Objective. Extravasations of anticancer agents may give serious complications and specific therapy might be needed. Topotecan is a new cytotoxic drug and is used in many clinical studies. In our clinic two extravasations of topotecan occurred, and the clinical consequences are discussed.
Clinical Features. The extravasations oc curred in two patients who were receiving topo tecan intravenously because of ovarian carcinoma stage III. The patients experienced some discom fort caused by the expansion of soft tissue. How ever, no serious complications were observed.
Case Progress and Outcome. Both patients received all further courses of topotecan without any negative effects.
Conclusion. In conclusion, besides stopping the injection, trying to aspirate the fluid, keeping the arm high, and cooling the swelling, we advise no specific measures to be taken after extravasa tion of topotecan.
Gottlieb JA, Guarino AM, Call JB, et al. Preliminary pharmacological and clinical evaluation of camptothecin sodium (NSC 100880). Cancer Chemother Rep.1970;54:461-470.
2.
Hertzberg RP , Caranfa MJ, Holden KG, et al. Modification of the hydroxy lactone ring of camptothecin: inhibition of mammalian topoisomerase I and biological activity. J Med Chem.1989 ;32:715-720.
3.
Hertzberg RP , Caranfa MJ, Hecht SMOn the mechanism of topoisomerase I inhibition by camptothecin: evidence for binding to an enzyme-DNA complex. Biochemistry.1989;28:4629 - 4638.
4.
Anonymous. DNA topoisomerases—new twist to tumour therapy . Lancet1988;i:512-513.
5.
Creemers GJ, Lund B., Verweij J.Topoisomerase I inhibitors: topotecan and irinotecan. Cancer Treatment Rev.1994;20:73-96.
6.
Carmichael J. , Gordon A., Malfetano J., et al. Topotecan, a new active drug, versus paclitaxel in advanced ovarian carcinoma: international study group trial . Proc Am Soc Clin Oncol.1996;15:283.
7.
Van Warmerdam LJC, Verweij J., Schellens Jhm, et al. Pharmacokinetics and pharmacodynamics of topotecan administered in a daily times five regimen every three weeks . Cancer Chemother Pharmacol.1995;35:237-245.
8.
Geervliet E. , Beijnen JH, Verweij SL, et al. Extravasation of antineoplastic agents . Pharm Weekbl Sci.1989;124:843- 853.
9.
Dorr RTAntidotes to vesicant chemotherapy extravasations. Blood Rev.1990;4:41-60.
10.
Bertelli A. , Gozza GB, Forno MG, et al. Topical dimethylsulfoxide for the prevention of soft tissue injury after extravasation of vesicant cytotoxic drugs: a prospective clinical study. J Clin Oncol.1995;13:2851-2855.
Muggia FM, Chachoua A., Hochster H.Doxorubicin. In: Cvitkovic E, Droz JP, Armand JP, et al, eds. Handbook of Chemotherapy in Clinical Oncology. Jersey, Channel Islands: Scientific Communication International Ltd; 1993;277-280.
