title: Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Medicine I, Clinical Division of Oncology, Comprehensive Cancer Center of the Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Ursula
authors.initials: U
authors.lastname: Pluschnig
authors.forename: Werner
authors.initials: W
authors.lastname: Haslik
authors.forename: Günther
authors.initials: G
authors.lastname: Bayer
authors.forename: Afschin
authors.initials: A
authors.lastname: Soleiman
authors.forename: Rupert
authors.initials: R
authors.lastname: Bartsch
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lamm
authors.forename: Günther G
authors.initials: GG
authors.lastname: Steger
authors.forename: Christoph C
authors.initials: CC
authors.lastname: Zielinski
authors.forename: Robert M
authors.initials: RM
authors.lastname: Mader
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000009:adverse effects / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D004149:Dioxoles / Q000627:therapeutic use; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012074:Remission Induction; D043823:Taxoids / Q000009:adverse effects / Q000627:therapeutic use; D044005:Tetrahydroisoquinolines / Q000627:therapeutic use; D000077606:Trabectedin; D016896:Treatment Outcome; D014748:Vinca Alkaloids / Q000009:adverse effects / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D004149:Dioxoles; D043823:Taxoids; D044005:Tetrahydroisoquinolines; D014748:Vinca Alkaloids; D000077606:Trabectedin; D002945:Cisplatin