Review : Utilization of dimethyl sulfoxide for treating anthracycline extravasation

Abstract

Objective. To review the literature available on the use of dimethyl sulfoxide (DMSO) to treat anthracy cline extravasation.

Data Sources. English-language literature was gathered using Medline, EMBASE International Phar maceutical Abstracts, CINAHL, and references from bibliographies.

Study Selection. Studies selected for review included controlled animal studies and any available human studies, including case reports and case series. All studies must have used DMSO in the treatment of an anthracycline extravasation.

Data Extraction. Data extracted from animal studies included the animal model used; method of doxorubicin and DMSO administration; ulcer out come ; and statistical significance. Individual case re ports and case series were abstracted for the anti neoplastic agent extravasated; associated symptoms; DMSO administration; concurrent therapies; and short- and long-term results (symptoms, functional damage).

Data Synthesis. One of six animal studies indi cated a significant difference in peak lesion size and area under the curve between DMSO and control. However, local cooling resulted in less toxicity as compared with DMSO, and the time to ulcer healing was actually prolonged in the DMSO-treated group. Clinical experience with DMSO has resulted in no surgical intervention and no residual function impair ment after anthracycline extravasation.

Conclusion. The controversial animal data and the lack of controlled clinical experience with DMSO should preclude its use as the sole initial therapy of anthracycline extravasations. A comparison study be tween topical DMSO and local cooling versus local cooling alone would aid in determining the true benefit of DMSO in the treatment of anthracycline extravasation.