Late-Onset Fluorouracil Extravasation in a Patient with Nasopharyngeal Carcinoma: A Case Report from Persahabatan Hospital

Abstract

Background: Extravasation in chemotherapy remains one of the serious complications of chemotherapy administration and can result in patient injury with an incidence of 0.09%. Management of extravasation in cancer patients requires interprofessional collaboration. Pharmacists can also play a role in the management of extravasation.

Case: In this article, we report the case of a 46-year-old patient diagnosed with advanced-stage nasopharyngeal carcinoma of the squamous cell carcinoma type. The patient had undergone radiotherapy 35 times. Subsequently, the doctor planned adjuvant chemotherapy with a regimen of cisplatin 150 mg on the first day and fluorouracil 1500 mg from the first to the fifth day. Five days after the second cycle of chemotherapy, the patient complained of dark red discoloration and heat along the venous line. The pharmacist managed the patient by identifying the cause, recording and reporting the drug side effects to the hospital and pharmacovigilance, recommending a protocol change by adding dilution to fluorouracil, recommending the application of hydrocortisone ointment for the scar, and monitoring the patient’s condition at home after treatment. The recommendations were accepted, and the patient’s condition improved in the subsequent chemotherapy cycle after the above management.

Conclusion: The role of pharmacists is crucial in identifying and recommending appropriate treatments to doctors regarding medications and patient therapy management to ensure patient safety is always maintained.