous 5-FU infusion. The primary endpoint was the incidence of phlebitis. Secondary endpoints were the success rate of MLC insertion, complications, and patient-reported outcomes.
Of the 61 patients enrolled, 59 were included in the analysis. The median age was 68 years, and primary cancer types were esophageal (51%) and head and neck (46%). The median MLC indwelling duration was 5.5 days (2-28 days). No phlebitis was observed (0%, 95% CI: 0-6.2), achieving the primary endpoint. The insertion success rate was 98.3%, with complications in 6.8%. Over 90% of patients and 80% of healthcare providers reported high satisfaction levels.
MLC insertion is a safe and effective approach for continuous 5-FU infusion, eliminating phlebitis, potentially improving patients' quality of life, and reducing healthcare providers' workloads. (ClinicalTrials.gov Identifier: jRCTs042230058).
外周静脉输注5-氟尿嘧啶（5-FU）常导致静脉炎，需要更换导管，给患者和医护人员都带来负担。在上臂插入中线导管（MLC），其尖端位于腋静脉，可能会降低静脉炎的发生率。本研究评估了MLC用于癌症患者持续输注5-FU的安全性和有效性。
这项前瞻性研究纳入了需要至少4天持续输注5-FU的癌症患者。主要终点是静脉炎的发生率。次要终点是MLC插入成功率、并发症以及患者报告的结局。
在纳入的61例患者中，59例纳入分析。中位年龄为68岁，原发癌症类型为食管癌（51%）和头颈癌（46%）。MLC的中位留置时间为5.5天（2 - 28天）。未观察到静脉炎（0%，95%CI：0 - 6.2），达到了主要终点。插入成功率为98.3%，并发症发生率为6.8%。超过90%的患者和80%的医护人员报告满意度高。
MLC插入是持续输注5-FU的一种安全有效的方法，可消除静脉炎，可能改善患者生活质量，并减轻医护人员的工作量。（ClinicalTrials.gov标识符：jRCTs042230058）
