Management of Extravasation of Antineoplastic Agents in Patients Undergoing Treatment for Cancer: A Systematic Review.

PROBLEM IDENTIFICATION: This systematic review was conducted to inform the development of clinical practice guidelines on the management of extravasation of antineoplastic agents in patients with cancer. LITERATURE SEARCH: PubMed®, Embase®, CINAHL®, and Cochrane databases were searched for eligible studies from June 2014 to June 2024. Citations of guidelines and a previous systematic review were reviewed for records that met eligibility criteria. Two reviewers independently screened titles, abstracts, and full texts for inclusion. DATA EVALUATION: Two independent reviewers assessed all studies that met inclusion criteria using the Risk of Bias in Nonrandomized Studies of Interventions for cohort studies and JBI critical appraisal tool for case series. The certainty of evidence was assessed using GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology. SYNTHESIS: For patients who have an extravasation of an antineoplastic agent, although there is very low certainty in the evidence overall, interventions include administration of an antidote, compress, and surgical referral or escalation of care for extravasation of central lines. IMPLICATIONS FOR PRACTICE: Antidotes, application of a compress, and referral for surgical or wound care are effective strategies for managing extravasation of antineoplastic agents.