{"entity":{"id":"chemotherapy-extravasation-management","kind":"protocol","name":"Management of chemotherapy extravasation by drug class","aka":["Extravasation management","Vesicant extravasation","Anthracycline extravasation","Chemotherapy leak into tissue"],"tldr":"If a chemotherapy drug leaks out of the vein into the skin around a drip or port, the nurse stops the drip at once, draws back what they can, marks the area and then treats it according to the drug, with an antidote or a cold or warm pack. Tell the team straight away if the site stings, burns, swells or changes colour, during treatment or in the days after.","summary":"Extravasation is leakage of an intravenous anticancer drug into the surrounding tissue. Management starts the same way for every drug: stop the infusion, leave the cannula or port needle in place, aspirate what can be withdrawn without flushing, mark and photograph the area, inform the senior nurse and doctor, then remove the device and elevate the limb.\n\nThe specific measures depend on the drug's class. Vesicants are split into DNA-binding agents (anthracyclines, mitomycin, dactinomycin, mechlorethamine), which are localised and neutralised with cold, and non-DNA-binding agents (vinca alkaloids, taxanes), which are dispersed with warmth and hyaluronidase. The ONS/ASCO 2025 guideline, the newest GRADE-based one, recommends antidotes where available: dexrazoxane for doxorubicin, daunorubicin, epirubicin and idarubicin; hyaluronidase for vinca alkaloids, and conditionally for paclitaxel and docetaxel; topical dimethyl sulfoxide for mitomycin and mitoxantrone, or for an anthracycline when dexrazoxane is unavailable or contraindicated; sodium thiosulfate for more than 20 ml of high-concentration cisplatin and for bendamustine. Thermal compresses are used three to four times daily for 48 to 72 hours: cold for most vesicants, warm for vinca alkaloids, etoposide and oxaliplatin, and for taxanes when hyaluronidase is given.\n\nDexrazoxane is given intravenously in the opposite limb, 1000 mg/m2 on days 1 and 2 and 500 mg/m2 on day 3, the first dose within six hours, with cooling removed 15 minutes beforehand and no dimethyl sulfoxide alongside. Extravasation from a central venous access device, and high-risk cases, are referred early for surgical review. The Japanese 2024 guideline differs on heat (it weakly recommends against warm compresses alone) and makes no recommendation on aspiration; it weakly recommends against local steroid injection and against debriding an ulcer without necrosis. Documentation, patient teaching and follow-up for weeks complete the protocol.","asOf":"2026-11-11","links":[],"tags":[],"related":["dmso-dimethyl-sulfoxide","sodium-thiosulfate"],"cancers":[],"sections":[],"technologies":["implanted-ports","picc-lines"],"targets":[],"drugs":["dexrazoxane","doxorubicin","daunorubicin","epirubicin","idarubicin","vincristine","vinblastine","vinorelbine","paclitaxel","docetaxel","mitomycin","mitoxantrone","dactinomycin","mechlorethamine","trabectedin","oxaliplatin","etoposide","cisplatin","bendamustine","carmustine","dacarbazine"],"companies":[],"institutions":[],"pathways":[],"terms":["extravasation-infusion-reaction","central-venous-access"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"domain":"chemotherapy-administration","setting":{"who":["nurse","doctor","pharmacist","surgical-team","patient-or-carer"],"where":["chemotherapy-day-unit","ward","outpatient-clinic","home"]},"population":"Adults receiving intravenous anticancer drugs through a peripheral cannula or a central venous access device. Children are outside every source read here; the Savene label says safety and efficacy below 18 have not been established and does not recommend it in elderly patients, in whom it was not studied.","trigger":"During or after an intravenous anticancer infusion, the patient reports pain, burning or swelling at the site, or the nurse sees redness, swelling, a change in skin colour or blanching around the site, or loss of blood return from