Epirubicin chemotherapy in women with breast cancer: Alternating arms for intravenous administration to reduce chemical phlebitis

Abstract

Objective: To establish whether using alternating arms for peripheral intravenous epirubicin administration affects the severity or duration of epirubicin-induced phlebitis.Methods: An observational study of women with breast cancer (n = 237) in a UK Cancer Centre. Data were analysed after receiving three treatment cycles according to the arm used for epirubicin administration: same, alternating or mixed arm (two consecutive cycles in one arm and one in the alternate arm). Phlebitis severity was graded by clinical staff after each treatment; participants also self-reported symptoms during treatment and for up to 6 months after. Results:The alternating arm group experienced significantly less severe symptoms than the other arm use groups, 6% (4 of 64) compared with 34% (p < 0.001, odds ratio: 0.13 (95% CI: 0.043-0.38) alternating arm compared with same arm group). The alternating arm group reported less pain (p = 0.013), lower overall impact (p = 0.009), lower effect on function (p = 0.032) and shorter duration of symptoms (p = 0.001) than the other arm use groups.Conclusion: Using alternating arms for peripheral administration of epirubicin significantly reduces the severity and duration of chemical phlebitis and is recommended to improve patient experience and reduce the need for central venous access devices. K E Y W O R D Sbreast cancer, chemical phlebitis, chemotherapy, epirubicin, peripheral venous cannulation, phlebitis severity

The Development and Testing of a Chemotherapy-Induced Phlebitis Severity (CIPS) Scale for Patients Receiving Anthracycline Chemotherapy for Breast Cancer

“…The final version of the phlebitis scale ( Figure 2) was used for testing for inter-rater reliability in this study. Ethical approval to use the CIPS scale was included as part of a study on anthracycline induced phlebitis (REC reference: 16/WA/0074) [9].…”

“…Out of 122 assessments, assessor 1 fully completed 98% (120 of 122) of the assessment forms and assessor 2 fully completed 97% (118 of 122) of the assessment forms. After development and testing for inter-rater reliability the final version of CIPS was used for a study of anthracycline induced phlebitis [9]. Included in this study was a questionnaire, enabling patients to self-report and score any phlebitis symptoms, which was used in parallel with the staff assessment of symptoms using the CIPS scale.…”

“…At their most severe, phlebitis symptoms can last for months following the completion of chemotherapy, which can have a considerable impact on patients' quality of life and their ability to carry out normal daily activities [8]. However, for patients who only experience mild and transient symptoms, these may be viewed as an inconvenience requiring no clinical intervention, which would not justify the additional risks and costs of placement of a central venous catheter [9]. The reported rates of chemotherapy-induced phlebitis vary considerably from 3% to 89%, with the exact incidence and severity being difficult to assess due to the different methodology and assessment scales used [10,11].…”

Factores asociados a flebitis química en pacientes en tratamiento quimioterapéutico, revisión sistemática de la literatura

“…Por otra parte, un estudio encontró relación entre la flebitis y la pérdida de peso 34 , aunque en otro artículo se evidenció que el IMC de 29 favoreció la flebitis 37 . En adición, un estudio mencionó que la estancia hospitalaria entre 10 y 20 días aumentó la incidencia de flebitis 34 .…”

pH-Responsive, Adorned Nanoniosomes for Codelivery of Cisplatin and Epirubicin: Synergistic Treatment of Breast Cancer

“…Epirubicin (EPI) is a semisynthetic analog of doxorubicin (DOX) with reduced cardiac toxicity that is one of the most effective chemotherapy drugs in breast cancer treatment. EPI inhibits topoisomerase II and plays an important role in cancer therapy because it can inhibit DNA replication and lipid peroxidation. , Cisplatin (CIS) is another effective chemotherapeutic drug that has been extensively used to treat human cancers such as breast, lung, neck, bladder, ovarian, head, and testicular types. CIS also causes DNA damage and induces apoptosis in cancer cells .…”