[Extravasation of cytostatic agents: a serious complication of oncological treatment].
The extravasation of cytostatic agents is a known, serious situation that can easily occur and cause chronic, irreversible damage. The incidence of extravasation ranges from 0.1 %-6.5 %, according to different studies. Many cases of extravasation can be prevented by systematizing the administration techniques for cytostatic agents. We present the clinical and histological characteristics of a series of patients with extravasation lesions. Included in the study were all patients treated with chemotherapy who developed localized lesions in the area of the cytostatic injection after extravasation was detected during administration. The patients were studied and followed up for a three-year period, from January 2000 to December 2003, inclusive. We found nine cases of extravasation among the 2,186 patients who were treated with chemotherapy, which represents an incidence of 0.41 %, and 3.4 % of all chemotherapy-induced skin lesions. The cytostatic agent most often involved was vinorelbine, and the most frequent location was the antecubital fossa. The intensity of the lesions made it necessary to delay the next cycle of treatment in 55 % of the cases. The histological findings varied depending on when the biopsy was done, showing panniculitis with low cellularity together with epidermal lesions attributable to direct cytotoxicity. The best treatment for extravasation is prevention, but when it has already occurred, measures vary depending on the cytostatic drug extravasated and the intensity of the lesions. Conservative measures are advisable before surgery.
Alfaro-Rubio
Alberto
A
Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, España.
Sanmartín
Onofre
O
Requena
Celia
C
Llombart
Beatriz
B
Botella-Estrada
Rafael
R
Nagore
Eduardo
E
Serra-Guillén
Carlos
C
Hueso
Luis
L
Guillén
Carlos
C
D000328:Adult; D000368:Aged; D000931:Antidotes / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001706:Biopsy; D003646:Debridement; D003875:Drug Eruptions / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control / Q000601:surgery; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control / Q000601:surgery; D005260:Female; D006229:Hand Dermatoses / Q000139:chemically induced / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D007509:Irritants / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D015434:Panniculitis / Q000139:chemically induced / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D000077235:Vinorelbine
D000931:Antidotes; D000970:Antineoplastic Agents; D007509:Irritants; D014747:Vinblastine; D000077235:Vinorelbine