ADMINISTRATION OF CHEMOTHERAPEUTIC-AGENTS - TECHNIQUES AND CONTROVERSIES

Safe and pain-free vascular access is now the achievable goal for ever y patient receiving systemic chemotherapy. The dis comfort and anxiety that used to accompany multiple (often unsuccessful) venipunctures ca n be avoided by placement of a longterm central-venous-access device a s part of the patient's early treatment plan. In the United States, ap proximately 5 x 10(5) such devices are now inserted each year. This re view discusses and compares the different types of devices currently a vailable, methods of insertion, and management of morbidity. Future st udies should focus on the cost effectiveness of these devices, better selection of patients for the various types of access, and avoidance, recognition, and treatment of complications.