the device.","steps":[{"action":"Recognise it: check the site and the line for loss of blood return, pain, redness, swelling, and skin colour change or blanching","why":"Early signs are often subtle, and treatment works best when it starts as soon as extravasation is suspected.","source":"ons-asco-algorithm-2025"},{"action":"Stop the infusion at once and leave the cannula or port needle in place","why":"Leaving the device in gives a route to draw back drug still sitting in the line or tissue.","source":"ons-voice-2025","quote":"Stop the infusion immediately but leave the needle or catheter in place to allow for the possibility of aspirating any residual drug from the line or tissue."},{"action":"Gently aspirate as much drug as possible through the device with a syringe, without flushing and without pressing on the area, then disconnect the tubing","why":"Less drug left in the tissue means less damage; flushing or pressure would push more of it in.","source":"ons-voice-2025","quote":"Attempt to withdraw as much of the drug as possible using a syringe, then disconnect the tubing."},{"action":"Call for help: inform a doctor straight away, and a consultant for any vesicant or any extravasation from a central line","why":"Antidotes and referrals need a prescriber, and some have to start within hours.","source":"wm-eag-2017","quote":"A doctor should be informed of the incident immediately; in the case of vesicants or an extravasation via a CVAD a consultant should be informed."},{"action":"Measure the area, outline it with a pen and photograph it","why":"A marked outline and a photograph show later whether the injury is spreading or settling.","source":"wm-eag-2017","quote":"Mark the extravasated area with a pen, take a digital image if possible."},{"action":"Remove the peripheral cannula or the port needle without pressing hard on the site, and raise a peripheral limb","why":"Raising the limb helps the fluid be absorbed; firm pressure spreads the drug.","source":"ons-asco-algorithm-2025"},{"action":"Identify the drug and its class: DNA-binding vesicant, non-DNA-binding vesicant, irritant or non-vesicant","why":"The class decides whether the area is cooled to keep the drug in one place or warmed to spread it, and which antidote applies.","source":"wm-eag-2017","quote":"DNA – binding: these drugs are absorbed locally, enter cells and bind to their DNA, precipitating the death of the cell. Following this, the drug can then be re-released to further destroy healthy cells leading to deeper erosion of cells within the tissue"},{"action":"Cold compresses for anthracyclines, alkylating agents, antimetabolites, and taxanes when hyaluronidase is not given","why":"Cold narrows the vessels, which keeps the drug in a small area.","source":"ons-voice-2025","quote":"Cold compresses vasoconstrict and reduce spread and are best for alkylating agents, anthracyclines, taxanes (without hyaluronidase use), and antimetabolites."},{"action":"Warm compresses for vinca alkaloids, etoposide and oxaliplatin, and for paclitaxel or docetaxel when hyaluronidase is given","why":"Warmth spreads the drug so that it is diluted and absorbed.","source":"ons-voice-2025","quote":"Warm compresses disperse the agent and should be used for vinca alkaloids, etoposide, oxaliplatin, paclitaxel, and docetaxel (when coadministering hyaluronidase)."},{"action":"Apply the compress for 15 to 20 minutes at a time, three to four times a day, for 48 to 72 hours","why":"The guideline panel preferred this longer course to a single day.","source":"ons-voice-2025","quote":"Using compresses use three to four times daily over 48–72 hours is recommended over shorter durations (e.g., 24 hours)."},{"action":"Anthracyclines (doxorubicin, daunorubicin, epirubicin, idarubicin): give dexrazoxane, the first dose as soon as possible and within six hours","why":"Dexrazoxane is the antidote licensed for anthracycline extravasation, and the window for the first dose is short.","source":"savene-smpc","quote":"The first infusion should be initiated as soon as possible, within the first six hours after the accident."