Clinical effect and safety of venous access ports and peripherally inserted central catheters in patients receiving tumor chemotherapy: a systematic review and meta-analysis

Background: To evaluate the effects and safety of peripherally inserted central catheters (PICCs) and venous access ports (PORTs) for cancer patients receiving chemotherapy. Methods: We searched randomized controlled trials and retrospective cohort studies comparing PICCs to PORTs in cancer patients receiving chemotherapy. Data were extracted from relevant studies. We sought to evaluate procedure time, quality of life and thrombosis [risk ratio (RR) =4.37, 95% CI, 2.10, 9.07, P<0.0001, I-2=22%]. Sensitivity analysis and the funnel plot showed that our study was robust and exhibited low publication bias. Results: Ten previous studies were incorporated into this study for a total sample size of 2,585 patients. There was no difference between the PICC and PORT groups in QOL (MD =-1.12, 95% CI, -6.14, 3.91, P=0.66, fixed effect model, I-2 =32%). PORT required a longer procedure time than the PICC procedure (the overall MD was -5.55 with 95% CI, -6.96, -4.14, I-2=0%), and PICCs had more associated complications than PORTs including occlusion (MD =5.42, 95% CI, 2.13, 13.75, P=0.0004, I-2=40%) and thrombosis (risk ratio (RR) =4.37, 95% CI, 2.10, 9.07, P<0.0001, I-2=22%). Sensitivity analysis and the funnel plot showed that our study was robust and exhibited low publication bias. Discussion: Our study suggested that PORTs had similar clinical effects to PICCs in cancer patients receiving chemotherapy. However, PORTs were associated with fewer complications than PICCs.