Document Detail


Accelerated radiotherapy, carbogen and nicotinamide (ARCON) in locally advanced head and neck cancer: a feasibility study.
MedLine Citation:
PMID:  9424007     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: ARCON (Accelerated Radiotherapy, CarbOgen, Nicotinamide) achieves a large therapeutic gain in rodents. A phase I/II study was therefore undertaken to determine its feasibility in patients with locally advanced head and neck cancer. MATERIALS AND METHODS: The accelerated regime CHART was used in 35 patients given carbogen and/or nicotinamide with 11 small volume fractions. Eight patients received carbogen, 12 received nicotinamide and 15 were treated with ARCON. Treatment compliance, side-effects and acute mucositis were monitored in all cases. RESULTS: All patients underwent CHART as intended. In the 23 patients receiving carbogen, two failed to complete treatment. Compliance with nicotinamide was much lower. Out of 25 patients, only 52% received 10-11 doses of the 80 mg/kg/day of the drug. The most common side-effect was nausea and vomiting, which responded to standard anti-emetics in almost half of the patients. Historical comparisons with the CHART head and neck trials indicate that there was no increase in the severity of acute mucositis in any of these patients. Although the observation period is not sufficiently long to be definitive (median 20 months) there is no evidence of an increase in late normal tissue reactions. CONCLUSIONS: ARCON using CHART as the radiotherapy protocol is feasible in patients with advanced head and neck cancer. However, we are concerned about the low compliance rate in our patients, which is far lower than that reported elsewhere. The implications are discussed together with identifying strategies for increasing compliance.
Authors:
M I Saunders; P J Hoskin; K Pigott; M E Powell; K Goodchild; S Dische; J Denekamp; M R Stratford; M F Dennis; A M Rojas
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Publication Detail:
Type:  Clinical Trial; Clinical Trial, Phase I; Clinical Trial, Phase II; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology     Volume:  45     ISSN:  0167-8140     ISO Abbreviation:  Radiother Oncol     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1998-01-28     Completed Date:  1998-01-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8407192     Medline TA:  Radiother Oncol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  159-66     Citation Subset:  IM    
Affiliation:
Marie Curie Research Wing, Mount Vernon Hospital, Northwood, Middlesex, UK.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Aerosols
Antiemetics / therapeutic use
Carbon Dioxide / administration & dosage*,  adverse effects
Disease-Free Survival
Dose Fractionation
Dose-Response Relationship, Radiation
Feasibility Studies
Head and Neck Neoplasms / pathology,  radiotherapy*
Humans
Metoclopramide / therapeutic use
Nausea / chemically induced,  drug therapy
Niacinamide / administration & dosage*,  adverse effects
Oxygen / administration & dosage*,  adverse effects
Radiation-Sensitizing Agents / administration & dosage*,  adverse effects
Radiotherapy, High-Energy*
Vomiting / chemically induced,  drug therapy
Chemical
Reg. No./Substance:
0/Aerosols; 0/Antiemetics; 0/Radiation-Sensitizing Agents; 124-38-9/Carbon Dioxide; 364-62-5/Metoclopramide; 7782-44-7/Oxygen; 8063-77-2/carbogen; 98-92-0/Niacinamide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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