},{"action":"Anthracyclines: dose dexrazoxane at 1000 mg/m2 on day 1, 1000 mg/m2 on day 2 and 500 mg/m2 on day 3, each at the same hour plus or minus 3 hours, no single dose above 2000 mg, and halved if creatinine clearance is below 40 ml/min","why":"This is the licensed three-day schedule used in the trials that supported it.","source":"savene-smpc","quote":"Treatment should be given once daily for 3 consecutive days. The recommended dose is: Day 1: 1000 mg/m2 Day 2: 1000 mg/m2 Day 3: 500 mg/m2"},{"action":"Anthracyclines: infuse dexrazoxane over 1 to 2 hours into a large vein of another limb, and take cold packs off the area at least 15 minutes before","why":"The drug has to reach the injured tissue through the blood, which cold slows.","source":"savene-smpc","quote":"Cooling procedures such as ice packs should have been removed from the area at least 15 minutes before the Savene administration in order to allow sufficient blood flow."},{"action":"Anthracyclines: do not apply dimethyl sulfoxide to a patient receiving dexrazoxane","why":"In animal studies the combination caused skin wounds that dexrazoxane alone prevented.","source":"savene-smpc","quote":"Dimethylsulfoxide (DMSO) should not be used in patients who are administered dexrazoxane to treat anthracycline extravasation"},{"action":"Mitomycin, mitoxantrone, or an anthracycline when dexrazoxane is unavailable or contraindicated: use topical dimethyl sulfoxide","why":"Dimethyl sulfoxide is thought to protect tissue by scavenging free radicals.","source":"ons-voice-2025","quote":"Dimethyl sulfoxide for extravasation occurring with mitomycin C and mitoxantrone as well as when dexrazoxane is not available or is contraindicated"},{"action":"Dimethyl sulfoxide: paint a thin layer over the marked area only, let it dry, and stop if it blisters","why":"It should treat the injured area without irritating healthy skin.","source":"wm-eag-2017","quote":"Carefully apply a thin layer of DMSO topically to the marked area avoiding contact with unaffected areas"},{"action":"Dimethyl sulfoxide: start within 10 to 25 minutes, using a 50 to 99 per cent solution every 8 hours for 7 days over an area twice the size of the extravasation","why":"This is the schedule the ONS/ASCO algorithm gives; see the variants for a six-hourly one.","source":"ons-asco-algorithm-2025"},{"action":"Vinca alkaloids (vincristine, vinblastine, vinorelbine): give hyaluronidase and use warm compresses","why":"Hyaluronidase breaks down the tissue's binding substance so the drug spreads and is absorbed.","source":"ons-voice-2025","quote":"Hyaluronidase for extravasation occurring with vinca alkaloids, paclitaxel, and docetaxel"},{"action":"Hyaluronidase: inject 1 ml (150 units) as five 0.2 ml injections under the skin around the edge of the area","why":"Ringing the area spreads the enzyme evenly through it.","source":"wm-eag-2017","quote":"Subcutaneously (or intradermally) inject 1 ml (150 IU) of hyaluronidase as 5 separate 0.2 ml injections around the periphery of extravasation site."},{"action":"Taxanes (paclitaxel, docetaxel): consider hyaluronidase with warm compresses; without it, use cold","why":"Taxane leaks may not cause severe injury, but the panel judged the possible benefit worth the low risk.","source":"ons-voice-2025","quote":"Although paclitaxel or docetaxel extravasations may not result in severe tissue injury, the experts made a conditional recommendation that patients receive hyaluronidase as an antidote because of a potential benefit in minimizing injury and the low potential for harm.","grade":"conditional recommendation"},{"action":"Cisplatin (more than 20 ml at above 0.5 mg/ml) and bendamustine: give sodium thiosulfate","why":"The ONS/ASCO panel names it as the antidote for these two drugs.","source":"ons-voice-2025","quote":"Sodium thiosulfate for extravasation occurring with > 20 ml of cisplatin in high concentration (greater than 0.5 mg/ml) and bendamustine"},{"action":"Mechlorethamine (chlormethine), carmustine, dacarbazine and other DNA-binding vesicants with no antidote named: manage on the DNA-binding pathway, with cold to localise","why":"The UK network guideline classes these as DNA-binding vesicants and puts them on the cold, localise pathway.","source":"wm-eag-2017"},{"action":"Irritants, non-vesicants and drugs not listed: choose a compress by the drug's mechanism, the pain or swelling, and the patient's comfort","why":"Irritants rarely break the skin down, so comfort and the drug's action guide the choice.","source":"ons-voice-2025","quote":"For extravasation of agents not listed, consider the mechanism of action, presence of pain or swelling, and patient comfort when selecting a compress."},{"action":"Do not inject steroids into the site","why":"In the evidence the Japanese panel reviewed, injected steroids were linked to worse injury and slower recovery.","source":"jscn-jsmo-jaspo-2024","quote":"It is weakly recommended not to inject local steroids for EV of anticancer drugs.","grade":"Not recommend (weak), certainty D"},{"action":"Refer for surgical review promptly after any central line extravasation of a vesicant, and consider it for DNA-binding vesicants, large volumes and grade 2 or worse symptoms","why":"The panel judged these patients the likeliest to benefit from early specialist review.","source":"ons-voice-2025","quote":"The panel suggested that patients with central line extravasation of vesicants or irritants with vesicant properties be referred for surgical evaluation or escalation of care in addition to conservative management when indicated."},{"action":"Do not debride an ulcer that has no dead tissue; refer for surgery where necrosis or pain persists beyond 10 days","why":"Ulcers without necrosis can heal without surgery, and it is hard to judge early how deep the damage goes.","source":"jscn-jsmo-jaspo-2024","quote":"It is weakly recommended not to debride EV-induced skin ulcer lesions without necrosis.","grade":"Not recommend (weak), certainty C"},{"action":"Document the drug, dose, volume, site, device, timings, every measure taken and the response, and report the incident","why":"A full record guides follow-up and lets the service learn from each event.","source":"ons-voice-2025","quote":"Document the event carefully, including the drug, dose, timing, interventions taken, and the patient’s response."},{"action":"Teach the patient or carer to keep the area clean and dry, raise the limb, keep up the compresses, and report redness, pain, blistering, peeling or fever","why":"Damage can appear days or weeks later, at home.","source":"ons-voice-2025","quote":"Monitor the area for changes such as redness, pain, blistering, peeling, or streaks and report any delayed reactions such as fever higher than 100.4º F."},{"action":"Review the site within a week, booked before the patient leaves","why":"A planned review catches injury that is getting worse.","source":"wm-eag-2017","quote":"All patients must have a review of their extravasation injury within 1 week, this appointment must be arranged prior to the patient leaving clinic"},{"action":"Keep following up DNA-binding vesicant injuries for at least three weeks, in person or remotely, starting within a day","why":"Injury from DNA-binding drugs has a history of appearing late.","source":"ons-asco-algorithm-2025"}],"bestInClass":{"statement":"The strongest current recommendation is the ONS/ASCO guideline (2025, GRADE): stop, aspirate and mark; use the drug's antidote where one exists (dexrazoxane for anthracyclines, hyaluronidase for vinca alkaloids and conditionally for taxanes, dimethyl sulfoxide for mitomycin and mitoxantrone or when dexrazoxane cannot be used, sodium thiosulfate for concentrated cisplatin and bendamustine); thermal compresses for 48 to 72 hours, cold for most vesicants and warm for vinca alkaloids, etoposide and oxaliplatin; and early surgical referral after a central line extravasation. Dexrazoxane follows its licensed three-day schedule, started