(1) Background: Central venous access devices (CVADs) have been commonly employed during various courses of anticancer treatment. Currently, there are a few types of clinically available CVADs, which are associated with short-term and long-term complications. However, little is known about the complication rates when CVADs are used only in palliative care settings. We therefore performed a systematic review and meta-analysis of all the published literature to evaluate the complication rates of CVADs in this clinical setting. (2) Methods: A systematic review and meta-analysis were conducted to identify publications from PubMed/MEDLINE, Embase (Ovid), Scopus, Cochrane Library, CINAHL, Google Scholar, and trial registries. Publications reporting the complication rates of PICCs, central lines, and PORTs in palliative settings for terminally ill cancer patients were included, while those on the use of systemic anticancer therapy and peripheral venous catheters were excluded. The outcome measures included overall complication rate, rate of catheter-related bloodstream infection (CRBSI), and rate of thromboembolism (TE). This systematic review was registered with PROSPERO (CRD42023404489). (3) Results: Five publications with 327 patients were analyzed, including four studies on PICCs and one study on central lines. No studies on PORTs were eligible for analysis. The overall complication rate for PICCs (pooled estimate 7.02%, 95% CI 0.27–19.10) was higher than that for central lines (1.44%, 95% CI 0.30–4.14,p= 0.002). The risk of CRBSI with PICCs (2.03%, 95% CI 0.00–9.62) was also higher than that with central lines (0.96%, 95% CI 0.12–3.41,p= 0.046). PICCs also had a trend of a higher risk of TE (2.10%, 95% CI 0.00–12.22) compared to central lines (0.48%, 95% CI 0.01–2.64,p= 0.061). (4) Conclusions: PICCs for palliative cancer care were found to have greater complications than central lines. This might aid in the formulation of future recommendation guidelines on the choice of CVAD in this setting.
（1）背景：中心静脉通路装置（CVADs）在各类抗癌治疗过程中已被广泛应用。目前临床上有多种类型的CVADs，它们均伴随短期及长期并发症风险。然而，关于CVADs在姑息治疗场景中单独使用时的并发症发生率，目前认知尚不充分。为此，我们对已发表文献进行了系统性综述与荟萃分析，旨在评估该临床情境下CVADs的并发症发生率。 （2）方法：本研究通过系统性检索PubMed/MEDLINE、Embase（Ovid）、Scopus、Cochrane Library、CINAHL、Google Scholar及临床试验注册库，筛选相关文献。纳入标准为报道终末期癌症患者姑息治疗中使用经外周静脉置入中心静脉导管（PICCs）、中心静脉导管及输液港（PORTs）并发症发生率的研究，排除涉及全身抗癌治疗及外周静脉导管的研究。结局指标包括总体并发症发生率、导管相关性血流感染（CRBSI）发生率及血栓栓塞（TE）发生率。本系统综述已在PROSPERO平台注册（注册号CRD42023404489）。 （3）结果：共纳入5篇文献（涉及327例患者），其中4项研究针对PICCs，1项研究针对中心静脉导管，未发现符合分析条件的PORTs相关研究。PICCs的总体并发症发生率（合并估计值7.02%，95% CI 0.27–19.10）显著高于中心静脉导管（1.44%，95% CI 0.30–4.14，p=0.002）。PICCs的CRBSI风险（2.03%，95% CI 0.00–9.62）亦高于中心静脉导管（0.96%，95% CI 0.12–3.41，p=0.046）。与中心静脉导管相比，PICCs的血栓栓塞风险（2.10%，95% CI 0.00–12.22）亦呈现升高趋势（0.48%，95% CI 0.01–2.64，p=0.061）。 （4）结论：在癌症姑息治疗中，PICCs相较于中心静脉导管具有更高的并发症风险。这一发现可能为未来制定该场景下CVAD选择的相关推荐指南提供依据。
肿瘤(癌症)患者之家