Extravasation associated with cancer drug therapy: multidisciplinary guideline of the Japanese Society of Cancer Nursing, Japanese Society of Medical Oncology, and Japanese Society of Pharmaceutical Oncology

Midline catheter use for cancer patients receiving 5-FU chemotherapy: prospective study of safety and outcomes

BACKGROUND

Peripheral intravenous 5-fluorouracil (5-FU) administration often causes phlebitis and necessitates catheter replacement, imposing burdens on both patients and healthcare providers. Insertion of a midline catheter (MLC) into the upper arm with tip positioned in the axillary vein may reduce the incidence of phlebitis. This study evaluated the safety and effectiveness of MLC use for continuous 5-FU infusion in cancer patients.

METHODS

This prospective study included patients with cancer requiring at least 4 days of continuous 5-FU infusion. The primary endpoint was the incidence of phlebitis. Secondary endpoints were the success rate of MLC insertion, complications, and patient-reported outcomes.

RESULTS

Of the 61 patients enrolled, 59 were included in the analysis. The median age was 68 years, and primary cancer types were esophageal (51%) and head and neck (46%). The median MLC indwelling duration was 5.5 days (2-28 days). No phlebitis was observed (0%, 95% CI: 0-6.2), achieving the primary endpoint. The insertion success rate was 98.3%, with complications in 6.8%. Over 90% of patients and 80% of healthcare providers reported high satisfaction levels.

CONCLUSION

MLC insertion is a safe and effective approach for continuous 5-FU infusion, eliminating phlebitis, potentially improving patients' quality of life, and reducing healthcare providers' workloads. (ClinicalTrials.gov Identifier: jRCTs042230058).