Docetaxel-induced extravasation injury: a report of three cases

Bruce R Harrison, MS, RPh, BC0P, Jennifer R Ketts, PharmD Michelle Z Schultz, MD and Susan Yackzan, MSN, RN, AOCN

Extravasation of chemotherapy drugs may cause serious adverse effects in cancer patients. The clinical course and preferred treatment of some of the newer chemotherapy drugs has not been well described. Three cases of docetaxel extravasation are presented in this report.
The three patients experienced four extravasations of docetaxel and were observed for periods ranging from nine to 19 weeks. Symptoms were fairly similar in all three patients including pain, erythema, edema, pruritus, dyschromia, and hypoesthesia. All three patients received subsequent therapy with docetaxel with no delays in therapy or apparent exacerbation of symptoms. None of these patients had ulceration or visible necrosis. Case 3 received treatment with ice to the second extravasation site. No treatment was administered following the other extravasations.
No recommendations for treating docetaxel extravasation were found. Observations of these three cases suggest that docetaxel is an irritant, but there currently is no evidence to implicate doectaxel as a vesicant. Docetaxel extravasation should be managed conservatively.

J Oncol Pharm Practice (2000) 6, 122-125.
Key Words: Extravasation; docetaxel; chemotherapy; vesicant.