Abstract
BACKGROUND: Extravasation (EV) as an adverse effect of chemotherapy can induce tissue damage. Japanese guidelines on EV associated with cancer drug therapy were published in December 2022. However, few large-scale investigations on the frequency and patient clinical characteristics of EV have been conducted. In addition, although current guidelines newly recommend topical steroid use and consultation with dermatologists or plastic surgeons, it is necessary to clarify the actual status of EV management prior to the guideline revision in order to evaluate compliance with the current recommendations in the future. However, the real-world status has not been clarified to date. This study aimed to investigate the frequency of EV, the characteristics of patients who experienced EV, and the management of EV associated with docetaxel (DTX), a vesicant anticancer agent, using a large Japanese medical claims database. METHODS: Patients with cancer who received DTX monotherapy between 2008 and 2020 were evaluated. The patients were identified from the hospital-based medical claims database of Medical Data Vision Co., Ltd. The baseline characteristics of the study patients, the characteristics of patients who experienced EV, steroid prescriptions, and consultations with dermatologists or plastic surgeons were descriptively investigated. RESULTS: Among the 46,698 patients evaluated, 0.075% (35) patients developed DTX-related EV. In patients who experienced EV, 8.6% (3/35) had a history of EV. This proportion was higher than that of the overall study population. Only 34.3% (12/35) of the patients were prescribed injectable or topical steroids for EV, and 11.4% (4/35) received a consultation from the dermatology or plastic surgery department. CONCLUSIONS: DTX monotherapy-related EV occurs in 0.075% of cancer patients. The proportion of patients with a history of EV was higher among those who experienced EV than among the overall study population. Only a small proportion of patients who develop EV are prescribed topical steroids or receive consultation from the dermatology or plastic surgery department. The incidence and management of EV may change following the publication of the 2023 edition of the Japanese EV guidelines, and thus, further investigation is warranted.