Top

International Journal of Clinical Oncology

Published in:

01-04-2015 | Original Article

Administration of chemotherapy via the median cubital vein without implantable central venous access ports: port-free chemotherapy for metastatic colorectal cancer patients

Authors: Yoichiro Yoshida, Seiichiro Hoshino, Naoya Aisu, Masayasu Naito, Syu Tanimura, Ai Mogi, Toshihiro Tanaka, Keiji Hirata, Kazuo Tamura, Yuichi Yamashita

Published in: International Journal of Clinical Oncology | Issue 2/2015

Abstract

Background

Repeated venous punctures are usually required during chemotherapy administration for cancer patients. Central venous catheters and implantable port systems have substantially facilitated vascular access, and safe, easy-to-handle port systems have become an integral part of daily clinical routines in oncology. However, several serious complications are associated with central venous ports (CV-ports), and recent developments of combined oral capecitabine and oxaliplatin (XELOX) therapies allow CV-port-free administration. In this study, the safety and efficacy of CV-port-free chemotherapy administration via the median cubital vein was assessed in metastatic colorectal cancer patients.

Methods

This study included 144 patients who received XELOX + bevacizumab (BV) or XELOX therapy for metastatic colorectal cancer without CV-port implantation.

Results

Eighty-five patients experienced transient vascular pain. The drip infusion route was switched to the opposite side following vascular pain in only 1 patient. No patients required CV-port implantation or delayed treatment due to adverse events associated with drug administration via the peripheral vein. Grade 3 or higher hemotoxicity and grade 3 or higher non-hematological toxicity was noted in 12.5 and 17.4 % of patients, respectively.

Conclusions

Port-free-chemotherapy administration via the median cubital vein is appropriate for patients with colorectal cancer, thereby avoiding complications associated with CV-ports.

Niederhuber JE, Ensminger W, Gyves JW et al (1982) Totally implanted venous and arterial access system to replace external catheters in cancer treatment. Surgery 92:706–712PubMed

Torramadé JR, Cienfuegos JA, Hernández JL et al (1993) The complications of central venous access systems: a study of 218 patients. Eur J Surg 159:323–327PubMed

Mansfield PF, Hohn DC, Fornage BD et al (1994) Complications and failures of subclavian-vein catheterization. N Engl J Med 331:1735–1738PubMedCrossRef

Teichgräber UK, Gebauer B, Benter T et al (2004) Long-term central venous lines and their complications. Rofo 176:944–992 (in German)PubMedCrossRef

Kuwahara T, Asanami S, Kubo S (1998) Experimental infusion phlebitis: tolerance osmolality of peripheral venous endothelial cells. Nutrition 14:496–501PubMedCrossRef

Nakayama S, Matsubara N, Sakai T et al (2002) The incidence of phlebitis in the patients administrated vinorelbine by intravenous bolus injection—a retrospective study. Gan To Kagaku Ryoho 29:633–635 (in Japanese)PubMed

Curran CF, Luce JK, Page JA (1990) Doxorubicin-associated flare reactions. Oncol Nurs Forum 17:387–389PubMed

Matsuyama K, Mishima H, Ueno H et al (2011) Etiology and management of venous pain during intravenous administration of oxaliplatin. Gan To Kagaku Ryoho 38:411–414PubMed

Yoshida Y, Hoshino S, Aisu N et al (2012) Dexamethasone as a means not only for controlling vascular pain caused by the administration of oxaliplatin via the peripheral vein but also for controlling oxaliplatin-induced hypersensitivity reactions. Br J Med Med Res 2:132–141CrossRef

10.

Petrioli R, Pascucci A, Francini E et al (2008) Neurotoxicity of FOLFOX-4 as adjuvant treatment for patients with colon and gastric cancer: a randomized study of two different schedules of oxaliplatin. Cancer Chemother Pharmacol 61:105–111PubMedCrossRef

11.

