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- Title
Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol.
- Authors
Pluschnig, Ursula; Haslik, Werner; Bayer, Günther; Soleiman, Afschin; Bartsch, Rupert; Lamm, Wolfgang; Steger, Günther; Zielinski, Christoph; Mader, Robert
- Abstract
Purpose: In a longitudinal observation, extravasation of antitumoural compounds and the efficacy of its structured interdisciplinary management were assessed in a routine setting. Methods: One hundred sixty-nine patients with extravasation of cytotoxics were managed according to a prospective approach documenting the extravasated compound, localisation, duration until full symptom resolution and sequelae. Surgery was implemented in the case of failure of conservative measures. Results: In 155 (91.7 %) out of 169 patients, conservative management was successful (surgical intervention, 14 patients). Extravasations of anthracyclines ( N = 44), platinum compounds ( N = 41), vinca alkaloids ( N = 20) and taxanes ( N = 19) were often associated with erythema, oedema and pain. The median period until full resolution of symptoms differed among the administered cytotoxics (anthracyclines, 55 days; taxanes and vinca alkaloids, 27 days; platinum compounds, 14 days) with statistical significance between the vesicants. Histologically, surgically resected specimens showed extensive necrotic areas with inflammatory infiltrates at the periphery of the removed lesions. Conclusions: In a routine setting, the standardised management of cytotoxic extravasations by an interdisciplinary task force resulted in a satisfactory outcome. When surgical intervention was indicated, complete remission of the lesions within a median of 14 days reduced the delay in the administration of further chemotherapy to a minimum. The proposed approach is therefore considered as suitable to manage extravasations in cancer chemotherapy in a large number of subjects and to ensure patient adherence to cytotoxic treatment.
- Subjects
PHYSIOLOGICAL effects of chemotherapy; TREATMENT effectiveness; EXTRAVASATION; DISEASE management; MEDICAL protocols; ANTINEOPLASTIC agents; MEDICAL care
- Publication
Supportive Care in Cancer, 2015, Vol 23, Issue 6, p1741
- ISSN
0941-4355
- Publication type
Article
- DOI
10.1007/s00520-014-2535-2