References:
General Hematology/Oncology
- He, E. et al. Clinical Effect and Safety of Venous Access Ports and Peripherally Inserted Central Catheters in Patients Receiving Tumor Chemotherapy: A Systematic Review and Meta-Analysis. Ann Palliat Med 2021.
- A systematic review and meta-analysis of 2,585 patients with cancer receiving either a PICC or PORT for chemotherapy. PORTs had similar clinical effects to PICCs in cancer patients receiving chemotherapy. However, PICCs had more complications that PORTs, including occlusion and thrombosis risk.
- Lin, B. et al. Peripherally Inserted Central Catheters Versus Implantable Port Catheters For Cancer Patients: A Meta Analysis. Front Oncol 2023.
- A systematic review and meta-analysis including 22 studies including patients with cancer receiving chemotherapy either through a PICC or an implanted vascular access port. The results suggested that ports have a superior safety profile, with lower incidences of overall adverse effects, catheter-related thrombosis, and allergic reactions than typically expected with PICC. Additionally, PICC was non-inferior to ports with respect to DVT and infection.
- Moss, J et al. Central Venous Access Devices for the Delivery of Systemic Anticancer Therapy (CAVA): A Randomised Controlled Trial. Lancet 2021.
- Open-label, multi-center randomized controlled trial of 1,061 adult patients receiving systemic anticancer treatment (SACT) for solid or hematological malignancy via PICCs vs Hickman vs Ports. Findings suggest that for most patients receiving SACT, Ports are more effective and safer than both Hickman and PICCs.
- Pu, Y. et al. Complications and Costs of Peripherally Inserted Central Venous Catheters Compared with Implantable Port Catheters for Cancer Patients: A Meta-Analysis. Cancer Nursing 2020.
- A meta-analysis of 15 articles of patients with PICCs and implantable port catheters (IPC) in place for patients with cancer receiving chemotherapy. PICC use was associated with higher complication rates than IPC, including occlusion, infection, malposition, catheter-related thrombosis, extravasation, phlebitis, and accidental removal rate. The life span of IPC was longer than that of PICC, and the costs of IPC were lower.
- Sheng Y. et al. Implementation of Tunneled Peripherally Inserted Central Catheters Placement in Cancer Patients: A Randomized Multicenter Study. Clin Nurs Res 2024
- 694 patients who needed PICC placement were randomized to either a tunneled PICC group (experimental group) or non-tunneled PICC group (control group). After 6 months of follow-up, the tunneled PICCs group showed a significant decrease in the frequency of total complications, especially in infection (3.0% vs. 7.1%, p = .021) and catheter-related thrombosis (3.3% vs. 8.3%, p = .008), although approximately 0.5 ml bleeding and 3.5 min time were increased.
- Sun, Y. et al. Complications of Implanted Port Catheters and Peripherally Inserted Central Catheters in Chemotherapy-Treated Cancer Patients: A Meta-Analysis. Adv Clin Exp Med 2023.
- A meta-analysis of 11,801 patients in 28 articles. These patients were receiving chemotherapy via either PICCs or implanted port catheter. PICCs had significantly higher incidence of occlusion complications, longer durations of local infection, higher incidence of catheter-related infection, higher rate of malposition, higher rates of catheter-related thrombosis, higher incidence of phlebitis complications, higher incidence of accidental removal, and a shorter catheter lifespan in subjects undergoing chemotherapy compared to those in whom implanted port catheters were used.
- Yeow, M. et al. A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials on Choice of Central Venous Access Device for Delivery of Chemotherapy. J Vasc Surg Venous Lymphat Disord 2022.
- A meta-analysis of 11 articles of patients receiving chemotherapy via non-tunneled central venous catheter, PICC, totally implantable venous access ports (TIVAPs) and tunneled CVC. All articles included in the meta-analysis were randomized controlled trials. TIVAPs were found to be superior in terms of complications and quality of life compared with other CVADs, without compromising cost-effectiveness, and should be considered the standard of care for patients receiving chemotherapy.
Acute Leukemia/Aggressive Lymphoma
- Picardi, M. et al. A Frontline Approach with Peripherally Inserted Versus Centrally Inserted Central Venous Catheters for Remission Induction Chemotherapy Phase of Acute Myeloid Leukemia: A Randomized Comparison Clin Lymphoma Myeloma Leuk 2019.
- A randomized trial of patients with previously untreated acute myeloid leukemia (AML) in patients receiving a PICC (N=46) and centrally inserted central catheters (N=47). The use of a PICC is safer than that of a CICC and maintains the effectiveness for patients with AML undergoing chemotherapy, with an approximate fourfold lower combined risk of infection or thrombosis at 30 days.
Solid Tumor Malignancy
- Clatot, F. et al. Randomised Phase II Trial Evaluating the Safety of Peripherally Inserted Catheters Versus Implanted Port Catheters During Adjuvant Chemotherapy in Patients with Early Breast Cancer. Eur J Cancer 2020.
- A randomized trial of patients with early breast cancer (EBC) who were eligible for adjuvant chemotherapy. Catheter-related significant adverse events (CR-SAE) in patients with EBC are frequent but rarely impact the adjuvant chemotherapy process. Compared with PORTs, PICCs are associated with a significantly higher risk of CR-SAEs and more discomfort.
- Liu, Y. et al. Comparison Between Arm Port and Chest Port for Optimal Vascular Access Port in Patients with Breast Cancer: A Systematic Review and Meta-Analysis. Biomed Res Int 2020.
- A meta-analysis and systematic review of 22 articles (6 comparative studies and 16 single-arm studies) involving 4,131 cases and 5,272 controls. Included patients had breast cancer and were receiving treatment via a chest port or arm port. This study indicated that an arm port might increase the risk of overall complications, as well as risk of catheter-related thrombosis compared to a chest port.
- Peng, SY. et al. A Model to Assess the Risk of Peripherally Inserted Central Venous Catheter-Related Thrombosis in Patients with Breast Cancer: A Retrospective Cohort Study. Support Care Cancer 2021.
- Study developed a model to assess the risk of PICC-related thrombosis. In their cohort, a PICC-related thrombosis occurred in 40/1,284 patients (4.1%). Multivariable analysis identified 9 variables: chronic obstructive pulmonary disease, prior central venous catheter placement, higher level of platelets, higher level of D-dimer, lower level of activated partial thromboplastin time, menopause, no prior breast surgery, upper extremity lymphedema, and endocrine therapy as a predictor for PICC-related thrombosis.