Extravasation in daycare oncology centers
Abstract:
Background: Establishing benchmarks for extravasation incidences with systemic anti-cancer therapy from various global regions is crucial. Reliable data can inform practices aimed at reducing both the occurrence and severity of extravasation events.
Methods: This prospective observational study evaluated extravasation incidences in patients receiving systemic anti-cancer therapy for solid tumors at a tertiary oncology daycare center over a period of 15 months. Multiple risk factors potentially contributing to extravasation and influencing its severity were systematically recorded and analyzed.
Results: Out of 66,540 infusions, a total of 58 extravasation cases were identified, resulting in an overall incidence of 0.087%. The extravasation incidence was 0.13% for vesicant drugs and 0.045% for irritant drugs. Specifically, DNA-binding vesicants had an incidence of 0.2%, while non-DNA binding vesicants had an incidence of 0.11%. The predominant symptom reported was infusion site swelling (86%), followed by pain (43%) and erythema (36%). Grade 3 extravasation occurred in 13 cases (22.4%), with vesicants responsible for all but one event. Median symptom resolution time was 20 days overall, extending to 40 days in grade 3 cases. Notably, the occurrence of symptoms either during infusion or within 6 h post-infusion significantly correlated with milder grade 1 extravasations, lower incidence of severe grade 3 cases, and quicker symptom resolution within three weeks.
Conclusions: Daycare oncology centers should implement standardized protocols for systemic therapy administration, emphasizing preventive strategies and prompt identification and management of extravasation to reduce associated morbidity.
Reference:
Sansar B, Kapoor A, Gupta A, Mishra BK, Singh A, Ojha K, Dandeti R. Extravasation with systemic anti-cancer directed therapy administration at daycare in a tertiary care oncology centre: Insights from a prospective observational study (EXACT study). J Oncol Pharm Pract. 2025 Oct 16:10781552251372872. doi: 10.1177/10781552251372872. Epub ahead of print. PMID: 41099729.