Complications of venous access ports in 132 patients with disseminated testicular cancer treated with polychemotherapy.

Lemmers, Nicole; Gels, M. E.; Sleijfer, Dirk; Plukker, John; Graaf, Winette T.A. van der; Langen, Zacharias J. de; Droste, J. H. J.; Koops, H. Schraffordt; Hoekstra, HJ

doi:10.1200/jco.1996.14.11.2916

Cited by 67 publications

(50 citation statements)

References 35 publications

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“…Still, the observed antitumour potential, which is in agreement with the previously mentioned phase II studies of Roth et al (2000) (RR 56%, median survival 9 months), and Ridwelski et al (2001) (RR 37%, median survival 10.4 months), suggests that taxane/cisplatin-based combination chemotherapy might be as active as second-or even third-generation regimens including ECF or the more intense and toxic PELF (Cascinu et al, 1997;Webb et al, 1997). Potential advantages of the described biweekly and other taxane+cisplatin combination regimens are related to the non-requirement of a central venous access and external infusional devices with their associated risks and costs (Lemmers et al, 1996;Kock et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

Effective combination chemotherapy with paclitaxel and cisplatin with or without human granulocyte colony-stimulating factor and/or erythropoietin in patients with advanced gastric cancer

Kornek¹,

Raderer²,

Schüll³

et al. 2002

Br J Cancer

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A phase II trial was performed to determine the antitumour efficacy and tolerance of combined paclitaxel and cisplatin with or without hematopoetic growth factor support in patients with advanced gastric cancer. Forty-five patients with histologically confirmed metastatic gastric cancer were entered in this trial. Treatment consisted of 2-weekly courses of paclitaxel 160 mg per m 2 and cisplatin 60 mg per m 2 both given on day 1. Depending on absolute neutrophil counts on the days of scheduled chemotherapeutic drug administration (1000 -2000 per ml), a 5-day course of human granulocyte colony-stimulating factor 5 mg kg 71 per day was given subcutaneously; in addition, if haemoglobin was 512.0 mg dl 71 , erythropoietin 10 000 IU was administered subcutaneously three times per week. The confirmed overall response rate (intent-to-treat) was 44%, including five complete (11%) and 15 partial remissions (33%). Twelve patients had stable disease (27%), 11 (24%) progressed while on chemotherapy, and two patients were not evaluable. The median time to response was 3 months, the median time to progression 7.0 months, and the median survival time was 11.2 months with 12 patients currently alive. Haematologic toxicity was common, though WHO grade 4 neutropenia occurred in only five patients (11%). Apart from total alopecia in 16 patients (36%), severe non-haematologic adverse reactions included grade 3 peripheral neuropathy in six (13%) and anaphylaxis in two patients. In addition, there was one patient each who experienced grade 3 emesis, diarrhea, and infection, respectively. Our data suggest that the combination of paclitaxel and cisplatin with or without G-CSF and/or erythropoietin has promising therapeutic activity in patients with advanced gastric cancer.

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Section: Discussionmentioning

confidence: 99%

Effective combination chemotherapy with paclitaxel and cisplatin with or without human granulocyte colony-stimulating factor and/or erythropoietin in patients with advanced gastric cancer

Kornek¹,

Raderer²,

Schüll³

et al. 2002

Br J Cancer

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“…Częstość tego zdarzenia określana jest na 0,1-6% [72]. Wśród jego przyczyn wymienia się niewłaściwe wkłucie igły, przemieszczenie się igły, przeciek przez uszkodzoną lub nadmiernie zużytą membranę portu lub jego nieprawidłowe połączenie z cewnikiem, uszkodzenie, niedrożność, lub przemieszczenie końca cewnika.…”

