Acute and late morbidity in the treatment of advanced bladder carcinoma with accelerated radiotherapy, carbogen, and nicotinamide
Acute and late morbidity in the treatment of advanced bladder carcinoma with accelerated radiotherapy, carbogen, and nicotinamide
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DOI：
10.1002/cncr.21048
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发表时间：
2005-06-01
期刊：
影响因子：
6.2
通讯作者：
Saunders, MI
中科院分区：
文献类型：
--
作者：
Hoskin, PJ;Rojas, AM;Saunders, MI
背景。在晚期头颈癌和膀胱癌患者的 II 期研究中，加速放疗联合卡波金和烟酰胺 (ARCON) 克服肿瘤缺氧和细胞增殖，实现了较高的肿瘤控制和生存率。因此，对后一项研究的发病率和治疗结果进行了分析，以评估 ARCON.METHODS 的治疗潜力。对 105 名高级别浅表性或肌层浸润性膀胱癌患者的急性和晚期发病率进行了评估，这些患者接受单独卡波金或 ARCON 加速放疗（4 周内 50-55 戈瑞）。排尿功能障碍根据白天尿频、夜尿、尿失禁、排尿困难、血尿和尿急进行评分。肠道发病率取决于大便频率和稠度、直肠分泌物、失血量和药物治疗。治疗结果的终点是总生存期、无病生存期和局部控制。结果。尽管 20-30% 的患者夜间功能几乎正常，但几乎所有患者的留尿能力都会下降超过 2 小时。 ARCON 组急性中度或更严重排尿困难的发生率为 41%，卡波金组为 56%；分别有 96% 和 76% 的患者每天排便次数 >= 3 次。放疗开始后 10-12 周，急性反应恢复到基线水平。 3岁时，白天的频率！每小时 2 次大约为双臂的 75%。严重血尿的发生率（
BACKGROUND. Accelerated radiotherapy combined with carbogen and nicotinamide (ARCON) to overcome tumor hypoxia and cell proliferation achieved high tumor control and survival in Phase II studies of patients with advanced head and neck and bladder carcinomas. Thus, morbidity and treatment outcomes from the latter study were analyzed to evaluate the therapeutic potential of ARCON.METHODS. Acute and late morbidity was assessed in 105 patients with high-grade superficial or muscle-invasive bladder carcinoma who were given accelerated radiotherapy (50-55 grays in 4 weeks) with carbogen alone or with ARCON. Urinary dysfunction was scored based on daytime frequency, nocturia, incontinence, dysuria, hematuria, and urgency. Bowel morbidity was based on stool frequency and consistency, rectal discharge, blood loss, and medication. Endpoints for treatment outcome were overall survival, disease-free survival, and locoregional control.RESULTS. Nearly all patients experienced reduced ability to retain urine beyond 2 hours, although 20-30% had almost normal function at night. Incidence of acute moderate or worse dysuria was 41% with ARCON and 56% with carbogen; 96% and 76% of patients, respectively, had bowel frequencies >= 3 times per day. By 10-12 weeks from the start of radiotherapy, acute reactions returned to baseline levels. At 3 years, the daytime frequency ! 2 times per hour was approximate to 75% in both arms. Incidence of severe hematuria (