Background Cytostatic extravasation is the inadvertent leakage of intravenous anticancer agents out of the vein into surrounding tissue. Extravasation is only considered to be problematic with chemotherapy drugs known to have irritant or vesicant attributes. Depending on the substance that is extravasated into the tissue, the degree of injury can range from a very mild skin reaction to severe necrosis.
Purpose To evaluate the incidence, types of anticancer agents involved and consequences of extravasation.
Material and methods Observational, retrospective study, from March 2010 to October 2015, of all patients who suffered an extravasation during the infusion of chemotherapy drugs in a tertiary hospital.
Data were obtained from the electronic medical history and the extravasation database. Data collected were demographics, date of extravasation, type of cytostatic agent infused, infusion time until extravasation, extravasation area and local reactions.
Results The study included 24 patients (58.3% males), mean age 62.7 years (18–81). All extravasations were resolved by following the procedures of the extravasation protocol established in our hospital. Among 61 463 patients who received chemotherapy, 24 (0.04%) experienced extravasation.
The chemotherapy drugs involved in the extravasation were paclitaxel (7), etoposide (4), oxaliplatin (3), docetaxel (3), carboplatin (2), vinorelbine (2), dacarbazine (2), 5-fluorouracil (1) and cisplatin (1). According to the ESMO–EONS Clinical Practice Guidelines, 15 drugs were irritants and 9 vesicants.
The mean duration between the start of infusion and extravasation was 46 min (2–240). The average extravasation area was 22.1 cm2 (4–84). Of the 24 patients, 20 experienced induration or swelling at the injection site, 11 erythema, 4 pain and 1 burning.
The incidence of extravasation in our study was very low (0.04%). This result agrees with other incidence rates published in several studies, which vary greatly from 0.01% to 7%.
All extravasations were cured without surgical intervention by management according to our guidelines.
Despite the irritants and vesicants of the chemotherapy drugs involved, patients only suffered mild skin reactions.
References and/or Acknowledgements
Management of chemotherapy extravasation: ESMO–EONS Clinical Practice Guidelines. Ann Oncol 2012;23(Suppl 7):vii167–vii173, doi:10.1093/annonc/mds294.
References and/or AcknowledgementsNo conflict of interest.
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