Comparison of peripherally inserted central venous catheters (PICC) versus subcutaneously implanted port-chamber catheters by complication and cost for patients receiving chemotherapy for non-haematological malignancies

• Published in: Supportive care in cancer 2014, Vol.22 (1), p.121-128
• Main Authors: Patel, G. S., Jain, K., Kumar, R., Strickland, A. H., Pellegrini, L., Slavotinek, J., Eaton, M., McLeay, W., Price, T., Ly, M., Ullah, S., Koczwara, B., Kichenadasse, G., Karapetis, C. S.
• Format: Article
• Language: English
• Subjects: Aged; Analysis; Antineoplastic Agents - administration & dosage; Australia; Cancer; Catheterization; Catheterization, Central Venous - adverse effects; Catheterization, Central Venous - economics; Catheterization, Central Venous - instrumentation; Catheterization, Peripheral - adverse effects; Catheterization, Peripheral - economics; Catheterization, Peripheral - instrumentation; Catheters; Central Venous Catheters - adverse effects; Central Venous Catheters - economics; Chemotherapy; Comparative studies; Drug delivery systems; Economic aspects; Female; Health care expenditures; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasms - blood; Neoplasms - drug therapy; Neoplasms - economics; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Quality of Life; Rehabilitation Medicine; Survival Rate; Thrombosis - economics; Thrombosis - etiology; Vascular Access Devices - adverse effects; Vascular Access Devices - economics
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-013-1941-1

Purpose Indwelling central venous catheters (CVCs) have been increasingly used to enable delivery of intravenous chemotherapy. We aimed to compare the safety and cost of two commonly used CVCs, peripherally inserted central venous catheter (PICCs) and ports, in the delivery of chemotherapy in patients with non-haematological malignancies. Methods Seventy patients were randomly assigned to receive either a PICC or a port. The primary endpoint was occurrence of major complications, which required removal of the CVC and secondary endpoints included occurrence of any complications. Results Port devices were associated with fewer complications compared with PICC lines (hazard ratio of 0.25, CI, 0.09–0.86, P  = 0.038). Major complication rate was lower in the port arm compared to the PICC arm (0.047 versus 0.193 major complications/100 catheter days, P  = 0.034) with 6 versus 20 % of patients experiencing major complications, respectively. Thrombosis, the most common complication, was significantly higher in the PICC arm compared to the port arm (25 versus 0 %, P  = 0.013). Quality of life and cost estimates did not differ significantly between the two arms. Conclusions Port devices are associated with a lower risk of complications, with no difference in cost, compared to PICC lines in patients with non-haematological malignancies receiving intravenous chemotherapy.