The Effect of Carbogen Breathing and Nicotinamide Added to Standard (Chemo)Radiation Treatment of Advanced Cervical Cancer in Indonesia

Abstract

Addition of CON to standard (chemo)radiation gives comparable survival and control rates. The effect of CON might be underestimated due to differences in baseline characteristics. Because chemotherapy cannot always be (completely) administered in low-resource settings, CON could be a worthy substitute. The CON treatment is feasible and safe.

Effect of Carbogen to Chemoradiation in Volume of Rectal Cancer

“…Our study showed a significantly higher tumor volume shrinkage in the treatment group without additional toxicity. Subjects were comfortable after underwent chemoradiotherapy with additional carbogen, as also shown in several previous studies (20,24).…”

“…The addition of carbogen and nicotinamide in radiotherapy showed the improvement of the treatment response, especially in patients that have a contraindication for chemotherapy. Therapy with carbogen and nicotinamide was safe, although, some patients exhibited the nicotinamide intolerance (10,19,20). Nausea and vomiting appeared in patients who underwent head and neck radiation in conjunction with nicotinamide (23).…”

“…Various efforts have been made to improve radiotherapy response, such as oral 5-Fluorouracil (5-FU) chemotherapy administration (11,25). An oxygen diffusion modifier by carbogen administration and tissue perfusion enhancer by drugs such as nicotinamide were also performed to improve the radiotherapy response (19,20). Another modality that was shown to be effective in improving radiotherapy response was anemia correction (26).…”

“…Carbogen is simple and easy to be administered simultaneously with fractionated radiotherapy and could improve tumor oxygenation by increasing the amount of dissolved oxygen in plasma and raise the systemic blood pressure. The study showed that (chemo) radiation combined with carbogen as radiosensitizer and nicotinamide as a vasodilator is effective in increasing response therapy and safe as a cervical cancer treatment (20). This idea was supported by a study on the mouse sarcoma model showing that concurrent 6 liters/hour of carbogen for 5-15 minutes during radiation treatment increased tumor oxygenation and radiation response (21).…”

A Mini Systematic Review: Eucheuma cottonii, a Red Algae, as a Radiosensitizer?

“…Radiosensitizer is a compound which, when combined with radiation, will provide greater tumour inactivation than the additive effect of each modality. 3,4 The majority of radiosensitizers are synthetic chemical compounds, which have been proven to be too toxic in effective clinical doses. Radiosensitizer made of natural materials is believed to be safer than synthetic materials.…”