Journal article
Concurrent carbogen and nicotinamide with radiation therapy in muscle invasive bladder cancer: A report on feasibility in the Australian setting
Journal of Medical Imaging and Radiation Oncology, Vol.65(6), pp.768-777
2021
Abstract
Introduction: The incidence of bladder cancer increases with age, and elderly patients with muscle invasive bladder cancer (MIBC) are significantly under-treated. Bladder preservation trimodality therapy (BPTT) is an alternative to radical cystectomy in the curative setting. The use of concurrent carbogen and nicotinamide (CON) with radiation therapy (RT) as radiosensitisers have shown significant improvement in the overall survival and local relapse in the UK BCON Trial and is part of the standard of care for patients with MIBC in the UK. This is the first study in the Australian setting to demonstrate the feasibility in setting up a CON radiation oncology department. Methods: Based on the UK BCON trial, circuit systems for carbogen gas delivery were set up in consultation with the anaesthetics and respiratory teams. TGA exemption was obtained for 98% oxygen and 2% carbon dioxide carbo-gen gas mixture and delivery apparatus for each patient. Seven patients with histological locally advanced bladder cancer were recruited into this study. Results: The establishment of a CON department took approximately 24 months. Development of trial protocol was based on the equipment availability in Aus-tralia and proper transport, storage and handling of the equipment was guided by local occupational, health and safety (OHS) regulations. All patients received full of dose of CON. Increased urinary frequency, urgency and diarrhoea were the most commonly reported acute bladder and bowel toxicities. Conclusions: This is the first study in Australia to demonstrate the feasibility of concurrent CON with radiation therapy. It is a safe and cost-effective treatment that provides a new therapeutic option in the treatment of patients with MIBC, particularly those with limited treatment options.
Details
- Title
- Concurrent carbogen and nicotinamide with radiation therapy in muscle invasive bladder cancer: A report on feasibility in the Australian setting
- Authors
- Anzela Anzela (Author) - Gosford HospitalMyo Min (Author) - University of the Sunshine Coast, QueenslandMarcel Knesl (Author) - Sunshine Coast University HospitalNicole Buddle (Author) - Sunshine Coast University HospitalMaree Azzopardi (Author) - Sunshine Coast University HospitalRiaz Hooshmand (Author) - Griffith UniversitySalena Barrett (Author) - Sunshine Coast University HospitalAndria Notman (Author) - Sunshine Coast University HospitalHelen Woolls (Author) - Sunshine Coast University HospitalJennifer Wilson (Author) - Sunshine Coast University HospitalDharman Dinesh Vignarajah (Corresponding Author) - Sunshine Coast University Hospital
- Publication details
- Journal of Medical Imaging and Radiation Oncology, Vol.65(6), pp.768-777; 10
- Publisher
- Wiley-Blackwell Publishing Asia
- DOI
- 10.1111/1754-9485.13265
- ISSN
- 1754-9485
- Organisation Unit
- University of the Sunshine Coast, Queensland; Thompson Institute
- Language
- English
- Record Identifier
- 99548404202621
- Output Type
- Journal article
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- Radiology, Nuclear Medicine & Medical Imaging
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Source: InCites