Indication of Thiotepa:
Thiotepa is useful in the palliative treatment of: - Breast cancer.- Ovarian cancer.It can also be used to: - Control effusions secondary to neoplastic diseases of various cavities.- Treat superficial papillary carcinoma of the urinary bladder.Thiotepa has been useful against lymphomas but has largely been superseded by other treatments.
Action of Thiotepa:
Thiotepa is an alkylating agent. This is a type of antineoplastic agent that works by interfering with DNA in a number of ways. Extra molecules, called alkyl groups, are added to DNA, which causes it to break apart as the cell tries to replace them. Thiotepa also interferes with the bonds between DNA strands, stopping them from separating, which is a step required in DNA replication. By replacing bases (important components of DNA) alkylating agents also create mismatching, another way to stop DNA being reproduced properly. All these changes occur when a cell is preparing to divide, and the permanent damage they cause results in cessation of division and cell death.
Dose Advice of Thiotepa:
Thiotepa is intended for intravenous, intracavitary and intravesical (intra-bladder) use only. Thiotepa is non-vesicant and can be administered without need for slow injection or large amounts of diluent.Intravenous administration: - 0.3-0.4mg/kg at one to four week intervals.- Reconstitute in 15ml water for injections.Intracavitary administration: - 0.6-0.8mg/kg.- Through the same tube used to remove the fluid involved in the effusion.Use in bladder cancer: - Ensure patient is dehydrated for 6-12 hours prior to treatment.- Dilute 60mg of Thiotepa in 30-60ml distilled water and instil via a catheter into the bladder.- Solution should be retained for 2 hours for maximal effect.- Patient should be repositioned every 15 minutes for maximum surface coverage.- Process should be repeated once a week for 4 weeks.- Repeat courses should be withheld until haematological parameters have returned to normal.
Schedule of Thiotepa:
S4
Common side effects of Thiotepa:
The most important effect of Thiotepa is bone marrow suppression, which causes decreased white and red blood cells and platelets. This results in increased infection and bleeding risk, and anaemia.Other adverse effects include: - Fatigue.- Fever.- Discharge from cutaneous lesion due to breakdown of tumour tissue.- Pain at injection site.- Nausea.- Vomiting.- Abdominal pain.- Loss of appetite.- Pain on urination.- Urinary retention.- Dizziness.- Headache.- Blurred vision.- Cessation of menstruation.- Dermatitis.- Hair loss.
Uncommon side effects of Thiotepa:
- Allergic reactions (including wheezing and hives).- Blood in the urine (after bladder administration).- Changes in skin pigmentation (following topical use).- Conjunctival inflammation (following topical use).
Diseases treated by Thiotepa:
Bladder Cancer (Squamous Cell Carcinoma of the Bladder)
