5-Fluorouracil induced extravasation injury

Area of Science:

• Oncology
• Pharmacology

Background:

• Antineoplastic drugs are classified as irritants, vesicants, or non-vesicants based on their potential for local tissue damage.
• Extravasation (EV) is a known complication of chemotherapy administration.
• Previous literature suggests vesicant chemotherapy agents are more frequently associated with severe EV than irritant agents.

Observation:

• A 55-year-old woman with esophageal squamous cell carcinoma developed grade III extravasation.
• The extravasation occurred during the third cycle of chemotherapy involving a Docetaxel, Cisplatin, and 5-Fluorouracil (DCF) regimen administered via peripheral venous access.
• The event was specifically linked to the administration of 5-fluorouracil (5-FU).

Findings:

• This case represents the first documented instance of severe (grade III) extravasation caused by the irritant chemotherapy drug 5-fluorouracil (5-FU).
• The patient experienced significant pain and erythema, necessitating immediate discontinuation of 5-FU from the treatment regimen.
• Complete recovery from extravasation symptoms was observed in the subsequent treatment cycle.

Implications:

• The findings challenge the traditional classification of extravasation risks, indicating that irritant agents like 5-FU can cause severe local damage.
• The absence of a specific antidote for chemotherapy extravasation underscores the importance of preventative measures.
• Further research is needed to identify predisposing factors for extravasation to improve patient safety during chemotherapy administration.