Extravasation associated with cancer drug therapy: multidisciplinary guideline of the Japanese Society of Cancer Nursing, Japanese Society of Medical Oncology, and Japanese Society of Pharmaceutical Oncology

IF 7.1 2区医学 Q1 ONCOLOGY ESMO Open Pub Date : 2024-10-01 DOI:10.1016/j.esmoop.2024.103932

K. Matsumoto , Y. Ryushima , J. Sato , Y. Aizawa , T. Aoyama , Y. Akaishi , R. Okamoto , Y. Sato , K. Sugano , K. Tazumi , M. Tsuji , N. Fujikawa , S. Bun , K. Yagasaki

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Abstract

Background

Extravasation (EV), or the leakage of anticancer drugs into perivascular and subcutaneous tissues during intravenous administration, can cause serious conditions that may require surgical intervention. Therefore, updated guidelines for EV based on systematic review are needed. Additionally, classifications for anticancer drugs that cause EV are not standardized across the current guidelines, and some novel drugs have not been classified. Therefore, this study aimed to formulate guidelines using evidence-based information for shared decision making on prevention, early detection, treatment, and care for EV in Japan and provide additional classification for tissue injury based on systematic review.

Materials and methods

The members of the Japanese Society of Cancer Nursing (JSCN), Japanese Society of Medical Oncology (JSMO), and Japanese Society of Pharmaceutical Oncology (JASPO) were surveyed about significant clinical challenges related to EV, and 17 clinical questions (CQs) were formulated. PubMed and ICHUSHI Web were searched using the Patient, Intervention, Comparison, and Outcomes terms listed in each CQ as key words. For the classification of new drugs, articles published through February 2021 were selected using the search terms ‘extravasation’, ‘injection-site reaction’, ‘adverse events’, and the names of individual drugs as key words.

Results

Recommendations based on the results of randomized controlled trials (RCTs) were made with regard to the selection of central venous (CV) devices (CQ2, CQ3a, CQ3b, and CQ3c), regular replacement of peripheral venous catheters (CQ5), and use of fosaprepitant (CQ7). These CQs are novel and were not mentioned in previous guidelines. Warm compression monotherapy (CQ10b) and local injection of steroids (CQ12) are discouraged for the management of EV. Ten new drugs were classified for EV tissue injury.

Conclusions

This study provides updated guidelines for the prevention and treatment of EV, which can be used to help health care providers and patients and their families practice better EV management.

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与癌症药物治疗相关的外渗：日本癌症护理学会、日本肿瘤内科学会和日本肿瘤药学会的多学科指南。

背景：外渗（EV），即抗癌药物在静脉给药过程中渗漏到血管周围和皮下组织，可导致严重的情况，可能需要手术干预。因此，需要根据系统性回顾更新有关 EV 的指南。此外，目前各指南对导致EV的抗癌药物的分类并不统一，一些新型药物尚未进行分类。因此，本研究旨在利用循证信息制定日本 EV 预防、早期检测、治疗和护理的共同决策指南，并根据系统回顾提供组织损伤的补充分类：对日本癌症护理学会（JSCN）、日本肿瘤内科学会（JSMO）和日本肿瘤药学会（JASPO）的会员进行了有关 EV 重要临床挑战的调查，并制定了 17 个临床问题（CQs）。以每个 CQ 中列出的患者、干预、比较和结果为关键词，对 PubMed 和 ICHUSHI Web 进行了检索。在对新药进行分类时，以 "外渗"、"注射部位反应"、"不良事件 "和单个药物名称为关键词，选择了 2021 年 2 月之前发表的文章：根据随机对照试验（RCT）的结果，就中心静脉（CV）装置的选择（CQ2、CQ3a、CQ3b 和 CQ3c）、外周静脉导管的定期更换（CQ5）以及福沙匹坦（CQ7）的使用提出了建议。这些 CQ 都是以往指南中未提及的新内容。在治疗 EV 时，不鼓励使用单一热敷疗法（CQ10b）和局部注射类固醇（CQ12）。十种新药被归类为治疗EV组织损伤的药物：本研究提供了预防和治疗 EV 的最新指南，可用于帮助医疗服务提供者和患者及其家属更好地进行 EV 管理。

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来源期刊

ESMO Open Medicine-Oncology

CiteScore

11.70

自引率

2.70%

发文量

255

审稿时长

10 weeks

期刊介绍： ESMO Open is the online-only, open access journal of the European Society for Medical Oncology (ESMO). It is a peer-reviewed publication dedicated to sharing high-quality medical research and educational materials from various fields of oncology. The journal specifically focuses on showcasing innovative clinical and translational cancer research. ESMO Open aims to publish a wide range of research articles covering all aspects of oncology, including experimental studies, translational research, diagnostic advancements, and therapeutic approaches. The content of the journal includes original research articles, insightful reviews, thought-provoking editorials, and correspondence. Moreover, the journal warmly welcomes the submission of phase I trials and meta-analyses. It also showcases reviews from significant ESMO conferences and meetings, as well as publishes important position statements on behalf of ESMO. Overall, ESMO Open offers a platform for scientists, clinicians, and researchers in the field of oncology to share their valuable insights and contribute to advancing the understanding and treatment of cancer. The journal serves as a source of up-to-date information and fosters collaboration within the oncology community.