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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2020.1008    [Accepted]
Safety, Efficacy, and Patient Satisfaction with Initial Peripherally Inserted Central Catheters Compared with Usual Intravenous Access in Terminally Ill Cancer Patients: A Randomized Phase II Study
Eun Ju Park1, Kwonoh Park2, Jae-Joon Kim2, Sang-Bo Oh2, Ki Sun Jung2, So Yeon Oh2, Yun Jeong Hong3, Jin Hyeok Kim4, Joo Yeon Jang4, Ung-Bae Jeon4
1Department of Family Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
2Medical Oncology and Hematology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
3Department of Neurology, Uijeongbu St. Mary’s Hospital, Catholic University of Korea, Uijeongbu, Korea
4Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea

*This study was presented in part at the ESMO Virtual Congress 2020, 19 September - 21 September 2020.
Correspondence  Kwonoh Park ,Tel: 82-055-360-2366, Email: parkkoh@daum.net
Received: October 4, 2020;  Accepted: December 21, 2020.  Published online: December 22, 2020.
ABSTRACT
Purpose
The purpose of this study was to investigate whether routine insertion of PICC at admission to a hospice-palliative care (HPC) unit is acceptable in terms of safety and efficacy and whether it results in superior patient satisfaction compared to usual IV access.
Materials and Methods
Terminally ill cancer patients were randomly assigned to two arms: routine PICC access and usual IV access arm. The primary endpoint was IV maintenance success rate, defined as the rate of functional IV maintenance until the intended time (discharge, transfer, or death).
Results
A total of 66 terminally ill cancer patients were enrolled and randomized to study arms. Among them, 57 patients (routine PICC, 29; usual IV, 28) were analyzed. In the routine PICC arm, mean time to PICC was 0.84 (range, 0-3) days, 27 patients maintained PICC with function until the intended time. In the usual IV arm, 11 patients maintained peripheral IV access until the intended time, and 15 patients underwent PICC insertion. The IV maintenance success rate in the routine PICC arm (27/29, 93.1%) was similar to that in the usual IV arm (26/28, 92.8%, p=0.958). Patient satisfaction at day 5 was better in the routine PICC arm (97%, ‘a little comfort’ or ‘much comfort’) compared with the usual IV arm (21%) (p <0.001).
Conclusion
Routine PICC insertion in terminally ill cancer patients was comparable in safety and efficacy and resulted in superior satisfaction compared with usual IV access. Thus, routine PICC insertion could be considered at admission to the HPC unit (NCT03299868).
Key words: Peripherally inserted central catheter, Terminally ill cancer patients, Palliative care
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