Preventive effect of pre-warming, hot compress, and pH adjustment in oxaliplatin-induced venous pain
- 185 Downloads
Background Venous pain induced by peripheral intravenous administration of oxaliplatin remains clinically unresolved. Objective The aim of this study was to determine the efficacy of comprehensive intervention care for venous pain in colorectal cancer patients receiving oxaliplatin. Setting A Japanese tertiary hospital. Method We treated all outpatients after April 2012 with comprehensive intervention care including pre-warming of the oxaliplatin solution, use of a hot compress, and pH adjustment by combination with dexamethasone. We retrospectively reviewed the electronic medical records from colorectal cancer patients who had received oxaliplatin via a peripheral vein between December 2009 and June 2014. Main outcome measures The primary endpoint of this study was the incidence of venous pain at the administration site during oxaliplatin infusion, according to injection site reaction grade ≥ 2. Results We evaluated 271 treatment courses in 59 patients. Venous pain occurred in 42 courses (15.5%) among 26 patients. Multivariate logistic regression analysis revealed that female gender and body mass index ≥ 25 kg/m2 were significantly associated with an increased risk of venous pain during all courses (adjusted odds ratio [OR]: 3.18, 95% confidence interval [CI] 1.35–7.92; P < 0.01; and adjusted OR: 3.37, 95% CI 1.26–9.40; P = 0.02, respectively), whereas comprehensive intervention care were significantly associated with reduced risk of venous pain during all courses (adjusted OR: 0.10, 95% CI 0.02–0.44; P < 0.01). Conclusion Comprehensive intervention care is a clinical treatment option for oxaliplatin-induced peripheral venous pain in patients with colorectal cancer, especially females with obesity.
KeywordsDexamethasone Hot compress Oxaliplatin Pre-warming Venous pain
We thank all patients and medical staff at Ehime University Hospital who were involved in this study.
The authors have no financial support or financial conflicts.
Conflicts of interest
The authors declare that they have no conflict of interest.
- 2.Goldberg RM, Sargent DJ, Morton RF, Fuchs CS, Ramanathan RK, Williamson SK, et al. A randomized controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer. J Clin Oncol. 2004;22:23–30.CrossRefPubMedGoogle Scholar
- 3.Cassidy J, Clarke S, Díaz-Rubio E, Scheithauer W, Figer A, Wong R, et al. Randomized phase III study of capecitabine plus oxaliplatin compared with fluorouracil/folinic acid plus oxaliplatin as first-line therapy for metastatic colorectal cancer. J Clin Oncol. 2008;26:2006–12.CrossRefPubMedGoogle Scholar
- 6.Yamada Y, Takahari D, Matsumoto H, Baba H, Nakamura M, Yoshida K, et al. Leucovorin, fluorouracil, and oxaliplatin plus bevacizumab versus S-1 and oxaliplatin plus bevacizumab in patients with metastatic colorectal cancer (SOFT): an open-label, non-inferiority, randomised phase 3 trial. Lancet Oncol. 2013;14:1278–86.CrossRefPubMedGoogle Scholar
- 7.Yoshida Y, Hoshino S, Aisu N, Naito M, Tanimura S, Mogi A, et al. Administration of chemotherapy via the median cubital vein without implantable central venous access ports: port-free chemotherapy for metastatic colorectal cancer patients. Int J Clin Oncol. 2015;20:332–7.CrossRefPubMedGoogle Scholar
- 9.Yoshida Y, Hoshino S, Aisu N, Shiwaku H, Beppu R, Tanimura S, et al. Dexamethasone as a means not only for controlling vascular pain caused by the administration of oxaliplatin via the peripheral vein but also for controlling oxaliplatin-induced hypersensitivity reactions. Br J Med Med Res. 2012;2:132–41.CrossRefGoogle Scholar
- 11.Nakauchi K, Kawazoe H, Miyajima R, Waizumi C, Rokkaku Y, Tsuneoka K, et al. Risk factors for oxaliplatin-induced phlebitis and venous pain, and evaluation of the preventive effect of preheating with a hot compress for administration of oxaliplatin. Gan To Kagaku Ryoho. 2015;42:1397–400 (in Japanese).PubMedGoogle Scholar
- 12.Hata T, Honda M, Kobayashi M, Toyokawa A, Tsuda M, Tokunaga Y, et al. Effect of pH adjustment by mixing steroid for venous pain in colorectal cancer patients receiving oxaliplatin through peripheral vein: a multicenter randomized phase II study (APOLLO). Cancer Chemother Pharmacol. 2015;76:1209–15.CrossRefPubMedGoogle Scholar
- 13.Common Terminology Criteria for Adverse Events (Internet). http://evs.nci.nih.gov/ftp1/CTCAE/About.html. Accessed 27 May 2016.
- 15.Royal College of Nursing. Standards for infusion therapy, the RCN IV therapy forum. 3rd ed. London: The Royal College of Nursing; 2010. p. 26–7.Google Scholar