within six hours. Guidelines disagree on two points. ONS/ASCO recommends warm compresses for the dispersing drugs and its algorithm advises aspiration; the Japanese JSCN/JSMO/JASPO guideline (2024) weakly recommends against warm compresses used alone, partly because hyaluronidase is not approved for extravasation in Japan, and makes no recommendation on aspiration because the evidence could not be weighed.","sources":["ons-voice-2025","ons-asco-algorithm-2025","savene-smpc","jscn-jsmo-jaspo-2024"]},"variants":[{"name":"UK network pathway: localise and neutralise, or disperse and dilute (West Midlands, 2017)","differs":"Sorts vesicants by DNA binding: DNA-binding drugs get cold compresses and antidotes, non-DNA-binding drugs get warmth and hyaluronidase. Compresses for 20 minutes four times daily for 1 to 2 days. Chooses the anthracycline antidote by volume: topical dimethyl sulfoxide under 3 ml, dexrazoxane over 3 ml. Starts hyaluronidase within 1 hour (ONS/ASCO says within 2 to 4 hours). Refers vesicant and irritant extravasations to the local plastics or flush-out team for a saline flush-out as soon as possible. Its dimethyl sulfoxide appendix says every 6 hours for 7 days while its own antidote table says every 8 hours.","evidence":"Expert consensus with no grades; the guideline describes the antidote evidence as often inconclusive. It passed its own review date in July 2019.","sources":["wm-eag-2017"]},{"name":"Japanese multidisciplinary guideline (JSCN, JSMO and JASPO, 2024)","differs":"Cold compresses weakly recommended; warm compresses alone weakly recommended against; topical steroids weakly recommended and injected steroids weakly recommended against; no recommendation on aspiration. Classifies oxaliplatin, docetaxel, paclitaxel and mitoxantrone as vesicants on its own systematic review, where the UK network list calls oxaliplatin and mitoxantrone irritants.","evidence":"GRADE with the Minds handbook; certainty very low (D) for most local measures and moderate (B) for dexrazoxane.","sources":["jscn-jsmo-jaspo-2024"]}],"grades":[{"claim":"Give dexrazoxane for anthracycline extravasation","grade":"Recommend (weak), certainty B","source":"jscn-jsmo-jaspo-2024","quote":"Administration of dexrazoxane for EV induced by an anthracycline cancer drug is weakly recommended."},{"claim":"Use cold compresses as local therapy","grade":"Recommend (weak), certainty D","source":"jscn-jsmo-jaspo-2024","quote":"Cold compression is weakly recommended as local therapy to prevent aggravation/progression of tissue injury and inflammation induced by EV."},{"claim":"Avoid warm compresses used alone","grade":"Not recommend (weak), certainty D","source":"jscn-jsmo-jaspo-2024","quote":"Avoidance of warm compresses (heat) is weakly recommended to prevent EV-induced skin damage and aggravation/progression of inflammation."},{"claim":"Aspirating residual drug or blood","grade":"None, certainty D","source":"jscn-jsmo-jaspo-2024","quote":"No recommendation (no vote)."},{"claim":"Do not inject steroids locally","grade":"Not recommend (weak), certainty D","source":"jscn-jsmo-jaspo-2024","quote":"It is weakly recommended not to inject local steroids for EV of anticancer drugs."},{"claim":"Apply topical steroids","grade":"Recommend (weak), certainty D","source":"jscn-jsmo-jaspo-2024","quote":"Applying topical steroids for EV of anticancer drugs is weakly recommended."},{"claim":"Do not debride an ulcer without necrosis","grade":"Not recommend (weak), certainty C","source":"jscn-jsmo-jaspo-2024","quote":"It is weakly recommended not to debride EV-induced skin ulcer lesions without necrosis."