Abstract:
In summary, we report a case of massive extravasation of doxorubicin, in which only immediate toxic effects were prevented by dexrazoxane treatment. This report, along with those of Langer and colleagues, Bos and co-workers, and Jensen and colleagues, should make anthracycline extravasation an indication for treatment with dexrazoxane. Dexrazoxane should be readily available wherever doxorubicin is administered. Langer and colleagues5 recommended that 1000 mg-m2 dexrazoxane should be given as soon as possible and repeated the next day. Our case indicates that delayed tissue necrosis might still occur when doxorubicin extravasation is substantial and we conclude that additional dexrazoxane - either more or higher doses - are probably necessary and should be tailored to the amount of extravasation. More research is needed to clarify this issue. Our case also highlights beneficial effects of intralesional GM-CSF, which induces formation formation of granulation tissue and accelerates wound healing without the need for skin grafts. Most oncologists see this doxorubicin extravasation once in a lifetime and need to know the treatment options available.