Hulshof M C, Rehmann C J, Booij J, van Royen E A, Bosch D A, González González D
Department of Radiotherapy, Academic Medical Center, University of Amsterdam, The Netherlands.
Radiother Oncol. 1998 Aug;48(2):135-42. doi: 10.1016/s0167-8140(98)00053-x.
Nicotinamide (NAM) and carbogen both have been shown to enhance the radiation effect in rodent tumour models and are currently being tested in clinical trials. These agents have demonstrated to act against hypoxia and one of their underlying mechanisms could be an increase of tumour blood perfusion.
To analyse the effect of both agents on normal brain perfusion and tumour perfusion in patients with glioblastoma.
Nineteen patients with glioblastoma were studied with 99mtechnetium-hexamethylpropyleneamine oxime single photon emission computed tomography (99mTc-HMPAO SPECT) before and after administration of carbogen and/or NAM. Another six patients were studied with the same procedure but without any flow modulator and were used as controls.
Although the variations between patients were large, no significant enhancement in mean tumour and normal brain perfusion could be demonstrated with NAM or carbogen compared to the control patients. Also no consistent changes in the mean perfusion ratio between tumour and surrounding normal brain were found, suggesting an absence of a selective perfusion effect.
No significant influence of carbogen and/or NAM on tumour perfusion and normal brain perfusion could be detected with SPECT in patients with glioblastoma.
烟酰胺（NAM）和卡波金均已在啮齿动物肿瘤模型中显示出增强放射效应的作用，目前正在进行临床试验。这些药物已被证明可对抗缺氧，其潜在机制之一可能是肿瘤血流灌注增加。
分析这两种药物对胶质母细胞瘤患者正常脑灌注和肿瘤灌注的影响。
对19例胶质母细胞瘤患者在给予卡波金和/或烟酰胺之前及之后进行了99m锝-六甲基丙烯胺肟单光子发射计算机断层扫描（99mTc-HMPAO SPECT）检查。另外6例患者采用相同程序但未使用任何血流调节剂进行检查，并作为对照。
尽管患者之间的差异很大，但与对照患者相比，烟酰胺或卡波金均未显示出平均肿瘤和正常脑灌注有明显增强。肿瘤与周围正常脑之间的平均灌注比也未发现一致变化，提示不存在选择性灌注效应。
对于胶质母细胞瘤患者，SPECT未检测到卡波金和/或烟酰胺对肿瘤灌注和正常脑灌注有显著影响。