},{"claim":"Give hyaluronidase after paclitaxel or docetaxel extravasation","grade":"conditional recommendation","source":"ons-voice-2025","quote":"the experts made a conditional recommendation that patients receive hyaluronidase as an antidote"}],"sources":[{"key":"ons-asco-2025","label":"ONS/ASCO Guideline on the Management of Antineoplastic Extravasation, Clinical Journal of Oncology Nursing 29(5):384-399","publisher":"Oncology Nursing Society and American Society of Clinical Oncology","year":2025,"url":"https://www.ons.org/publications-research/cjon/29/5/onsasco-guideline-management-antineoplastic-extravasation","doi":"10.1188/25.CJON.384-399","gradingScheme":"GRADE: recommendations are strong or conditional, with certainty of evidence high, moderate, low or very low.","read":"abstract","accessed":"2026-11-11"},{"key":"ons-voice-2025","label":"New Extravasation Guidelines Provide Recommendations for Protecting Patients and Standardizing Care, ONS Voice","publisher":"Oncology Nursing Society","year":2025,"url":"https://www.ons.org/publications-research/voice/news-views/10-2025/new-extravasation-guidelines-provide-recommendations","gradingScheme":"Reports the ONS/ASCO GRADE recommendations; prints a grade only for the taxane hyaluronidase recommendation.","read":"public-summary","accessed":"2026-11-11"},{"key":"ons-asco-algorithm-2025","label":"Algorithm on the Management of Antineoplastic Extravasation of Vesicant or Irritant with Vesicant Properties in Adults","publisher":"Oncology Nursing Society and American Society of Clinical Oncology","year":2025,"url":"https://www.ons.org/sites/default/files/2025-09/ons-asco-algorithm-on-antineoplastic-extravasation_09.2025.pdf","read":"full-text","accessed":"2026-11-11"},{"key":"jscn-jsmo-jaspo-2024","label":"Extravasation associated with cancer drug therapy: multidisciplinary guideline of the Japanese Society of Cancer Nursing, Japanese Society of Medical Oncology, and Japanese Society of Pharmaceutical Oncology, ESMO Open 9:103932","publisher":"Japanese Society of Cancer Nursing, Japanese Society of Medical Oncology and Japanese Society of Pharmaceutical Oncology","year":2024,"url":"https://europepmc.org/article/PMC/PMC11490930","doi":"10.1016/j.esmoop.2024.103932","gradingScheme":"GRADE and Minds: strength Recommend or Not recommend, strong or weak; certainty A high, B moderate, C low, D very low.","read":"full-text","accessed":"2026-11-11"},{"key":"savene-smpc","label":"Savene 20 mg/ml powder and solvent for concentrate for solution for infusion: Summary of Product Characteristics","publisher":"European Medicines Agency","year":2024,"url":"https://www.ema.europa.eu/en/documents/product-information/savene-epar-product-information_en.pdf","read":"full-text","accessed":"2026-11-11"},{"key":"wm-eag-2017","label":"Guidelines for the Management of Extravasation of a Systemic Anti-Cancer Therapy including Cytotoxic Agents, version 1","publisher":"West Midlands Expert Advisory Group for Systemic Anti-Cancer Therapy, NHS England","year":2017,"url":"https://www.england.nhs.uk/midlands/wp-content/uploads/sites/46/2019/05/management-extravasation-of-a-systemic-anti-cancer-therapy-including-cytotoxic-agents.pdf","read":"full-text","accessed":"2026-11-11"},{"key":"esmo-eons-2012","label":"Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines, Annals of Oncology 23 Suppl 7:vii167-vii173","publisher":"ESMO and European Oncology Nursing Society","year":2012,"url":"https://doi.org/10.1093/annonc/mds294","doi":"10.1093/annonc/mds294","read":"not-reachable","accessed":"2026-11-11"}],"upgrades":[],"gaps":["The full text of the ONS/ASCO guideline could not be read (bot checks on PubMed Central and the publisher), so the strength and certainty of each of its recommendations are not quoted, except the conditional recommendation for hyaluronidase after taxane extravasation that ONS's own summary prints.","The ESMO-EONS guideline (2012) could not be read: the publisher's site returned a bot check and no abstract is indexed. No step rests on it. No newer ESMO edition was found.","No source that could be read recommends sodium thiosulfate for mechlorethamine (chlormethine) extravasation. ONS/ASCO recommends it for concentrated cisplatin and bendamustine; the UK network guideline lists mechlorethamine as a DNA-binding vesicant without naming an antidote.","The ONS Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (2023) is a paid book and was not read.","Hyaluronidase