Pigott K, Dische S, Saunders M I
Mount Vernon Hospital, Northwood, Middlesex, UK.
Br J Radiol. 1995 Feb;68(806):215-8. doi: 10.1259/0007-1285-68-806-215.
Tumour cell hypoxia is a recognized cause of resistance to radiotherapy. Using clinically relevant dose-fractionation schedules in a mouse tumour model, the addition of carbogen and nicotinamide to overcome chronic and acute hypoxia results in a marked increase in radioresponsiveness with a lower degree of sensitization in normal tissue. Carbogen and nicotinamide were added to the palliative radiation treatment given to six patients with locally advanced breast cancer. The aim of the pilot study was to determine if patients tolerated the addition of carbogen and nicotinamide and to assess if there was any increase in radiosensitivity of the skin. Patients received 30 Gy prescribed to the intersection dose in six fractions over 17/18 days with full skin bolus to the tumour. All patients were given 6 g of nicotinamide orally 90 min before radiation treatment. Carbogen breathing was started 5 min prior to treatment and continued during it. Patients tolerated the treatment well, with vomiting in one patient being the only side effect that could be related to the nicotinamide, and this settled with an anti-emetic. No increase in skin reaction was noted with the addition of carbogen and nicotinamide, and good tumour regression was achieved.
肿瘤细胞缺氧是公认的放疗抵抗原因。在小鼠肿瘤模型中使用临床相关的剂量分割方案，添加卡波金和烟酰胺以克服慢性和急性缺氧，可显著提高放射敏感性，同时正常组织的敏化程度较低。将卡波金和烟酰胺添加到对6例局部晚期乳腺癌患者进行的姑息性放射治疗中。该初步研究的目的是确定患者是否能耐受添加卡波金和烟酰胺，并评估皮肤的放射敏感性是否有增加。患者在17/18天内分6次接受30 Gy的照射，照射剂量以交叉剂量为准，对肿瘤进行全皮肤敷贴。所有患者在放疗前90分钟口服6 g烟酰胺。在治疗前5分钟开始吸入卡波金，并在治疗期间持续吸入。患者对治疗耐受性良好，唯一可能与烟酰胺有关的副作用是1例患者出现呕吐，使用止吐药后症状缓解。添加卡波金和烟酰胺后未观察到皮肤反应增加，且肿瘤实现了良好的消退。
