Treatment interruptions and complications with two continuous hepatic artery floxuridine infusion systems in colorectal liver metastases.
Continuous hepatic artery floxuridine infusion benefits patients with colorectal liver metastases. Implanted infusion pumps are more expensive but may result in fewer treatment interruptions than when using an external pump connected to a port. We have assessed device-related complications, treatment interruptions and added nurse interventions in 95 patients undergoing a total of 959 treatment cycles via either implanted pump (64 patients) or port (31 patients). Compared with the implanted pump, the port was associated with a significant increase (P < 0.003) in catheter blockage (24/31 vs 2/64 patients), treatment interruption (15/265 vs 12/694 treatments) and added nurse intervention (80/265 vs 20/694 treatments). Survival in patients with colorectal liver metastases is limited and the complications of treatment should be kept to a minimum. An implanted subcutaneous infusion pump offers the benefit of a 3-fold lower incidence of treatment interruption and a 30-fold lower incidence of catheter blockage than when continuous infusion chemotherapy is given via an external infusion device.
Fordy
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Department of Surgery, Charing Cross and Westminster Medical School, Chelsea and Westminster Hospital, London, UK.
Burke
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Earlam
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Twort
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Allen-Mersh
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D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D005467:Floxuridine / Q000008:administration & dosage*; D006499:Hepatic Artery; D006801:Humans; D015918:Infusion Pumps, Implantable / Q000009:adverse effects*; D007261:Infusions, Intra-Arterial / Q000009:adverse effects*; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary*
D000964:Antimetabolites, Antineoplastic; D005467:Floxuridine