TOP-TRIAL The Safety of Not Flushing the Non-used PORT-A-CATH® in Cancer Patients - a Prospective, Two-arm Phase I Trial, Pilot Trial
Trial Snapshot
- Phase
- Phase 1
- Status
- Terminated
- Sponsor
- Enrollment
- 4
- Locations
- 1
- Primary Endpoint
- incidences of PORT-A-CATH® related events (persistent malfunction, thrombosis, infection)
Study Overview
Brief Summary
The benefits and risks of flushing or not flushing the non-used PORT-A-CATH® in cancer patients and the time interval of eventual PORT-A-CATH® flushing are currently unknown. The manufacturers of PORT-A-CATH® recommend regular flushings every 4 weeks. In clinical practice, the intervals are usually at least three months. Regular flushing might lead to a decreased risk of PORT-A-CATH® thrombosis, but may also lead to an increased infection or thrombosis rate and patients discomfort. Therefore, this study investigates the safety of not flushing the PORT-A-CATH® for 6 or 12 months.
Detailed Description
Currently it is unknown if flushing a non-used PORT-A-CATH® every 4 weeks is a valid strategy to preserve its functioning. Even more, decision to keep the PORT-A-CATH® after completion of adjuvant therapy cannot be based on profound patient information as there exist hardly any data regarding PORT-A-CATH® related complications of non-used PORT-A-CATH®.
The proposed prospective, two arm trial aims to investigate if no flushing of a non-used PORT-A-CATH® over a period of one year has equal PORT-A-CATH® related complications compared to flushing the PORT-A-CATH® every 4 weeks.
The proposed trial also aims to examine the frequencies of PORT-A-CATH® related complications in non-used PORT-A-CATH®. The authors put up the hypothesis that there will be fewer port-a-cath related infections in the experimental arms compared to the infection rate mentioned in the literature up to 27 %, since the puncture of the PORT-A-CATH® and the administration of fluids are the main causes of infection.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Health Services Research
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 90 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Cancer patients in curative setting, with port a cath Implantation for systemic chemotherapy, including neo-adjuvant and adjuvant chemo-immunotherapy and supportive therapy (e.g. parenteral Nutrition)
- •Completion of curative Treatment with port a cath indication, operation included, regardless of a non-intravenous (subcutaneous or oral) given therapy (endocrine therapy, chemo-immunotherapy, radiotherapy)
- •patients with pectoral port a cath systems
- •No port a cath associated complications during curative therapy such as investigated events: persistent malfunction, thrombosis, infection of the port-a-cath (to puncture the port a cath under X-ray control is allowed except it results in diangosis of persistent malfunction)
- •No therapeutic anticoagulant therapy (phenprocoumon/Marcoumar®, heparin)
- •No evidence of metastatic disease
- •≥18 years
- •Willing to participate
Exclusion Criteria
- •No signed informed consent
- •Patients with port a cath systems other than pectoral port a cath systems (e.g. forearm port a cath System)
- •Unable to attend control timepoints
- •Use of the port-a-cath after the above defined curative treatment (within the investigational period)
- •Willing to explant the port-a-cath
- •Willing to become pregnant within one year after adjuvant treatment
- •Patient with heparin-induced Thrombocytopenia (HIT)
Arms & Interventions
6 months
evaluation of PORT-A-CATH®, blocking with Medunasal®-Heparinblock, restoration of PORT-A-CATH® with Alteplase
Intervention: evaluation of PORT-A-CATH® (Procedure)
6 months
evaluation of PORT-A-CATH®, blocking with Medunasal®-Heparinblock, restoration of PORT-A-CATH® with Alteplase
Intervention: blocking with Medunasal®-Heparinblock (Drug)
6 months
evaluation of PORT-A-CATH®, blocking with Medunasal®-Heparinblock, restoration of PORT-A-CATH® with Alteplase
Intervention: restoration of PORT-A-CATH® with Alteplase (Drug)
12 months
evaluation of PORT-A-CATH®, blocking with Medunasal®-Heparinblock, restoration of PORT-A-CATH® with Alteplase
Intervention: evaluation of PORT-A-CATH® (Procedure)
12 months
evaluation of PORT-A-CATH®, blocking with Medunasal®-Heparinblock, restoration of PORT-A-CATH® with Alteplase
Intervention: blocking with Medunasal®-Heparinblock (Drug)
12 months
evaluation of PORT-A-CATH®, blocking with Medunasal®-Heparinblock, restoration of PORT-A-CATH® with Alteplase
Intervention: restoration of PORT-A-CATH® with Alteplase (Drug)
Outcomes
Primary Outcomes
incidences of PORT-A-CATH® related events (persistent malfunction, thrombosis, infection)
Time Frame: 6 or 12 months
Secondary Outcomes
- incidences of restoration of PORT-A-CATH® function by alteplase(6 or 12 months)
- rate of necessary PORT-A-CATH® removal(6 or 12 months)
