Extravasation of anticancer drugs – updated recommendations
Abstract:
Background: Extravasation (paravasation) of chemotherapy and other anticancer drugs represents a significant complication in the patient care. Preventive and therapeutic measures effectively reduce the incidence, severity and extent of extravasation-related complications and its consequences. A working group of authors from expert groups developed recommendations for standard care.
Aim: To provide a concise summary of recommended interventions for daily clinical practice. These recommendations are based either on long-term, evidence-based clinical experience or consensus opinions among expert groups representatives.
Results: Preventive measures are critical and include early consideration of indications for long-term venous access devices, appropriate selection of the injection and exit sites, thorough venous access device assessment before each anticancer drug administration, and comprehensive patient education. Therapeutic interventions following extravasation primarily involve the administration of specific antidotes (dimethylsulfoxide, hyaluronidase, dexrazoxane) along with the application of dry cold or heat, depending on the specific anticancer agent involved. The use of subcutaneous corticosteroids, moist heat or moist cooling, and compression is not recommended.
Conclusion: Adherence to these recommendations significantly decreases the risk and mitigates the consequences of extravasation. Clinical sites may adapt and expand these guidelines based on local policies and specific patient care requirements.
Reference:
Vokurka S, Maňásek V, Navrátilová Hrabánková D, Rozsívalová P, Kletečka J, Šípová S, Pavlicová V, Žák P, Kozáková Š, Vlasáková A, Brojáčová D, Turková L, Víšek B. Extravasation (paravasation) of anticancer drugs – updated recommendations (2025) for standard care in the Czech Republic based on multidisciplinary cooperation. Klin Onkol. 2025;38(3):224-232. English. PMID: 40762204.