Conservative approach to the treatment of chemotherapy-induced extravasation.
One of the local complications of certain chemotherapeutic agents is tissue necrosis resulting from extravasation. The purpose of this study was to evaluate the effectiveness of a conservative approach to treatment in order to minimize necrosis and the need for reconstructive surgery. Fifty-three patients entered this study. Twenty-one had old lesions while 32 had recent extravasations. Drugs responsible for the extravasations were doxorubicin, epirubicin, vinblastine, mitoxantrone, and mitomycin C. The basis of treatment was betamethasone ointment, which was applied to the lesion with a tight elastic bandage and was replaced every 12 hours for the first 2 days and then every 24 hours until complete healing. For old lesions a keratolytic ointment was initially applied, whereas in the new lesions multiple subcutaneous injections with hydrocortisone solution preceded the application of betamethasone ointment. None of our patients developed tissue necrosis and sloughing that necessitated surgery. All lesions healed in patients. Healing time varied with the different drugs used and was proportional to the extension of extravasation and to the time when therapy was begun. We conclude that the application of conservative measures in extravasated areas from chemotherapy may avoid tissue necrosis and reconstructive surgery.
Tsavaris
N B
NB
Second Department of Medical Oncology, Metaxas Cancer Hospital, Piraeus, Greece.
Karagiaouris
P
P
Tzannou
I
I
Komitsopoulou
P
P
Bacoyiannis
C
C
Karabellis
A
A
Papanicolaou
V
V
Mylonakis
N
N
Karvounis
N
N
Zoannou
A
A
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001623:Betamethasone / Q000627:therapeutic use; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000473:pathology*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D008937:Mitomycins / Q000008:administration & dosage / Q000009:adverse effects; D008942:Mitoxantrone / Q000008:administration & dosage / Q000009:adverse effects; D012871:Skin Diseases / Q000139:chemically induced / Q000188:drug therapy* / Q000473:pathology; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects
D000970:Antineoplastic Agents; D008937:Mitomycins; D015251:Epirubicin; D014747:Vinblastine; D004317:Doxorubicin; D001623:Betamethasone; D008942:Mitoxantrone