Ardalan B, Flores M R
Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Jackson Memorial Hospital, FL 33136, USA.
Cancer. 1995 Apr 15;75(8):2165-8. doi: 10.1002/1097-0142(19950415)75:8<2165::aid-cncr2820750821>3.0.co;2-w.
The use of permanent intravenous access devices for chemotherapy administration has become a common practice in clinical oncology. Therefore, awareness of potential complications is important. The authors previously reported the use of high dose 5-fluorouracil (5-FU) (2600 mg/m2) and leucovorin (500 mg/m2) as a weekly 24-hour infusion for patients with colorectal carcinoma. In this report, a new complication of permanent indwelling catheters with high dose 5-fluorouracil (2600 mg/m2) and leucovorin (500 mg/m2) as a weekly 24-hour infusion for colorectal carcinoma is described.
Twenty-two patients in the previous Phase II trial on weekly high dose 5-FU and leucovorin were included in this study. All patients had either a single-lumen Port-o-cath (Pharmacia Deltec, St. Paul, MN) or Hickman catheter (Travenol Laboratories, Deerfield, IL). Occluded catheters were explanted, and the material found in their lumen was analyzed using infrared spectroscopy.
Eleven of 22 patients had catheter blockage, and calcium carbonate formation (Calcite 100%) was identified within these catheters.
Calcite formation causing catheter occlusion is a new and important complication resulting from using intravenous access devices for chemotherapy administration. Oncologists should be alerted to this phenomenon when high dose 5-FU and leucovorin are administered for 24 hours by continuous infusion using a single-port port-o-cath.
在临床肿瘤学中，使用永久性静脉通路装置进行化疗给药已成为一种常见做法。因此，了解潜在并发症很重要。作者之前报道了使用高剂量5-氟尿嘧啶（5-FU）（2600mg/m²）和亚叶酸钙（500mg/m²）作为每周24小时输注方案用于治疗结直肠癌患者。在本报告中，描述了一种新的并发症，即使用高剂量5-氟尿嘧啶（2600mg/m²）和亚叶酸钙（500mg/m²）作为每周24小时输注方案治疗结直肠癌时，永久性留置导管出现的并发症。
本研究纳入了之前II期试验中接受每周高剂量5-FU和亚叶酸钙治疗的22名患者。所有患者均使用单腔植入式静脉输液港（美国Pharmacia Deltec公司，明尼苏达州圣保罗）或Hickman导管（美国Travenol Laboratories公司，伊利诺伊州迪尔菲尔德）。堵塞的导管被取出，对管腔内发现的物质进行红外光谱分析。
22名患者中有11名出现导管堵塞，在这些导管内发现了碳酸钙形成（方解石100%）。
方解石形成导致导管堵塞是使用静脉通路装置进行化疗给药引起的一种新的重要并发症。当使用单腔植入式静脉输液港连续输注高剂量5-FU和亚叶酸钙24小时时，肿瘤学家应警惕这种现象。
