The delivery of cancer chemotherapy by constant venous infusion ambulatory management of venous access and portable pump

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Abstract
Fifty chemotherapy trials with 5-fluorouracil;31 mitomycin C;9 vinblastine;3 Adriamycin;5 and cis-platinol2 were initiated employing constant (24-hour) intravenous infusion for protracted periods (14–94 days). The use of the tunneled subclavian line for greater than 2200 patient days was associated with minimal complications and no instances of thrombosis or infection were observed. The use of an ambulatory infusion pump was associated with a pump efficiency of greater than 85% in 38 of 39 evaluable trials. Only four of 50 trials were associated with excess drug infusion and in no instance was a drug complication encountered. Constant infusion cancer chemotherapy is feasible, reliable, and safe. Objective tumor regression is observed but the superiority of this drug schedule over the standard intermittent bolus schedule is yet to be determined. Nonetheless, drug toxicity patterns are altered substantially and, in particular, gastrointestinal side effects of chemotherapeutic drugs may be eliminated without compromising cumulative dose.