Prevalence and factors associated with chemotherapy extravasation

Introduction:
Systemic anticancer therapy causes many complications, including the extravasation of cytostatics. Extravasation arises from the unintentional release of a drug from the vein into the surrounding tissues or through direct tissue infiltration. Unfortunately, using drugs administered by methods other than intravenous injection (such as tablets) is not always possible. Various factors can contribute to extravasation of drugs, and depending on the mechanism of the drug damaging the vessel, appropriate therapy should be used. The aim of the study is to determine extravasation incidence and the associated factors in outpatient and inpatient departments of the cancer center.

Material and methods:
The study involved a retrospective analysis of 151 medical records of patients who experienced drug extravasation while receiving chemotherapy at the Professor Franciszek Lukaszczyk Cancer Center in Bydgoszcz in 2017–2019. Extravasation events were analyzed based on the drug used, treatment administration time and duration, extravasation symptoms, and patient characteristics.

Results:
The number of systemic therapies adminis- tered was 145,003 in the inpatient setting and 120,933 in the outpatient setting, with an extravasation incidence of 0.05% in both. The most commonly extravasated agent was 5-fluorouracil, with all events occurring via the peripher- al route. Extravasation occurred less frequently at bedtime (8.6%, p < 0.001), and most lesions ranged 2.1–5 cm (68.2%, p < 0.001).

Conclusions:
Placing intravenous ports in oncology patients may solve the issue of extravasation. Since significantly fewer extravasations occurred at night than in the morning and early afternoon, a system for monitoring and analyzing side effects is crucial for prevention of chemotherapy extravasation.