Impact of home-based port infusion versus hospital-based peripheral infusion on anxiety, quality of life, and emergency visits in gastrointestinal cancer: a prospective observational study by the Turkish Oncology Group (TOG)

Home-based chemotherapy via port catheters offers logistical and potential psychological benefits but may pose unique challenges for patients undergoing prolonged regimens such as mFOLFOX6. Evidence on the association between home-based infusion and anxiety, quality of life, and healthcare use in gastrointestinal (GI) cancer patients remains limited. In this prospective study, 190 GI cancer patients scheduled for adjuvant mFOLFOX6 were enrolled between July 2020 and December 2024. Patients chose either home-based port infusion (n = 94) or hospital-based peripheral infusion (n = 96). Anxiety was assessed using the State-Trait Anxiety Inventory (STAI-1 and STAI-2), and quality of life via EORTC QLQ-C30 at baseline, after six cycles (~3 months), and after 12 cycles (~6 months). Treatment-related toxicities and emergency visits were recorded. Logistic regression identified factors associated with high anxiety, low quality of life, and emergency visits. Baseline characteristics were similar between groups except for younger age in the home-based group, which lost significance after Bonferroni correction. After six cycles, home-based patients showed significantly higher state and trait anxiety than hospital-based patients (p < 0.001), though differences diminished by 12 cycles. Home-based patients also reported worse dyspnea, pain, fatigue, and nausea/vomiting after six cycles, with most symptoms improving later. Emergency visits without organic pathology were more frequent in the home-based group (32% vs. 13%, p = 0.002), although this difference did not remain statistically significant after Bonferroni correction. Multivariable analysis identified home-based infusion, living alone, social inactivity, shorter treatment duration, and low quality of life as independent factors associated with high state anxiety. Similar factors were associated with high trait anxiety, low quality of life, and emergency visits. Home-based port infusion for mFOLFOX6 is associated with transient increases in anxiety and impairments in quality of life early in treatment, which diminished by the end of treatment. Psychosocial support and close follow-up may help reduce anxiety and unnecessary emergency visits, particularly for socially isolated patients. Further randomized studies are warranted.