Management of chemotherapy extravasation: ESMO–EONS Clinical Practice Guidelines

Complete Recovery of a Wide Local Reaction by the Use of Dexrazoxane 72 Hours after Epirubicin Extravasation: Case Report and Review of the Literature

“…Over several weeks, tissue destruction may progress and, in the worst case, severe necrosis and ulceration may eventually lead to an amputation [4,8,11]. Furthermore, pain is frequently present and risk of infection and impairment of joints and nerves are feared complications [4,9]. …”

“…To date, the management of extravasation is still discussed controversially within the literature, as we lack evidence-based clinical trials [2,3,5,9,10]. However, the immediate treatment with dexrazoxane against accidental anthracycline extravasation is a favorable treatment option [2,3,5,9,10].…”

“…Nowadays, immediate treatment with dexrazoxane, the only proven antidote in the case of accidental anthracycline extravasation, has been implemented into daily clinical practice [1,4,5,7,8]. Despite topical DMSO, it is the recommended specific antidote to be used as soon as possible (ideally not after 6 h) after anthracycline extravasation, as mentioned in the ESMO-EONS guidelines [9]. According to relevant guidelines, this ion chelator has to be administered intravenously once a day on 3 consecutive days in a dosage calculated by the body surface area [9,10].…”

“…Despite topical DMSO, it is the recommended specific antidote to be used as soon as possible (ideally not after 6 h) after anthracycline extravasation, as mentioned in the ESMO-EONS guidelines [9]. According to relevant guidelines, this ion chelator has to be administered intravenously once a day on 3 consecutive days in a dosage calculated by the body surface area [9,10]. Dexrazoxane has been approved by the European Medicines Agency in July 2006 for this indication [4].…”

<b>Notificação de extravasamento de agentes quimioterápicos em um hospital universitário - Notification of extravasation of chemotherapeutic agents in a university hospital<b>

“…Um destes eventos é o extravasamento de agentes quimioterápicos, sendo este classificado como toxicidade dermatológica local e definido como a difusão das drogas presentes no vaso sanguíneo para os tecidos circunjacentes (1) . Devido o prejuízo funcional e do comprometimento da qualidade de vida decorrentes dos possíveis danos teciduais e das lesões, a notificação destas ocorrências se evidencia como fundamental na atuação da equipe, especialmente da equipe de enfermagem, pois se constitui como importante estratégia para melhorar o reconhecimento de falhas, facilitar o seu monitoramento e implementar medidas de prevenção de novos casos (2) .…”