Japanese Journal of Clinical Oncology Advance Access originally published online on December 4, 2007
Japanese Journal of Clinical Oncology 2007 37(12):951-954; doi:10.1093/jjco/hym118
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© 2007 Foundation for Promotion of Cancer Research
Central Venous Access Port-related Complications in Outpatient Chemotherapy for Colorectal Cancer
1 Department of Diagnostic and Interventional Radiology
2 Department of Medical Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
For reprints and all correspondence: Yoshitaka Inaba, Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, 1-1Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan. E-mail: 105824{at}aichi-cc.jp
Received May 8, 2007; accepted August 2, 2007
Background: The current standard chemotherapy for advanced or metastatic colorectal cancer in Japan is FOLFOX or FOLFIRI therapy. Although both therapies include continuous infusion of 5-fluorouracil (5-FU), outpatient home chemotherapy is possible by placing a central venous access port (CV-port) and using a portable disposable pump. The port system has been placed more frequently since the approval of FOLFOX. Consequently, more complications involving ports and pumps have been encountered.
Methods: At our hospital, 232 patients with colorectal cancer underwent outpatient home chemotherapy by placing a CV-port and using a portable disposable pump for continuous infusion of 5-FU between 1998 and 2005. Incidence and contents of complications involving ports and pumps were investigated retrospectively.
Results: A total of 54 incidents of complications involving ports and pumps were identified in 3142 treatments (1.72%) from among 34 of the 232 patients (14.7%). In 2005, when FOLFOX was introduced, 31 incidents occurred in 1903 treatments (1.63%) for 19 of 149 patients (12.8%). Incidents involved port placement (n = 6), catheter and port system-related complications (n = 15), puncture needle-related complications (n = 3), skin complications related to tape fixation (n = 20) and pump-related complications (n = 10). In 10 patients (4.3%), system-related complications made therapy difficult to continue and system exchange was required.
Conclusions: Technical troubles involving ports and pumps occurred at a certain rate, and skin incision was required for system exchange in some cases. When performing outpatient chemotherapy using ports and pumps, thorough prior guidance and double-checking must be implemented, and proper countermeasures must be established.
Key Words: colorectal cancer • outpatient home chemotherapy • central venous access port • portable disposable pump • complication