Alternate Title
Basic Trial Information
Objectives
Entry Criteria
Expected Enrollment
Outcomes
Outline
Published Results
Trial Contact Information
Registry Information

Alternate Title

Radiation Therapy With or Without Carbogen and Niacinamide in Treating Patients With Bladder Cancer

Basic Trial Information

Phase	Type	Status	Age	Sponsor	Protocol IDs
Phase III	Treatment	Closed	Over 18	Other	MTVERNHOSP-BCON EU-20051, NCT00033436

Objectives

1. Compare the 6-month cystoscopic response in patients with locally advanced transitional cell carcinoma of the bladder treated with radical radiotherapy with or without radiosensitization with carbogen and niacinamide.
2. Compare the local failure-free and overall disease-specific survival of patients treated with these regimens.
3. Compare the treatment-related morbidity, in particular acute and chronic bowel and bladder symptoms, in patients treated with these regimens.
4. Compare the quality of life of patients treated with these regimens.

Entry Criteria

Disease Characteristics:

• Histologically confirmed transitional cell carcinoma of the bladder
  • Muscle invasive carcinoma (stage T2 or T3) of any grade

    OR

  • High-grade (G3) superficial bladder carcinoma (T1)

    OR

  • Prostatic invasion (T4a)
• No squamous cell carcinoma or adenocarcinoma of the bladder
• No locally advanced T4b carcinoma
• No distant metastasis or enlarged pelvic lymph nodes on CT staging scan of the pelvis

Prior/Concurrent Therapy:

Biologic therapy:

• Not specified

Chemotherapy:

• Not specified

Endocrine therapy:

• Not specified

Radiotherapy:

• Not specified

Surgery:

• Not specified

Patient Characteristics:

Age:

• Over 18

Performance status:

• Not specified

Life expectancy:

• Not specified

Hematopoietic:

• Not specified

Hepatic:

• Bilirubin no greater than 2 times normal

Renal:

• Creatinine no greater than 2 times normal

Cardiovascular:

• No ischemic heart disease or peripheral vascular disease requiring diuretics or angiotensin-converting enzyme inhibitors

Pulmonary:

• No concurrent respiratory disease with reduced respiratory drive that would preclude the delivery of 95% oxygen

Other:

• Capable of complying with a closed breathing system delivering carbogen through either a mask or a mouthpiece with nasal clip

Expected Enrollment

A total of 330 patients (165 per treatment arm) will be accrued for this study.

Outcomes

Cystoscopic response at 6 months after initiation radiotherapy
Local failure-free survival
Overall disease-specific survival

Treatment related morbidity (i.e., acute and chronic bowel and bladder symptoms)
Quality of life as assessed by FACT-BI scale at baseline, week 4, 3 months, 6 months, 12 months, and yearly thereafter for 5 years

Outline

This is a randomized, multicenter study. Patients are randomized to 1 of 2 treatment arms.

• Arm I: Patients receive radical radiotherapy once daily, 5 days a week, for 4-6.4 weeks. Patients also receive oral niacinamide once daily 1.5-2 hours before initiation of each radiotherapy dose and carbogen through a closed breathing system (face mask with a tight air seal or a mouthpiece with nasal clip) once daily beginning 5 minutes before initiation and continuing until completion of each radiotherapy dose.
• Arm II: Patients receive radiotherapy as in arm I.

Quality of life is assessed at baseline; at 4 weeks; at 3, 6, and 12 months; and then annually for 4 years.

Patients are followed at 8 and 12 weeks; at 6, 9, and 12 months; and then every 6 months for 4 years.

Peer Reviewed and Funded or Endorsed by Cancer Research UK

Hoskin PJ, Rojas AM, Saunders MI, et al.: Carbogen and nicotinamide in locally advanced bladder cancer: early results of a phase-III randomized trial. Radiother Oncol 91 (1): 120-5, 2009.[PUBMED Abstract]

Trial Contact Information

Trial Lead Organizations

Mount Vernon Cancer Centre at Mount Vernon Hospital

Peter Hoskin, MD, Protocol chair		Ph: 44-019-2384-4533

Registry Information
Official Title		A Multicenter Randomized Trial of Radical Radiotherapy with Carbogen in the Radical Treatment of Locally Advanced Bladder Cancer
Trial Start Date		2000-10-01
Registered in ClinicalTrials.gov		NCT00033436
Date Submitted to PDQ		2002-02-05
Information Last Verified		2002-12-06

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