Purpose: Phase II studies in laryngeal and bladder carcinoma of accelerated radiotherapy with carbogen and nicotinamide (RT+CON) suggested a therapeutic advantage. Therefore, a randomized phase-III trial of RT+CON in locally advanced bladder carcinoma compared to radiotherapy (RT) alone was undertaken.
Methods: One hundred and sixty-five patients with muscle-invasive transitional cell bladder carcinoma were randomized to RT alone and 168 to RT+CON. This paper reports on compliance and toxicity to nicotinamide (NAM) and carbogen and on early radiation-induced adverse bowel and urinary events.
Results: Of those receiving RT+CON, 65-69% accepted all doses of NAM. Sixty-four percent of patients presented Grade 1 NAM toxicity (nausea or vomiting), which was severe in 13%. Compliance to carbogen was 85% and none (32 fractions) and 2% (20 fractions) of patients presented severe toxicity. The highest prevalence of severe radiation acute morbidity was seen for urinary frequency (RT: 18% and RT+CON: 15%) and for diarrhea (RT: 3% and RT+CON: 5%).
Conclusions: There is no indication of an increase in radiation-induced morbidity by combining the tumour radiosensitizers carbogen and nicotinamide with radiotherapy. Late morbidity and treatment outcome will ultimately determine if there is a therapeutic benefit.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.radonc.2008.10.001 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Concomitant chemotherapy in trimodal treatment of patients with muscle invasive bladder cancer: A systematic review of prospective trials.
Crit Rev Oncol Hematol
January 2025
Department of Medical Oncology, Institut Bergonié, Bordeaux, France. Electronic address:
Background And Objective: For selected patients with muscle-invasive bladder cancer (MIBC), trimodal therapy (TMT) incorporating transurethral resection of the tumor and chemoradiotherapy is an alternative to radical cystectomy. Concurrent chemotherapy (CC) is a pivotal component of TMT, however, the optimal CC protocol remains unknown. This systematic review aims to assess efficacy and safety outcomes of CC protocols used in TMT.
View Article and Find Full Text PDFThe Impact of Tumor Hypoxia Modulation on sIL-2R Levels in Newly Diagnosed Diffuse Large B Cell Lymphoma (DLBCL) Patients Undergoing Chemotherapy: A Randomized Clinical Trial.
Asian Pac J Cancer Prev
April 2024
Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine Diponegoro University, Dr. Kariadi General Hospital, Semarang, Indonesia.
Objective: Tumor hypoxia induces the production of Hypoxia-Inducible Factor (HIF)-1 alpha, which interacts with NF-kB, leading to cancer proliferation and metastasis. This study investigated the effect of tumor hypoxia modulation using carbogen (95% O2 and 5% CO2) and nicotinamide on reducing soluble interleukin-2 receptor (sIL-2R) levels in newly diagnosed DLBCL patients with tissue overexpression of HIF-1α ≥10%.
Material And Methods: A prospective randomized controlled clinical trial was conducted at Dr.
Low CD8 T Cell Counts Predict Benefit from Hypoxia-Modifying Therapy in Muscle-Invasive Bladder Cancer.
Cancers (Basel)
December 2022
Division of Cancer Sciences, University of Manchester, Manchester M13 9PL, UK.
Background: As hypoxia can drive an immunosuppressive tumour microenvironment and inhibit CD8+ T cells, we investigated if patients with low tumour CD8+ T cells benefitted from hypoxia-modifying therapy.
Methods: BCON was a phase III trial that randomised patients with muscle-invasive bladder cancer (MIBC) to radiotherapy alone or with hypoxia-modifying carbogen plus nicotinamide (CON). Tissue microarrays of diagnostic biopsies from 116 BCON patients were stained using multiplex immunohistochemistry (IHC) with the markers CD8, CD4, FOXP3, CD68 and PD-L1, plus DAPI.
Correlation and colocalization of HIF-1α and pimonidazole staining for hypoxia in laryngeal squamous cell carcinomas: A digital, single-cell-based analysis.
Oral Oncol
May 2022
Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, the Netherlands.
Objective: Tumor hypoxia results in worse local control and patient survival. We performed a digital, single-cell-based analysis to compare two biomarkers for hypoxia (hypoxia-inducible factor 1-alpha [HIF-1α] and pimonidazole [PIMO]) and their effect on outcome in laryngeal cancer patients treated with accelerated radiotherapy with or without carbogen breathing and nicotinamide (AR versus ARCON).
Materials And Methods: Immunohistochemical staining was performed for HIF-1α and PIMO in consecutive sections of 44 laryngeal cancer patients randomized between AR and ARCON.
ATG12 deficiency results in intracellular glutamine depletion, abrogation of tumor hypoxia and a favorable prognosis in cancer.
Autophagy
August 2022
Department of Radiotherapy, Grow - School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Hypoxia is a common feature of solid tumors and is associated with increased tumor progression, resistance to therapy and increased metastasis. Hence, tumor hypoxia is a prognostic factor independent of treatment modality. To survive hypoxia, cells activate macroautophagy/autophagy.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!