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Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol

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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.

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Acknowledgments

We are grateful to Christoph Kornauth for his contribution to the histopathological examination of resected specimens. The authors would also like to acknowledge the valuable contribution of Simone Messner who provided the infusion statistics of the General Hospital/University Clinics Vienna.

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We declare that we have no conflict of interest.

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Correspondence to Robert M. Mader.

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Pluschnig, U., Haslik, W., Bayer, G. et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer 23, 1741–1748 (2015). https://doi.org/10.1007/s00520-014-2535-2

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  • DOI: https://doi.org/10.1007/s00520-014-2535-2

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