Kiernan MC, Krishnan AV (2006) The pathophysiology of oxaliplatin-induced neurotoxicity. Curr Med Chem 13:2901–2907PubMedCrossRef

12.

Jordan K, Behlendorf T, Surov A et al (2008) Venous access ports: frequency and management of complications in oncology patients. Onkologie 31(404–410):14

13.

Fonkalsrud EW, Pederson BM, Murphy J et al (1968) Reduction of infusion thrombophlebitis with buffered glucose solutions. Surgery 63:280–284

14.

Saif MW, Katirtzoglou NA, Syrigos KN (2008) Capecitabine: an overview of the side effects and their management. Anticancer Drugs 19:447–464PubMed

15.

Cassidy J, Clarke S, Díaz-Rubio E et al (2008) Randomized phase III study of capecitabine plus oxaliplatin compared with fluorouracil/folinic acid plus oxaliplatin as first-line therapy for metastatic colorectal cancer. J Clin Oncol 26:2006–2012PubMedCrossRef

16.

Tsunoda A, Yasuda N, Nakao K et al (2009) Phase II study of S-1 combined with irinotecan (CPT-11) in patients with advanced colorectal cancer. Oncology 77:192–196PubMedCrossRef

17.

Ishida H, Miyake Y, Fukunaga M et al (2009) A feasibility study of UFT/LV and irinotecan (TEGAFIRI) in advanced or metastatic colorectal cancer: Osaka Gastrointestinal Cancer Chemotherapy Study Group (OGSG) PROG 0304. Jpn J Clin Oncol 39:601–605PubMedCrossRef

18.

Eastridge BJ, Lefor AT (1995) Complications of indwelling venous access devices in cancer patients. J Clin Oncol 13:233–238PubMed

19.

de Gregorio MA, Miguelena JM, Fernández JA et al (1996) Subcutaneous ports in the radiology suite: an effective and safe procedure for care in cancer patients. Eur Radiol 6:748–752PubMedCrossRef

20.

Schwarz R, Groeger J, Coit D (1997) Subcutaneously implanted central venous access devices in cancer patients: a prospective analysis. Cancer 79:1635–1640PubMedCrossRef

21.

Kock HJ, Pietsch M, Krause U et al (1998) Implantable vascular access systems: experience in 1,500 patients with totally implanted central venous port systems. World J Surg 22:12–16PubMedCrossRef

22.

Biffi R, de Braud F, Orsi F et al (1998) Totally implantable central venous access ports for long-term chemotherapy: a prospective study analyzing complications and costs of 333 devices with a minimum follow-up of 180 days. Ann Oncol 9:767–773PubMedCrossRef

23.

Lorch H, Zwaan M, Kagel C et al (2001) Central venous access ports placed by interventional radiologists: experience with 125 consecutive patients. Cardiovasc Intervent Radiol 24:180–184PubMedCrossRef

24.

Vardy J, Engelhardt K, Cox K et al (2004) Long-term outcome of radiological-guided insertion of implanted central venous access port devices (CVAPD) for the delivery of chemotherapy in cancer patients: institutional experience and review of the literature. Br J Cancer 91:1045–1049PubMedCentralPubMed

25.

Inaba Y, Yamaura H, Sato Y et al (2007) Central venous access port-related complications in outpatient chemotherapy for colorectal cancer. Jpn J Clin Oncol 37:951–954PubMedCrossRef

26.

Kameyama H, Yamazaki T, Maeda C et al (2010) Central venous access port devices (CVAPD)-related complications in colorectal cancer patients. Gan To Kagaku Ryoho 37:453–455 (in Japanese)PubMed

27.

Silberzweig JE, Sacks D, Khorsandi AS, Society of Interventional Radiology Technology Assessment Committee et al (2000) Reporting standards for central venous access. J Vasc Interv Radiol 11:391–400PubMedCrossRef

28.

Yukisawa S, Fujiwara Y, Yamamoto Y et al (2010) Upper-extremity deep vein thrombosis related to central venous port systems implanted in cancer patients. Br J Radiol 83:850–853PubMedCentralPubMedCrossRef

29.

