Brown D F, Muirhead M J, Travis P M, Vire S R, Weller J, Hauer-Jensen M
Department of Pharmacy, John L. McClellan Memorial Veterans Administration Medical Center, Little Rock, Arkansas 72205, USA.
Cancer. 1997 Sep 1;80(5):966-72. doi: 10.1002/(sici)1097-0142(19970901)80:5<966::aid-cncr20>3.0.co;2-t.
Few reports have been made regarding the long term safety of implantable venous access devices used for the delivery of chemotherapeutic agents. The authors' goals were to determine the frequency of complications in patients receiving chemotherapy with these devices; to determine whether complications were associated with the mode of chemotherapy delivery (push/bolus or infusional regimens); and to evaluate the influence of other risk factors, including home-based versus hospital-based administration.
A total of 152 oncology patients at the John L. McClellan Memorial Veterans Administration Medical Center in Little Rock, Arkansas (ages 26-81 years; mean age, 62 years), who underwent surgical placement of an Infus-a-Port (Strato, Inc., Beverly, MA) between May 1, 1992 and May 31, 1994, were evaluated retrospectively for postplacement device complications, such as infection, thrombosis, and mechanical failure.
Twenty-seven patients experienced 1 complication each: 17 episodes of device-related sepsis, cellulitis, or fever of unknown origin; 8 episodes of thrombosis or catheter occlusion; 1 episode of drug extravasation; and 1 mechanical failure. Patient age, frequency of port accession, mode of chemotherapy delivery, tumor type, and neutropenia were evaluated as risk factors, but none was statistically significant. Complications were more frequent during the first 90 days after implantation, but they continued to occur throughout the observation period.
Complications attributable to an implantable venous access device were infrequent in this patient population. No differences in complications for patients receiving home-based versus hospital-based chemotherapy administration were noted, opening the possibility of significant time and cost savings with home treatment.
关于用于输送化疗药物的植入式静脉通路装置的长期安全性，相关报道较少。作者的目标是确定接受这些装置化疗的患者并发症的发生率；确定并发症是否与化疗给药方式（推注/大剂量注射或输注方案）相关；并评估其他风险因素的影响，包括居家给药与住院给药。
对阿肯色州小石城约翰·L·麦克莱伦纪念退伍军人管理局医疗中心的152例肿瘤患者（年龄26 - 81岁；平均年龄62岁）进行回顾性评估，这些患者在1992年5月1日至1994年5月31日期间接受了Infus-a-Port（Strato公司，马萨诸塞州贝弗利）的手术植入，以评估植入后装置的并发症，如感染、血栓形成和机械故障。
27例患者各发生1种并发症：17例与装置相关的败血症、蜂窝织炎或不明原因发热；8例血栓形成或导管堵塞；1例药物外渗；1例机械故障。对患者年龄、端口接入频率、化疗给药方式、肿瘤类型和中性粒细胞减少症等风险因素进行了评估，但均无统计学意义。并发症在植入后的前90天更为频繁，但在整个观察期内仍持续发生。
在该患者群体中，植入式静脉通路装置引起的并发症并不常见。未发现居家化疗与住院化疗患者并发症存在差异，这为居家治疗节省大量时间和成本提供了可能性。
