Central Institute for Tumors, Zagreb, Croatia
The extravasation of some i. v. administered cytostatic drugs can often cause local edema with skin redness, thrombophlebitis and, not infrequently, skin necrosis with chronic ulcers. Local treatment is usually ineffec-tive, and so far surgical ulcer excision has been the only curative approach. The tetrachlorodecaoxyhen anion acomplex (TCDO) has been shown to be highly active in healing chronic leg ulcers by increasing pOa in hypoxic wound tissue and stimulating phagocytosis as one of the antiinflammatory processes (Lancet I: 829 — 831, 1986). In order to study the local activity of TCDO in tissue necrosis and chronic ulcers caused by cytostatic drug extravasation, 46 patients with local skin complications underwent local treatment with TCDO in an isotonic water solution. Thirty four patients experienced only local edema with redness, while 12 patients had deep chronic ulcera. All these skin changes were complications occurring after i. v. administration of Doxorubicin, Cis Platinum, Dactino-mycin or Vinblastine. TCDO treatment was instituted 1—3 months after the appearance of ulcers, and 1 — 8 days after the occurrence of skin inflammation. TCDO was applied locally twice a day by impregnated cotton tissue for 4—6 weeks. Only measurable lesions were evaluable. Out of 34 patients with skin inflammation, complete resolution was achieved in 6 and partial resolution in 16 patients, while in 12 the lesion remained stable. This implied an overall response rate of 65% (22 out of 34 patients). The 12 patients with deep chronic ulcers required longer treatment (6 weeks); in 10 of these patients complete epithelization and resolution was achieved. In two cases the ulcer healed partially. No side effects were observed during treatment. The effect of locally applied TCDO in chronic ulcers caused by cytostatic application appears to justify this approach as being advantageous in addition to surgical treatment.
Local application of tetrachlorode-caoxygen anion complex (Oxoferin) in patients with tissue necrosis caused by cytostatic extravasation
