The Prophylactic Use of Thio-Tepa in Transitional Cell Carcinoma of the Bladder

Prophylactic Chemotherapy of Superficial Transitional Cell Bladder Carcinoma: an EORTC Randomized Trial Comparing Thiotepa, an Epipodophyllotoxin (VM26) and TUR Alone

“…Used as therapy against actual tumor masses, it undoubtedly does cause regression although the incidence is low. The most encouraging results have been with its use as adjuvant therapy after cystodiathermy in patients who have had multiple recurrences uncontrollable by the latter proce dure [8,10,11,20,21], The dose used in these studies has varied, but the results reported have been better using 50 and 90 mg than those achieved using 30 mg, which was used in this study. However, the study of the National Bladder Cancer Cooperative Group A, Koontz et al [8], has shown similar results when using 30-and 60-mg reg imens as prophylactic treatment.…”

“…While several reports have suggested the prophylactic value of thiotepa instillation, this has not been confirmed by other authors [4,7,10,[19][20][21], Staquet [17] has reviewed nine non-randomized studies with intravesical thiotepa and found a success rate ranging from 24 to 100%. The Veterans Administration Cooperative Urological Research Group [2] performed a prospective randomized study comparing intravesical thiotepa, oral pyridoxine and placebo as prophylactic agents to prevent tumor recurrence in patients with T1 bladder tumors.…”

The Use of Chemotherapeutic Agents in the Prophylaxis of Papillary Bladder Tumours

“…Unfortunately saccharo 1:4 lactone, a /i-glucuronidase inhibitor, was found to be ineffective. Some encouraging results have already been obtained by the post operative intravesical instillation of chemotherapeutic agents, such as thiotepa [2,3,5,6,8,11,12,13,15] or nitrogen mustard [1], or by the addition of drugs to the irrigating fluid used for transurethral procedures [7]. These data, as well as our own experience, indicate that recurrent neoplasms often grow after stopping the treatment.…”

The Randomized Clinical Trial: a Prerequisite for Rational Therapy

“…Intracavitary chemotherapy with thiotepa has been first tried in 1961 (35). Since then nu merous publications (table II) have appeared giving a response rate varying from 24 to 100 % (37)(38)(39)(40)(41)(42)(43)(44)(45). Side effects such as dysuria and hematuria are not rare.…”