To Yue-Yun, Sutcliffe Kimberly J, Hoen Helena M, Swaney Ramona A, Nicholls Justin D, Crocenzi Todd S
Providence Cancer Center, Earle A. Chiles Research institute, Glisan, Portland, OR, USA.
Providence Health and Services, Clinical Program Services, Halsey, Portland, OR, USA.
J Oncol Pharm Pract. 2016 Apr;22(2):256-60. doi: 10.1177/1078155215576254. Epub 2015 Mar 10.
Oxaliplatin, a platinum-type alkylator, is not classified as a vesicant but can cause local reactions when infused by peripheral vein. Providence Cancer Center, like other institutions, deferred the venous administration method to clinical judgment incorporating patient preference. Patient experience was evaluated for oxaliplatin-related local reactions by peripheral or central venous administration.
A retrospective review of the electronic medical record was performed of the period of January 2011 to March 2013 to identify patients who received oxaliplatin. Included were 59 patients who were given the option of either peripheral or central venous drug administration. The two patient groups (peripheral vein vs. central vein administration) were compared in terms of frequency and type of local reactions (redness/discoloration, swelling, numbness/cold, or pain/discomfort).
Nineteen (63.3%) of the patients in the peripheral vein group experienced some type of local reaction compared to none in the central vein group (p < .0001). Pain was the most common local reaction, occurring in 17 (56.7%) patients in the peripheral group. Despite the occurrence of a local reaction, the majority of patients did not alter their initial choice of infusion method.
This is the first published report to characterize and quantify a single institution's experience with oxaliplatin-related local reactions. A significantly greater number of local reactions, particularly pain, occurred with the administration of oxaliplatin peripherally vs. centrally. This analysis impacted our institution's best practice for oxaliplatin infusions.
奥沙利铂是一种铂类烷化剂，虽未被归类为发泡剂，但经外周静脉输注时可引起局部反应。普罗维登斯癌症中心与其他机构一样，将静脉给药方法交由临床判断并综合患者偏好来决定。对通过外周或中心静脉给药的奥沙利铂相关局部反应的患者体验进行了评估。
对2011年1月至2013年3月期间的电子病历进行回顾性分析，以确定接受奥沙利铂治疗的患者。纳入了59例可选择外周或中心静脉给药的患者。比较了两组患者（外周静脉给药组与中心静脉给药组）局部反应的频率和类型（发红/变色、肿胀、麻木/发冷或疼痛/不适）。
外周静脉给药组中有19例（63.3%）患者出现了某种类型的局部反应，而中心静脉给药组无一例出现（p < .0001）。疼痛是最常见的局部反应，外周给药组有17例（56.7%）患者出现。尽管发生了局部反应，但大多数患者并未改变其最初选择的输注方法。
这是首篇发表的描述和量化单一机构奥沙利铂相关局部反应经验的报告。与中心静脉给药相比，外周静脉给予奥沙利铂时出现的局部反应明显更多，尤其是疼痛。该分析影响了我们机构奥沙利铂输注的最佳实践。
