Radiotherapy With Concurrent Carbogen and Nicotinamide in Bladder Carcinoma.
Summary of "Radiotherapy With Concurrent Carbogen and Nicotinamide in Bladder Carcinoma."
PURPOSE Phase II clinical studies suggest that hypoxic modification with carbogen and nicotinamide (CON) may increase the efficacy of radiotherapy (RT). PATIENTS AND METHODS Three hundred thirty-three patients with locally advanced bladder carcinoma were randomly assigned to RT alone versus RT with CON. A schedule of either 55 Gy in 20 fractions in 4 weeks or 64 Gy in 32 fractions in 6.5 weeks was used. The primary end point was cystoscopic control at 6 months (CC(6m)) and secondary end points were overall survival (OS), local relapse-free survival (RFS), urinary and rectal morbidity. Results CC(6m) was 81% for RT + CON and 76% for RT alone (P = .3); however, just more than half of patients underwent cystoscopy at that time. Three-year estimates of OS were 59% and 46% (P = .04) and 3-year estimates of RFS were 54% and 43% (P = .06) for RT + CON versus RT alone. Risk of death was 14% lower with RT + CON (P = .04). In multivariate comparison, RT + CON significantly reduced the risk of relapse (P = .05) and death (P = .03). There was no evidence that differences in late urinary or GI morbidity between treatment groups or between fractionation schedules were significant. CONCLUSION RT + CON produced a small nonsignificant improvement in CC(6m). Differences in OS, risk of death, and local relapse were significantly in favor of RT + CON. Late morbidity was similar in both trial arms. Results indicate a benefit of adding CON to radical RT.
Affiliation
Cancer Centre, Mount Vernon Hospital, Northwood, Middlesex, HA6 2RN, United Kingdom; arc03@btconnect.com.
Journal Details
This article was published in the following journal.
Name: Journal of clinical oncology : official journal of the American Society of Clinical Oncology
ISSN: 1527-7755
Pages: 4912-4918
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20956620
- DOI: http://dx.doi.org/10.1200/JCO.2010.28.4950
Medical and Biotech [MESH] Definitions
Nicotinamide Phosphoribosyltransferase
An enzyme that catalyzes the formation of nicotinamide mononucleotide (NMN) from nicotinamide and 5-phosphoribosyl-1-pyrophosphate, the rate-limiting step in the biosynthesis of the NAD coenzyme. It is also known as a growth factor for early B-LYMPHOCYTES, or an ADIPOKINE with insulin-mimetic effects (visfatin).
Nicotinamide Mononucleotide
3-Carbamoyl-1-beta-D-ribofuranosyl pyridinium hydroxide-5'phosphate, inner salt. A nucleotide in which the nitrogenous base, nicotinamide, is in beta-N-glycosidic linkage with the C-1 position of D-ribose. Synonyms: Nicotinamide Ribonucleotide; NMN.
Nad+ Nucleosidase
An enzyme that catalyzes the hydrolysis of nicotinamide adenine dinucleotide (NAD) to NICOTINAMIDE and ADENOSINE DIPHOSPHATE RIBOSE. Some are extracellular (ectoenzymes).The enzyme from some sources also catalyses the hydrolysis of nicotinamide adenine dinucleotide phosphate (NADP).
Radiotherapy, Adjuvant
Radiotherapy given to augment some other form of treatment such as surgery or chemotherapy. Adjuvant radiotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment.
Carcinoma, Verrucous
A variant of well-differentiated epidermoid carcinoma that is most common in the oral cavity, but also occurs in the larynx, nasal cavity, esophagus, penis, anorectal region, vulva, vagina, uterine cervix, and skin, especially on the sole of the foot. Most intraoral cases occur in elderly male abusers of smokeless tobacco. The treatment is surgical resection. Radiotherapy is not indicated, as up to 30% treated with radiation become highly aggressive within six months. (Segen, Dictionary of Modern Medicine, 1992)
PubMed Articles
Carbogen gas and radiotherapy outcomes in prostate cancer.
Prostate cancer hypoxia is associated with inferior prognosis and resistance to treatment. The use of androgen deprivation therapy, both prior to and during radiotherapy, may exacerbate underlying hyp...
Carcinoma of the bladder is one of the most common urologic malignancies occurring worldwide. Diagnosis and monitoring of bladder urothelial carcinoma (UC) are based on cystoscopy and urinary cytology...
To evaluate the efficacy and toxicity of gemcitabine-based induction chemotherapy followed by concurrent gemcitabine and radiotherapy in advanced squamous cell carcinoma of head and neck. A total of 2...
We report a case of a metastatic transitional cell carcinoma of the bladder in a 20-year-old patient who had previously undergone resection of posterior urethral valves, clean intermittent catheteriza...
PURPOSE The aim of this prospective, phase II trial was to determine the response of muscle-invasive bladder cancer (MIBC) to concurrent chemoradiotherapy of weekly gemcitabine with 4 weeks of radioth...
Clinical Trials
Randomized Trial of ARCON in Larynx Cancer
TITLE: A multicentre, randomised, phase III clinical trial comparing accelerated radiotherapy with accelerated radiotherapy plus carbogen and nicotinamide (ARCON) in clinical stage T2-4...
Radiation Therapy With or Without Carbogen and Niacinamide in Treating Patients With Bladder Cancer
RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs such as carbogen and niacinamide may make tumor cells more sensitive to radiation therapy. It is not yet k...
Safety Study of Nicotinamide to Treat Alzheimer's Disease
The purpose of this study is to determine whether nicotinamide, or vitamin B3, is safe and effective in the treatment of Alzheimer's disease.
Intravesical Epirubicin Plus BCG to Prevent the Recurrence of Transitional Cell Carcinoma of Bladder
Biochemotherapy (combined immunotherapeutic drugs and chemotherapeutic drugs) has shown virtue than that use chemical or biological drugs alone in the treatment of some malignant tumor. He...
Dosimetric Analysis of Vaginal Cuff Brachytherapy in Endometrial Carcinoma
The purpose of this study is to investigate the effect of certain variables such as the fullness of the patients bladder and the position of the treatment applicator on the dose of radiati...
