title: Cytotoxic extravasation: an issue disappearing or a problem without solution?
abstract: OBJECTIVE
  The incidence and management of antitumoral compound extravasation that occurred in our medical day hospital unit were registered in a 10-year period.
  
  
  METHODS
  A total of 114 episodes were consecutively recorded out of an estimated number of 211,948 administrations performed (0.05%). Type of compound, localization, timing, symptoms, treatment, resolution, or sequelae were documented.
  
  
  RESULTS
  Extravasations after anthracyclines (17/114), platinum compounds (34/114), vinca alkaloids (7/114), and taxanes (34/114) were more frequently associated with edema and erythema ± pain. Five cases of monoclonal antibodies extravasation were observed without sequelae. With the involvement of an interdisciplinary task force and the use of dedicated guidelines, conservative management was successful in all patients. In the great majority of cases, recovery was complete within 48 hours after antidote administration. The support of our pharmacy was crucial. Physiatric evaluation was considered in several cases. No patients required surgery.
  
  
  CONCLUSIONS
  We confirm that the adopted standardized approach to this event resulted in a satisfactory outcome and could be suggested as appropriate for managing extravasation in a large clinical context.
authors.affiliation: SCDHM/Outpatient Therapy Oncology, Foundation IRCCS National Cancer Institute, Milan - Italy.
authors.forename: Laura A M
authors.initials: LA
authors.lastname: Ferrari
authors.affiliation: SCDHM/Outpatient Therapy Oncology, Foundation IRCCS National Cancer Institute, Milan - Italy.
authors.forename: Gabriella L
authors.initials: GL
authors.lastname: Dinoi
authors.affiliation: SC Pharmacy, Foundation IRCCS National Cancer Institute, Milan - Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Saibene
authors.affiliation: SC Pharmacy, Foundation IRCCS National Cancer Institute, Milan - Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Re
authors.affiliation: SC Palliative Care, Foundation IRCCS National Cancer Institute, Milan - Italy.
authors.forename: Augusta
authors.initials: A
authors.lastname: Balzarini
authors.affiliation: SCDHM/Outpatient Therapy Oncology, Foundation IRCCS National Cancer Institute, Milan - Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Giordano
authors.affiliation: SCDHM/Outpatient Therapy Oncology, Foundation IRCCS National Cancer Institute, Milan - Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Sala
authors.affiliation: SCDHM/Outpatient Therapy Oncology, Foundation IRCCS National Cancer Institute, Milan - Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Bregant
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage / Q000009:adverse effects; D000931:Antidotes / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D001768:Blister / Q000139:chemically induced / Q000628:therapy; D000072700:Conservative Treatment / Q000379:methods* / Q000592:standards; D004487:Edema / Q000139:chemically induced / Q000628:therapy; D004890:Erythema / Q000139:chemically induced / Q000628:therapy; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000139:chemically induced* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000139:chemically induced; D059408:Pain Management / Q000379:methods; D017671:Platinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D012307:Risk Factors; D040521:Subcutaneous Tissue / Q000187:drug effects* / Q000293:injuries / Q000473:pathology; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D014456:Ulcer / Q000139:chemically induced / Q000628:therapy*; D014748:Vinca Alkaloids / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D018943:Anthracyclines; D000931:Antidotes; D000970:Antineoplastic Agents; D017671:Platinum Compounds; D043823:Taxoids; D014748:Vinca Alkaloids