Vascular access in chemotherapy of locally advanced or advanced soft tissue sarcomas and osteosarcomas
Delivering of chemotherapy for locally advanced or advanced soft tissue sarcomas and osteosarcomas patients has become infeasible without providing for pertinent vascular access. A majority of recent chemotherapeutic agents are either vesicants or irritants agents and therefore require special options for their intravascular administration, which provides for the most effective and safest systemic or regional effect. A number of various issues, associated with intravascular drug administration as a part of present sarcoma treatment regimes and providing of long-term vascular access for better quality of life of cancer patients is discussed in this article. Experience and techniques of insertion and maintenance of various types of vascular access systems, performed in N.N. Blokhin Russian Cancer Research Centre, are described in the article. Subcutaneous implantation of port - a totally implantable central venous access device designed for multiple intermittent infusions - is indicated in order to facilitate drug administration, avoiding extravasation, phlebitis and other complications, associated with systemic and regional chemotherapy.