Hyperfractionated chemoradiation with carbogen breathing, with or without erythropoietin: A stepwise developed treatment schedule for advanced head-and-neck cancer

Martínez, José C.; Villar, A.; Cabezón, M.A.; Serdio, Jose Luis de; Fuentes, C.; Espiñeira, M.; Perez, Maria D.; Gil, José; Artazkoz, Juan J.; Borque, C.; Suñer, Marcos; Saavedra, Juan A.

doi:10.1016/s0360-3016(00)01526-1

“…Various approaches have been evaluated to overcome the effects of hypoxia. Carbogen, a mixture of carbon dioxide and oxygen, reduces the hypoxic cell fraction and increases tumor oxygenation ( 22,23 ) . Blood transfusions and human recombinant Erythropoietin (rh‐EPO) are the most frequently used methods to correct anemia.…”

Section: Discussionmentioning

confidence: 99%

Anemia before and during concurrent chemoradiotherapy in patients with cervical carcinoma: Effect on progression-free survival

Obermair¹,

Cheuk²,

Horwood³

et al. 2003

Int J Gynecol Cancer

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To determine the impact of anemia before and during chemoradiation in patients with cervical cancer, we collected data on hemoglobin (Hb) levels before and during treatment from 60 unselected patients with cervical carcinoma. All patients had FIGO stage IB to IVA disease and were treated with concurrent chemoradiation for the aim of cure. Patients with an Hb value below or equal to the lower 25th quartile were considered anemic. Progression-free survival (PFS) was evaluated by univariate and multivariate analyses. After a median follow-up of 26.3 months, 20 patients developed disease progression. The lowest Hb during chemoradiation (nadir Hb), the stage of disease, and parametrial involvement were correlated significantly with PFS. On multivariate analysis, the nadir Hb (relative risk [RR] 0.29) and tumor stage (RR 3.4) remained the only prognostically relevant factors predicting PFS. At 60 months the PFS was 39.1% for anemic patients and 48.0% for nonanemic patients (P < 0.0002). In patients undergoing chemoradiation for cervical carcinoma, a low nadir Hb is highly predictive of shortened PFS, whereas the Hb before treatment is prognostically not significant.

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“…Logarithmic-phase cultures of SCC-VII, OC-19 and 3LL cells and mouse normal embryo fibroblasts were next transfected with MnSOD-PL or empty liposomes according to published methods (27). Twenty-four hours after transfection, radiation survival curves were determined.…”

Section: Mnsod-pl Transfection Sensitizes Squamous Cell Tumor Cells Imentioning

confidence: 99%

“…Squamous cell carcinomas of the aerodigestive tract are known to contain hypoxic and therefore relatively radioresistant areas (26,27). Tumor size increases beyond several millimeters in diameter result in tumor angiogenesis (28,30), but tumor growth can outpace neovascularization (30).…”

Section: Introductionmentioning

confidence: 99%

Effects of MnSOD-Plasmid Liposome Gene Therapy on Antioxidant Levels in Irradiated Murine Oral Cavity Orthotopic Tumors

Epperly

¹

,

Wegner

²

,

Kanai

³

et al. 2007

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Intraoral manganese superoxide dismutase (SOD2)-plasmid liposome (PL) radioprotective gene therapy prolongs the survival of mice with orthotopic oral cavity tumors within the irradiated field. To determine whether the mechanism involved effects in antioxidant pool, C57BL/6J mice bearing orthotopic oral cavity squamous cell carcinoma SCC-VII tumors received intraoral or intravenous MnSOD-PL gene therapy 24 h prior to 18 Gy irradiation to the head and neck region. Glutathione (GSH) levels and levels of radiation-generated nitric oxide and peroxynitrite were measured in orthotopic tumors and in adjacent oral mucosa. MnSOD-PL transfection of the SCC-VII tumor cells, but not normal embryo fibroblasts, produced acute radiosensitization. Furthermore, SCC-VII tumor cells demonstrated increased relative hydrogen peroxide (the product of MnSOD superoxide dismutation)-induced apoptosis in vitro. Radiation decreased levels of GSH and increased GPX in both tumor and normal cells in vitro, effects that were blunted by MnSOD-PL treatment. In vivo irradiation decreased GSH and GPX more effectively in tumors, and the decrease was not reversed by MnSOD-PL therapy. Intravenous but not intraoral administration of epitope-tagged hemagglutinin MnSOD-PL resulted in significant uptake in orthotopic tumors and decreased the levels of radiation-induced nitric oxide and peroxynitrite. Thus normal tissue radioprotective MnSOD-PL gene therapy radiosensitizes tumor cell lines in vitro and has a therapeutic effect on orthotopic tumors in part through its effects on tumor antioxidants.

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“…Various approaches have been evaluated to overcome the effects of hypoxia. Carbogen, a mixture of carbon dioxide and oxygen, reduces the hypoxic cell fraction and increases tumor oxygenation (22,23) . Blood transfusions and human recombinant Erythropoietin (rh-EPO) are the most frequently used methods to correct anemia.…”

Section: Discussionmentioning

confidence: 99%

Anemia before and during concurrent chemoradiotherapy in patients with cervical carcinoma: Effect on progression-free survival

Cheuk

¹

,

Crandon

²

,

Giannis

³

et al. 2003

International Journal of Gynecological Cancer

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To determine the impact of anemia before and during chemoradiation in patients with cervical cancer, we collected data on hemoglobin (Hb) levels before and during treatment from 60 unselected patients with cervical carcinoma. All patients had FIGO stage IB to IVA disease and were treated with concurrent chemoradiation for the aim of cure. Patients with an Hb value below or equal to the lower 25th quartile were considered anemic. Progression-free survival (PFS) was evaluated by univariate and multivariate analyses. After a median follow-up of 26.3 months, 20 patients developed disease progression. The lowest Hb during chemoradiation (nadir Hb), the stage of disease, and parametrial involvement were correlated significantly with PFS. On multivariate analysis, the nadir Hb (relative risk [RR] 0.29) and tumor stage (RR 3.4) remained the only prognostically relevant factors predicting PFS. At 60 months the PFS was 39.1% for anemic patients and 48.0% for nonanemic patients (P < 0.0002). In patients undergoing chemoradiation for cervical carcinoma, a low nadir Hb is highly predictive of shortened PFS, whereas the Hb before treatment is prognostically not significant.

show abstract

Hyperfractionated chemoradiation with carbogen breathing, with or without erythropoietin: A stepwise developed treatment schedule for advanced head-and-neck cancer

Cited by 12 publications

References 22 publications

Anemia before and during concurrent chemoradiotherapy in patients with cervical carcinoma: Effect on progression-free survival

Anemia before and during concurrent chemoradiotherapy in patients with cervical carcinoma: Effect on progression-free survival

Effects of MnSOD-Plasmid Liposome Gene Therapy on Antioxidant Levels in Irradiated Murine Oral Cavity Orthotopic Tumors

Anemia before and during concurrent chemoradiotherapy in patients with cervical carcinoma: Effect on progression-free survival

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