Kimmel Jaime, Fleming Patrick, Cuellar Sandra, Anderson Jennifer, Haaf Christina Mactal
1 Department of Pharmacy, University of Texas MD Anderson Cancer Center, USA.
2 Department of Pharmacy, University of Illinois Hospital & Health Sciences System, USA.
J Oncol Pharm Pract. 2018 Mar;24(2):129-138. doi: 10.1177/1078155217690924. Epub 2017 Feb 17.
Although the risk of extravasation of a chemotherapy (anticancer) medication is low, the complications associated with these events can have a significant impact on morbidity and health care costs. Institutions that administer anticancer agents should ideally have a current guideline on the proper management of the inadvertent administration of these toxic medications into tissues surrounding blood vessels. It is imperative that the health care team involved in administering drugs used to treat cancer be educated on the risk factors, preventative strategies and treatment of anticancer extravasations, as well as practice safe and proper administration techniques. Anticancer agents are generally divided into classes based on their ability to cause tissue damage. The review of current published guidelines and available literature reveals a lack of consensus on how these medications should be classified. In addition, many recently approved drugs for the treatment of cancer may lack data to support their classification and management of extravasation events. The treatment of the majority of extravasations of anticancer agents involves nonpharmacological measures, potentially in the ambulatory care setting. Antidotes are available for the extravasation of a minority of vesicant agents in order to mitigate tissue damage. Due to the limited data and lack of consensus in published guidelines, a working group was established to put forth an institutional guideline on the management of anticancer extravasations.
尽管化疗（抗癌）药物外渗的风险较低，但这些事件相关的并发症会对发病率和医疗保健成本产生重大影响。使用抗癌药物的机构理想情况下应具备一份关于将这些有毒药物意外注入血管周围组织的正确处理的现行指南。参与使用治疗癌症药物的医疗团队必须接受关于抗癌药物外渗的风险因素、预防策略和治疗方法的培训，并要掌握安全、正确的给药技术。抗癌药物通常根据其导致组织损伤的能力进行分类。对当前已发表的指南和现有文献的回顾显示，对于这些药物应如何分类缺乏共识。此外，许多最近获批用于治疗癌症的药物可能缺乏支持其外渗事件分类和管理的数据。大多数抗癌药物外渗的治疗涉及非药物措施，可能在门诊护理环境中进行。对于少数发泡剂药物外渗有解毒剂可用以减轻组织损伤。由于已发表指南中的数据有限且缺乏共识，因此成立了一个工作组来制定一份关于抗癌药物外渗管理的机构指南。