timing differs: within 2 to 4 hours in the ONS/ASCO algorithm, within 1 hour in the UK network guideline. Neither gives evidence for its window.","The dimethyl sulfoxide schedule differs between every 8 hours (ONS/ASCO algorithm) and every 6 hours (the UK network guideline's appendix, which contradicts its own table). Dimethyl sulfoxide is unlicensed for this use in the UK.","The Savene label has no data on extravasation from central venous access devices: those patients were excluded from its efficacy evaluation.","The West Midlands guideline passed its review date in July 2019, and an Irish national guideline (NCCP, 2023) could not be retrieved, so no UK or Irish guidance newer than 2017 was read."]},"route":"/protocols/chemotherapy-extravasation-management/","neighbours":{"technology":[{"id":"dmso-dimethyl-sulfoxide","kind":"technology","name":"DMSO (dimethyl sulfoxide)","route":"/technologies/dmso-dimethyl-sulfoxide/"},{"id":"implanted-ports","kind":"technology","name":"Implanted ports for chemotherapy (port-a-cath, power-injectable, apheresis and intraperitoneal ports)","route":"/technologies/implanted-ports/"},{"id":"picc-lines","kind":"technology","name":"Peripherally inserted central catheters (PICC lines)","route":"/technologies/picc-lines/"}],"drug":[{"id":"bendamustine","kind":"drug","name":"Bendamustine","route":"/drugs/bendamustine/"},{"id":"carmustine","kind":"drug","name":"Carmustine","route":"/drugs/carmustine/"},{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"},{"id":"dacarbazine","kind":"drug","name":"Dacarbazine","route":"/drugs/dacarbazine/"},{"id":"dactinomycin","kind":"drug","name":"Dactinomycin (actinomycin D)","route":"/drugs/dactinomycin/"},{"id":"daunorubicin","kind":"drug","name":"Daunorubicin","route":"/drugs/daunorubicin/"},{"id":"dexrazoxane","kind":"drug","name":"Dexrazoxane","route":"/drugs/dexrazoxane/"},{"id":"docetaxel","kind":"drug","name":"Docetaxel","route":"/drugs/docetaxel/"},{"id":"doxorubicin","kind":"drug","name":"Doxorubicin","route":"/drugs/doxorubicin/"},{"id":"epirubicin","kind":"drug","name":"Epirubicin","route":"/drugs/epirubicin/"},{"id":"etoposide","kind":"drug","name":"Etoposide","route":"/drugs/etoposide/"},{"id":"idarubicin","kind":"drug","name":"Idarubicin","route":"/drugs/idarubicin/"},{"id":"mechlorethamine","kind":"drug","name":"Mechlorethamine (chlormethine)","route":"/drugs/mechlorethamine/"},{"id":"mitomycin","kind":"drug","name":"Mitomycin C","route":"/drugs/mitomycin/"},{"id":"mitoxantrone","kind":"drug","name":"Mitoxantrone","route":"/drugs/mitoxantrone/"},{"id":"oxaliplatin","kind":"drug","name":"Oxaliplatin","route":"/drugs/oxaliplatin/"},{"id":"paclitaxel","kind":"drug","name":"Paclitaxel / nab-paclitaxel","route":"/drugs/paclitaxel/"},{"id":"sodium-thiosulfate","kind":"drug","name":"Sodium thiosulfate (otoprotectant)","route":"/drugs/sodium-thiosulfate/"},{"id":"trabectedin","kind":"drug","name":"Trabectedin","route":"/drugs/trabectedin/"},{"id":"vinblastine","kind":"drug","name":"Vinblastine","route":"/drugs/vinblastine/"},{"id":"vincristine","kind":"drug","name":"Vincristine","route":"/drugs/vincristine/"},{"id":"vinorelbine","kind":"drug","name":"Vinorelbine","route":"/drugs/vinorelbine/"}],"term":[{"id":"central-venous-access","kind":"term","name":"Central venous access (port, PICC line)","route":"/terms/central-venous-access/"},{"id":"extravasation-infusion-reaction","kind":"term","name":"Infusion reactions, hypersensitivity and extravasation","route":"/terms/extravasation-infusion-reaction/"}],"protocol":[{"id":"sact-administration-checks-at-the-chair","kind":"protocol","name":"Anticancer treatment administration checks at the chair: assessment, independent double checks and line tracing","route":"/protocols/sact-administration-checks-at-the-chair/"},{"id":"peripheral-cannula-for-anticancer-therapy","kind":"protocol","name":"Peripheral cannula for anticancer treatment: vein choice, siting and checks, including vesicants","route":"/protocols/peripheral-cannula-for-anticancer-therapy/"}]}}