Section: Powikłania Późneunclassified

Wszczepialne systemy dostępu naczyniowego u chorych na nowotwory

Domurat¹,

Sierko²,

Wojtukiewicz³

2015

Nowotwory. Journal of Oncology

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Wszczepialne systemy dostępu naczyniowego (totally implantable venous access devices -TIVDs) są bardzo dogodnymi, długotrwałymi dostępami do centralnego naczynia żylnego. Stanowią one niezastąpione rozwiązanie u pacjentów z trudnościami w dostępie do żył obwodowych wymagającymi chemioterapii, żywienia parenteralnego, antybiotykoterapii czy częstych pobrań krwi do badań laboratoryjnych. Porty naczyniowe implantowane są przez lekarzy różnych specjalności: chirurgów, anestezjologów, onkologów i radiologów inwazyjnych. Sam sposób kaniulacji naczynia również może być różny: drogą wenesekcji bądź przezskórnej punkcji. W celu osiągnięcia dostępu do żył centralnych najczęściej używane są prawe żyły: szyjna wewnętrzna i podobojczykowa. Implantacja portów naczyniowych, jak każda interwencja zabiegowa, wiąże się z możliwością wystąpienia powikłań ostrych, wczesnych i późnych. Powikłania ostre związane są bezpośrednio z zabiegiem i są wynikiem nieprawidłowej techniki implantacji bądź anomalii anatomicznych. Powikłania wczesne występują w niedługim okresie po implantacji portu. Spośród powikłań późnych w praktyce onkologicznej szczególnie uciążliwe są dwa: infekcje i zakrzepica związana z długotrwałą obecnością cewnika. Mimo wszystkich swoich ograniczeń i powikłań związanych ze stosowaniem portów naczyniowych od ponad trzech dekad nie znalazły one alternatywy. Stały postęp technologiczny i edukacja personelu medycznego pozwala na zastosowanie wszczepialnych systemów dostępu naczyniowego u wielu chorych, co przekłada się na usprawnienie terapii i poprawę jakości życia pacjentów onkologicznych.

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“…Mrs. Zatkó reported complications with "no serious consequences" (but not precisely determined) in case of 0.1 %, but the incidence of all events is not detailed 2 . The risk of extravasation can be reduced significantly by using centrally vein accessed ports and subcutaneously implanted "reservoirs" (subcutaneously implanted ports), but using this method cannot even guarantee to avoid this complication and in addition to the effects of cytostatic agents escaping into the tissues centrally, also unusual complications may develop [5,10,11,[18][19][20][21][22][23][24][25][26][27] .…”

Section: Incidence Of Extravasation and The Possibility Of Risk Incrementioning

confidence: 99%

Overview of extravasation management and possibilities for risk reduction based on literature data

Pikó¹,

Laczó²,

Szatmári³

et al. 2013

JNEP

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Background: The escape of cytostatic drugs from the blood vessels (paravasation, extravasation) during peripheral intravenous administration is a relatively frequent complication; in the United States of America it is reported in seven percent of cases with different severity and consequences. Although methods to completely avoid this complication are still unavailable, we are able to decrease its risk by identifying the patient and procedure-related factors. Methods:In this article the risk factors of extravasation, its prevention possibilities and in case of its development the available treatment choices will be reviewed based on the relevant literature data. Conclusion:The patient -if he/she was adequately informed -is a good indicator of extravasation therefore in case of patient's cooperation was not reliable due to any reason a closer nursing surveillance is required. The severity of tissue injury depends mainly on the chemical structure of the substance escaping from the blood vessels into the surrounding tissues (vesicant, irritant or non-vesicant) which may be modified by other factors as well. There are no high-level evidences available for the management of this complication, immediate discontinuation of the infusion and making an attempt to draw back the escaped drug through the cannula, elevation and immobilization of the affected extremity are required. Literature is contradictory about cooling or warming of the affected area and similarly there are still open questions regarding the value of using antidotes (dexrazoxane, dimethylsulfoxide, thiosulfate and hyaluronidase). If extravasation occurs early referral to dermatologist and surgeon is inevitable for definitive diagnosis and choosing the optimal management.

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Complications of venous access ports in 132 patients with disseminated testicular cancer treated with polychemotherapy.

Cited by 67 publications

References 35 publications

Effective combination chemotherapy with paclitaxel and cisplatin with or without human granulocyte colony-stimulating factor and/or erythropoietin in patients with advanced gastric cancer

Effective combination chemotherapy with paclitaxel and cisplatin with or without human granulocyte colony-stimulating factor and/or erythropoietin in patients with advanced gastric cancer

Wszczepialne systemy dostępu naczyniowego u chorych na nowotwory

Overview of extravasation management and possibilities for risk reduction based on literature data

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