Simon Jean Marc, Noël Georges, Chiras Jacques, Hoang-Xuan Khê, Delattre Jean Yves, Baillet François, Mazeron Jean Jacques
Department of Radiation Oncology, Hôpital de la Pitié-Salpêtrière, Hôpitaux de Paris, 47/83 Boulevard de l'hôpital, 75651 Cedex 13, Paris, France.
Radiother Oncol. 2003 Apr;67(1):45-51. doi: 10.1016/s0167-8140(03)00007-0.
Nicotinamide and carbogen have been shown to enhance the radiation effect in tumour models.
Prospective evaluation of the toxicity and efficacy of carbogen and nicotinamide with external beam radiotherapy in the management of inoperable glioblastoma.
From April 1995 to December 1997, 33 patients with inoperable biopsy-proven glioblastoma multiforme (GBM) were enrolled in a phase II trial, to undergo radiotherapy (59.4 Gy in 1.8 Gy/fraction), intra-arterial cerebral chemotherapy (ACNU 100 mg/m(2), three cycles), carbogen breathing (15 l/min), and nicotinamide (85 mg/kg). This experimental group was compared to a control group of 38 patients with inoperable GBM treated with radiotherapy and three cycles of nitrosourea-based chemotherapy from January 1990 to March 1995, in our institution.
In the experimental group, carbogen breathing was well tolerated, but only 51.5% of patients completed daily nicotinamide over the 6.5-week treatment period. Nausea and vomiting were the most frequent side effects of nicotinamide. No significant difference in overall survival was observed among the two treatment groups: median survival times were 36.7 and 35.3 weeks for patients treated with carbogen and nicotinamide, and for those treated in the control group, respectively.
The association of carbogen and nicotinamide with radiotherapy is feasible, but tolerable only in 51.5% of patients with GBM. Carbogen and nicotinamide did not appear to modify the evolution of glioblastoma.
在肿瘤模型中，烟酰胺和卡波金已被证明可增强放射效应。
前瞻性评估卡波金和烟酰胺联合外照射放疗治疗无法手术的胶质母细胞瘤的毒性和疗效。
1995年4月至1997年12月，33例经活检证实为多形性胶质母细胞瘤（GBM）且无法手术的患者参加了一项II期试验，接受放疗（59.4 Gy，每次1.8 Gy）、动脉内脑化疗（卡氮芥100 mg/m²，三个周期）、卡波金呼吸（15 l/min）和烟酰胺（85 mg/kg）。将该试验组与1990年1月至1995年3月在我们机构接受放疗和三个周期亚硝基脲类化疗的38例无法手术的GBM患者组成的对照组进行比较。
在试验组中，卡波金呼吸耐受性良好，但在6.5周的治疗期内，只有51.5%的患者完成了每日烟酰胺治疗。恶心和呕吐是烟酰胺最常见的副作用。两个治疗组的总生存期无显著差异：接受卡波金和烟酰胺治疗的患者以及对照组患者的中位生存期分别为36.7周和35.3周。
卡波金和烟酰胺联合放疗是可行的，但仅51.5%的GBM患者可耐受。卡波金和烟酰胺似乎并未改变胶质母细胞瘤的病程。
