Accidental extravasation of anthracyclines is a rare incident but if ever it happens, it can lead to serious complications, which could go as far as tissue necrosis with the need for surgery in most of the cases. In accordance with current recommendations, intravenous administration of Dexrazoxane within 6 hours of extravasation is recommended to reduce the risk of skin necrosis. We report the case of a 63-year-old patient, diagnosed with breast cancer, who presented with extravasation of Epirubicin, during her first cycle of adjuvant chemotherapy, with a favorable evolution after being treated with Dexrazoxane.
Cite this paper
Sbaiti, Y. , Ghozali, N. , Meliani, M. , Ruck, S. , Darif, K. , Amzerin, M. and M’rabet, F. Z. E. (2023). Effective Treatment of Epirubicin Extravasation with Dexrazoxane: A Case Report of Positive Clinical Outcomes. Open Access Library Journal, 10, e361. doi: http://dx.doi.org/10.4236/oalib.1110361.
Ulutin, H.C., Güden, M., Dede, M. and Pak, Y. (2000) Comparison of Granulocyte-Colony Stimulating Factor and Granulocyte Macrophage-Colony Stimulating Factor in the Treatment of Chemotherapy Extravasation Ulcers. European Journal of Gynaecological Oncology, 21, 613-615.
Lawrence, H.J., Walsh, D., Zapotowski, K.A., Denham, A., Goodnight, S.H. and Gandara, D.R. (1989) Topical Dimethyl Sulfoxide May Prevent Tissue Damage from Anthracycline Extravasation. Cancer Chemotherapy and Pharmacology, 23, 316-318. https://doi.org/10.1007/BF00292411
Pérez Fidalgo, J.A., García Fabregat, L., Cervantes, A., Margulies, A., Vidall, C. and Roila, F. (2012) Management of Chemotherapy Extravasation: ESMO-EONS Clinical Practice Guidelines. ESMO Guidelines Working Group. Annals of Oncology, 23, 167-173. https://doi.org/10.1093/annonc/mds294
Frost, A., Gmehling, D., Azemar, M., et al. (2006) Treatment of Anthracycline Extravasation with Dexrazoxane—Clinical Experience. Onkologie, 29, 314-318.
https://doi.org/10.1159/000093480
Jordan, K., Behlendorf, T., Mueller, F. and Schmoll, H. (2009) Anthracycline Extravasation Injuries: Management with Dexrazoxane. Therapeutics and Clinical Risk Management, 5, 316-366. https://doi.org/10.2147/TCRM.S3694
Vos, F.Y., Lesterhuis, W.J., Brüggemann, R.J. and van der Graaf, W.T. (2012) Recovery of Symptomatic Extravasation of Liposomal Doxorubicin after Dexrazoxane Treatment. Anti-Cancer Drugs, 23, 139-140.
https://doi.org/10.1097/CAD.0b013e32834be51a
Uña, E., Cuadrillero, F. and López-Lara, F. (2009) Drug Extravasation: A Dreaded Complication. BMJ Case Reports, 2009. https://doi.org/10.1136/bcr.09.2008.0887
Pericay, C., López, A., Soler, J.R., Bonfill, T., Dotor, E. and Saigí, E. (2009) Extravasation of Oxaliplatin: An Infrequent and Irritant Toxicity. Clinical and Translational Oncology, 11, 114-116. https://doi.org/10.1007/s12094-009-0324-z
Bos, A.M., van der Graaf, W.T. and Willemse, P.H. (2001) A New Conservative Approach to Extravasation of Anthracyclines with Dimethylsulfoxide and Dexrazoxane. Acta Oncologica, 40, 541-542
Arroyo, P.A., Perez, R.U., Amalia, M., et al. (2010) Good Clinical and Cost Outcomes Using Dexrazoxane to Treat Accidental Epirubicin Extravasation. Journal of Cancer Research and Therapeutics, 6, 573-574.
https://doi.org/10.4103/0973-1482.77081
Muthuramalingam, S., Gale, J. and Bradbury, J. (2013) Dexrazoxane Efficacy for Anthracycline Extravasation: Use in UK Clinical Practice. International Journal of Clinical Practice, 67, 244-249. https://doi.org/10.1111/ijcp.12103
Hale, O., Deutsch, P.G. and Lahiri, A. (2017) Epirubicin Extravasation: Consequences of Delayed Management. BMJ Case Reports, 2017, bcr2016218012.
https://doi.org/10.1136/bcr-2016-218012
Aigner, B. (2014) Complete Recovery of a Wide Local Reaction by the Use of Dexrazoxane 72 Hours after Epirubicin Extravasation: Case Report and Review of the Literature. Dermatology, 229, 288-292. https://doi.org/10.1159/000365391
Mouridsen, H.T., Langer, S.W., Buter, J., Eidtmann, H., Rosti, G., de Wit, M., et al. (2007) Treatment of Anthracycline Extravasation with Savene (Dexrazoxane): Results from Two Prospective Clinical Multicentre Studies. Annals of Oncology, 18, 546-550. https://doi.org/10.1093/annonc/mdl413