Department of Pharmacy Practice, Faculty of Pharmacy, M.S. Ramaiah University of Applied Sciences, Bangaluru, Karnataka, India.
Department of Medical Oncology, M.S. Ramaiah Medical College and Hospitals, Bengaluru, Karnataka, India.
Indian J Cancer. 2020 Oct-Dec;57(4):467-469. doi: 10.4103/ijc.IJC_281_19.
Antineoplastic drugs based on their ability to cause local damage are classified as irritants, vesicants, and non-vesicants. Previous literature has reported higher rate of vesicants induced extravasation (EV) compared to irritants. We report the first case of irritant, 5-fluorouracil causing grade III EV in 55-year-old woman. The patient was diagnosed with esophageal squamous cell carcinoma. Docetaxel, Cisplatin, and 5-Fluorouracil (DCF) chemotherapy regimen was planned and administered through peripheral venous access. Patient experienced grade 3 extravasation in her 3 cycle following 5-fluorouracil (5-FU) administration. The suspected drug was withdrawn immediately and discontinued from the 4 cycle of the regimen. The patient completely recovered from the symptoms of pain and erythema in the next cycle and care was taken not to infuse drug in the same site again. Since there is no appropriate antidote available to manage this condition, measures need to be taken to identify the predisposing factors for EV and prevent them.
基于其引起局部损伤的能力，抗肿瘤药物被分为刺激性药物、发泡剂和非发泡剂。既往文献报道，发泡剂引起外渗（EV）的发生率高于刺激性药物。我们报告首例刺激性药物 5-氟尿嘧啶（5-FU）导致 55 岁女性发生 3 级 EV 的病例。该患者诊断为食管鳞状细胞癌。计划采用多西紫杉醇、顺铂和 5-氟尿嘧啶（DCF）化疗方案，并通过外周静脉通路给药。在接受 5-FU 治疗的第 3 个周期时，患者出现 3 级外渗。立即停止输注可疑药物，并从第 4 个周期的方案中停用。在下一个周期，患者完全从疼痛和红斑等症状中恢复，并且注意不要再在同一部位输注药物。由于目前尚无合适的解毒剂来处理这种情况，因此需要采取措施识别 EV 的诱发因素并加以预防。