Nobili E, Di Cicilia R, Di Battista M et al (2010) Venous thromboembolism and port-related thrombosis in metastatic colorectal cancer patients: a monocenter experience. Pathophysiol Haemost Thromb 37:30–34PubMedCrossRef

30.

Walshe LJ, Malak SF, Eagan J et al (2002) Complication rates among cancer patients with peripherally inserted central catheters. J Clin Oncol 20:3276–3281PubMedCrossRef

31.

Yoshida Y, Hoshino S, Shiwaku H et al (2011) Early start of chemotherapy after resection of primary colon cancer with synchronous multiple liver metastases: a case report. Case Rep Oncol 4:250–254PubMedCentralPubMedCrossRef

32.

Yoshida Y (2012) Port free chemotherapy for recurrent or metastatic colorectal cancer. Is port really necessary? J Cancer Sci Ther 4:iv–iv. doi:10.4172/1948-5956.1000e105

33.

Yoshida Y, Hoshino S, Miyake T et al (2012) Early start of chemotherapy after resection of brain metastasis from colon cancer with synchronous multiple liver metastases. Case Rep Oncol 5:290–295PubMedCentralPubMedCrossRef

34.

Yoshida Y, Hoshino S, Miyake T et al (2013) Pilot study of the early start of chemotherapy after resection of primary colorectal cancer with distant metastases (Pearl Star 01). World J Surg Oncol 7(11):39CrossRef

35.

Yoshida Y, Hoshino S, Aisu N et al (2014) Efficacy of XELOX plus bevacizumab in brain metastasis from rectal cancer. Case Rep Oncol 7:117–121PubMedCentralPubMedCrossRef

36.

Eremin O, Marshall V (1977) Complications of intravenous therapy: reduction by buffering of intravenous fluid preparation. Med J Aust 2:528–531PubMed

37.

Driscoll DF, Newton DW, Bistrian BR (1994) Precipitation of calcium phosphate from parenteral nutrient fluids. Am J Hosp Pharm 51:2834–2836PubMed

38.

Hill SE, Heldman LS, Goo ED et al (1996) Fatal microvascular pulmonary emboli from precipitation of a total nutrient admixture solution. J Parenter Enteral Nutr 20:81–87CrossRef

39.

Kuwahara T, Asanami S, Kawauchi Y et al (1999) Experimental infusion phlebitis: tolerance pH of peripheral vein. J Toxicol Sci 24:113–121PubMedCrossRef

40.

Jerremalm E, Eksborg S, Ehrsson H (2003) Hydrolysis of oxaliplatin-evaluation of the acid dissociation constant for the oxalato monodentate complex. J Pharm Sci 92:436–438PubMedCrossRef

Title: Administration of chemotherapy via the median cubital vein without implantable central venous access ports: port-free chemotherapy for metastatic colorectal cancer patients
Authors: Yoichiro Yoshida
Seiichiro Hoshino
Naoya Aisu
Masayasu Naito
Syu Tanimura
Ai Mogi
Toshihiro Tanaka
Keiji Hirata
Kazuo Tamura
Yuichi Yamashita
Publication date: 01-04-2015
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 2/2015
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-014-0703-5

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2015

The present state and perception of young women with breast cancer towards breast reconstructive surgery

A phase I trial of preoperative S-1 in combination with oxaliplatin and pelvic radiation for lower rectal cancer with T4 and lateral pelvic lymph node metastasis

Clinical benefit of sequential use of endocrine therapies for metastatic breast cancer

Nationwide Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 Seed Implantation (J-POPS)

Carboplatin-based combination chemotherapy for elderly patients with advanced bladder cancer

[18F]fluoro-2-deoxyglucose-positron emission tomography for the assessment of histopathological response after preoperative chemoradiotherapy in advanced oral squamous cell carcinoma

Keynote webinar | Spotlight on antibody–drug conjugates in cancer