Effectiveness of cleaning of workplace cytotoxic surface.

PURPOSE: To minimize the risk of chronic occupational exposure of antineoplastic drugs, cleaning procedures must be evaluated. This study was conducted to compare the detergent efficiency of cleaning solutions (two hydro-alcoholic solutions, three disinfectants and two detergents) used in different cleaning protocols. METHODS: The central surface of a stainless steel plate (30 × 50 cm) was exposed to a carboplatin solution equivalent to 105,100 ng of platinum. After cleaning according to a standardized protocol, residual platinum contaminations were assayed on 10 × 10 cm sections. RESULTS: After standardized cleaning, the residual quantity of platinum on the surface of the deposit accounted for between 1.0 and >15 % of the initial deposit. Spread of contamination on the plate depended on the cleaning movement and was between 2.1 and 53.9 % of the total quantity on the plate. The two detergents were more efficient (2,793-4,780 ng/plate) than hydro-alcoholic solutions (>20,000 ng/plate). The efficacy of the disinfectant was intermediate (5,891-6,122 ng/plate for solutions and 15,360 ng/plate for pre-soaked gauze). The cleaning protocol was also important with better efficiency of 8 mL of cleaning solution for 1,500 cm(2) (versus 4 mL), sprayed directly on the plate (versus wiping) with no contact time (versus 5 min). CONCLUSION: The efficacy of chemical decontamination of cytotoxic work surfaces depends not only on the cleaning solution used, but also on the cleaning protocol. It is necessary to adapt the protocol to the surface to clean and it must be standardized and validated. This work is an example of an experimental procedure to evaluate the efficacy of cleaning solutions and protocols used at a workstation after exposure to antineoplastic drugs.

Cutaneous side effects associated with sunitinib: an analysis of 8 cases.

OBJECTIVE: Sunitinib is an antineoplastic agent, specifically a tyrosine kinase inhibitor. Thanks to its targeted action, this drug is relatively well tolerated. The main side effects are asthenia, gastrointestinal disturbances, and dermatological effects. The aim of our study was to collect information about dermatological side effects and assess them in patients treated with sunitinib. METHOD: A retrospective study was performed on 8 patients treated with sunitinib between January 2006 and July 2009. RESULTS: Twelve different types of side effects were observed: genital lesion (9), cutaneous eruption (7), hand-foot syndrome (6), yellow discoloration of skin (4), hair depigmentation (4), xerosis (4), pigmented lesion (4), vascular lesion (3), erythema (3), splinter haemorrhage of fingernails (1), facial oedema (1), and pruritus (1). To date vascular and pigmented lesions associated with sunitinib have not been recorded in literature, genital lesions have only been described in the scrotal region. These genital lesions led to discontinuation of treatment by 4 patients in our study. CONCLUSION: Although the risk/benefit ratio is favourable for sunitinib, all health care professionals must be aware of the risk of such adverse events. When genital lesions are observed, dose adjustment is recommended. Thorough clinical examination and patient interviews are necessary to detect these effects.