Last year in the UK over 60,000 cancer patients enrolled on clinical trials aimed at improving cancer treatments and making them available to all.
A study comparing 2 different types of central lines in people due to start a course of chemotherapy
Please note - this trial is no longer recruiting patients. We hope to add results when they are available.
This study is comparing different ways of giving chemotherapy using devices called portacaths and Hickman lines to look at the overall health and cost benefit. The trial is for people having treatment at Inverclyde Royal Infirmary or the Beatson West of Scotland Cancer Centre in Glasgow.
You usually have chemotherapy through a drip into a vein, through a small, thin plastic tube (cannula) into a vein in your hand or arm. Your nurse takes the cannula out after each treatment. But if you are having chemotherapy over a long period, you may have a device put in that stays in one of your veins for as long as it is needed. Examples of these are Hickman lines and portacaths.
A portacath is a small chamber that sits under the skin of your chest, with a tube running into a vein in your chest. It is completely enclosed in your body, and only usually possible to see under the skin if you are very thin. The nurse can take blood or connect you to a drip by putting a special needle into this chamber that can stay in place for as long as needed. A Hickman line is a tube that also sits in a vein in your chest, but the other end of the tube comes out onto your chest so that it can be connected to a drip.
Doctors use portacaths less often because they are a little more complicated to put in than Hickman lines, and much more expensive. But portacaths may be better. Several studies suggest that there is less risk of the device getting infected and having to be replaced. There may also be an improvement in quality of life. This study will compare Hickman lines with portacaths. The aim is to assess the overall health and cost benefit in patients who are given a Hickman line compared to those given a portacath.
Who can enter
You may be able to enter this study if you
- Have cancer
- Are due to have chemotherapy at Inverclyde Royal Infirmary or the Beatson West of Scotland Cancer Centre, Glasgow
- Are due to have a central line put in
- Are willing and able to have either a Hickman line or a portacath
- Are at least 18 years old
You cannot enter this study if you have any other medical condition or mental health condition that may make you unwell if you took part, or affect the results of the study – you can check this with your doctor.
Everyone will complete a short questionnaire at the start of the study, and then every month as long as the device is in place. The questionnaire will ask about any side effects you have had and about how you have been feeling. This is called a quality of life study.
The 75 people randomised to join group A will have a Hickman line. The 25 people randomised to join group B will have a portacath.
So, you have a 1 in 4 chance of having a portacath, and a 3 in 4 chance of having a Hickman line.
On the day of the procedure, you must not eat or drink for 4 hours before your appointment.
Before the procedure, you may have an antibiotic injection though a needle in your hand. If your platelet count is low, you may also have a drip containing platelets (a platelet transfusion). This will help your blood to clot during and after the procedure. You lie on a trolley which will be tilted slightly so that your head is lower than your feet, and then have a local anaesthetic. If you are anxious about the procedure, you can ask to have medicine to help you relax.
The doctor or nurse will then make small cuts in your skin and put in your Hickman line or portacath. If you have a Hickman line, they may use an ultrasound or continuous X-ray to help them guide the tube into the right place. You will have some stitches to close the skin where the Hickman line or portacath was put in. Some stitches dissolve, but your nurse will remove the others when your skin has healed.
With both procedures, you have an X-ray afterwards to check that everything is in place. Both procedures take about 30 to 45 minutes. You can watch a short animation showing how a Hickman line is put in.
There is one extra visit to hospital as part of this study, to talk to the study team and complete a short questionnaire.
You may have some discomfort where your Hickman line or portacath was put in, but this should fade after a few hours.
Complications of Hickman lines and portacaths include the risk of blockage with blood clots, or a risk of infection. Your doctor may prescribe a low dose of warfarin to help prevent blood clots, and antibiotics to treat infection. But sometimes if the problem cannot be cleared up, you may have to have the device removed.
The team will give you an information sheet to help you spot possible problems, as well as who to contact if you are worried about your Hickman line or portacath.
How to join a clinical trial
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Professor Jon Moss
Cancer Research UK Clinical Trials Unit
Chief Scientist Office (CSO)
NHS Greater Glasgow and Clyde
National Institute for Health Research Cancer Research Network (NCRN)