Docetaxel (Taxotere) Extravasation: A Report of Five Cases With Treatment Recommendations

A 62-year-old man diagnosed with a stage I lung adenocarcinoma was treated by an upper right lobectomy. Eighteen months later an elevation of carcinoembryoinc antigen (CEA) was detected, and CT tomography revealed a stage IV disease. Chemotherapy including cisplatin (Platinol) and docetaxel (Taxotere) was administered. He presented 12 days after receiving an intravenous infusion because he noticed a burning sensation, erythema and blisters at the site of the last infusion and proximal to that area. On physical examination he had a 9×4.5 cm swollen area of erythema and multiple blisters. The diagnosis of delayed and distant docetaxel extravasation was made. The treatment consisted of normal saline washes, topical hydrocortisone and antibiotic-based ointment which produced relief of the symptoms. This reaction resolved over the next 6 weeks, leaving two areas of brownish pigmentation of the skin as the only sequelae.

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“…Many cases with delayed lesions have been described with this agent,12 but none secondary to two indolent extravasations.…”

Section: Discussionmentioning

confidence: 99%

Drug extravasation: a dreaded complication

Uña¹,

Cuadrillero²,

López-Lara³

2009

Case Reports

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“…Acutely, there is local pain, erythema, bullae formation, or phlebitis 1,153 which resolves over weeks, leaving residual hyperpigmentation. 1,171 Necrosis is not seen with irritant reactions. A single vesicant reaction with subsequent necrosis from docetaxel has been reported.…”

Section: Taxanesmentioning

confidence: 99%

Chemotherapeutic agents and the skin: An update

Heidary

Naik

Burgin

2008

Journal of the American Academy of Dermatology

222

138

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“…In these studies, the initial symptom of docetaxel extravasation was irritant reaction. By contrast, other studies (13)(14)(15)(16)(17)(18)(19) have indicated that docetaxel was a surficial vesicant drug. In the study by Cifuentes et al (13), the ultrasonic image indicated change in cell lysis in the subcutaneous layer.…”

Section: Discussionmentioning

confidence: 86%

Rat injury model of docetaxel extravasation

Zhu

Jiao

et al. 2014

Biomedical Reports

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Abstract. Docetaxel is a novel type of chemotherapy drug that actively treats a number of malignant tumors. The aim of the present study was to explore the severity and natural course of tissue damage induced by docetaxel extravasation and to confirm the vesicant potential of docetaxel. Rats were selected for the establishment of the ulcer model. Different volumes and concentrations were explored to induce the skin ulcer and to confirm the optimum rational injection model. The natural course of tissue injury and pathological changes produced by docetaxel extravasation were observed by comparing to vinorelbine extravasation. A 0.4 ml volume and a 6 mg/ml concentration were the optimum rational injection model for the induction of the skin ulcer. The docetaxel extravasation induced local tissue necrosis, followed by granuloma formation and hyperpigmentation or scar formation. The severity of the injury depended on the concentration of the extravasation used in the rat model. The injury occurred on the first day following extravasation and lasted 4-6 weeks. The damage from docetaxel was weaker than vinorelbine in association with the depth and extension of necrosis. In conclusion, docetaxel extravasation can induce tissue necrosis. However, the severity of necrosis was weaker than that of vinorelbine. Docetaxel has superficial vesicant properties.

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Docetaxel (Taxotere) Extravasation: A Report of Five Cases With Treatment Recommendations

Cited by 33 publications

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Drug extravasation: a dreaded complication

Drug extravasation: a dreaded complication

Chemotherapeutic agents and the skin: An update

Rat injury model of docetaxel extravasation

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