Epirubicin hydrochloride, which is used in adjuvant or neoadjuvant chemotherapy of breast cancer, causes vascularrelated adverse reactions such as phlebitis, pain at the injection site, and venous irritation. Although several methods for preventing epirubicin-induced phlebitis had been attempted, the incidence of all grade phlebitis was still high (as high as approximately 50%). In this study, we evaluated a new preventive regimen of epirubicin-induced phlebitis. The major changes are as follows: 1) switch of the diluted solution of epirubicin from 100 mL of 5% glucose solution to 50 mL of physiological saline, 2) reduction of infusion time of epirubicin, and 3) addition of 200 mL of infusion solution mixed with dexamethasone 6.6 mg after drip infusion of epirubicin. The incidence of phlebitis was 20.0% in the new regimen group, while it was 50.0% in the previous regimen group (P < 0.05). Severe phlebitis was significantly reduced in the new regimen group compared with that in the previous regimen group (1.8% vs 13.5%, P < 0.05).
These results suggest that the reduction in infusion time of epirubicin and the addition of infusion solution mixed with dexamethasone after the administration of epirubicin are useful for the prevention of epirubicin-induced phlebitis.