Recall reaction of a severe local peripheral neuropathy after paclitaxel extravasation.

Peripheral neuropathy with numbness, tingling, and burning pain in a glove-and-stocking distribution is the most common nonhematologic side effect associated with paclitaxel (Taxol) therapy, whereas nerve damage leading to motor dysfunction is uncommon (J). We report here on a 53-year-old man with both non-insulin-dependent diabetes mellitus without systemic complications and locally advanced non-small-cell lung cancer. The patient was started on paclitaxel that was administered through the right antecubital vein at 175 mg/m2 in a 3-hour infusion (total dose, 360 mg). He also received standard recommended premedication and carboplatin; the carboplatin dose was targeted to an area under the curve for drug concentration as a function of time of 7 (total dose, 1080 mg). During the infusion of paclitaxel, an extravasation of approximately one fifth of the dose occurred. The rest of the paclitaxel dose followed by carboplatin was given through peripheral access in the left arm.