Chu, E., Haller, D., Cartwright, T., Twelves, C., Cassidy, J., Sun, W., Saif, M.W., McKenna, E., Lee, S. and Schmoll, H.-J. (2014) Epidemiology and natural history of central venous access device use and infusion pump function in the NO16966 trial. British Journal of Cancer, 110(6), pp. 1438-1445. (doi: 10.1038/bjc.2014.74)
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Abstract
Background: Central venous access devices in fluoropyrimidine therapy are associated with complications; however, reliable data are lacking regarding their natural history, associated complications and infusion pump performance in patients with metastatic colorectal cancer.<p></p> Methods: We assessed device placement, use during treatment, associated clinical outcomes and infusion pump perfomance in the NO16966 trial.<p></p> Results: Device replacement was more common with FOLFOX-4 (5-fluorouracil (5-FU)+oxaliplatin) than XELOX (capecitabine+oxaliplatin) (14.1% vs 5.1%). Baseline device-associated events and post-baseline removal-/placement-related events occurred more frequently with FOLFOX-4 than XELOX (11.5% vs 2.4% and 8.5% vs 2.1%). Pump malfunctions, primarily infusion accelerations in 16% of patients, occurred within 1.6–4.3% of cycles. Fluoropyrimidine-associated grade 3/4 toxicity was increased in FOLFOX-4-treated patients experiencing a malfunction compared with those who did not (97 out of 155 vs 452 out of 825 patients), predominantly with increased grade 3/4 neutropenia (53.5% vs 39.8%). Febrile neutropenia rates were comparable between patient cohorts±malfunction. Efficacy outcomes were similar in patient cohorts±malfunction.<p></p> Conclusions: Central venous access device removal or replacement was common and more frequent in patients receiving FOLFOX-4. Pump malfunctions were also common and were associated with increased rates of grade 3/4 haematological adverse events. Oral fluoropyrimidine-based regimens may be preferable to infusional 5-FU based on these findings.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Cassidy, Professor James |
Authors: | Chu, E., Haller, D., Cartwright, T., Twelves, C., Cassidy, J., Sun, W., Saif, M.W., McKenna, E., Lee, S., and Schmoll, H.-J. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cancer Sciences |
Journal Name: | British Journal of Cancer |
Publisher: | Nature Publishing Group |
ISSN: | 0007-0920 |
ISSN (Online): | 1532-1827 |
Copyright Holders: | Copyright © 2014 Cancer Research UK |
First Published: | First published in British Journal of Cancer 110(6):1438-1445 |
Publisher Policy: | Reproduced under a Creative Commons License |
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