Abstract | BACKGROUND AND PURPOSE: Treatment of head and neck tumors by the ARCON regimen has yielded high local control rates. As a result of this treatment intensification there was some increase in mainly acute toxicity of radiotherapy, but nicotinamide by itself has specific side effects such as nausea and vomiting. Due to these side effects and with the initial dose of 80 mg/kg, 31% of the patients discontinued nicotinamide intake. The aim of the study was to investigate the effect of a dose reduction to 60 mg/kg, and the addition of domperidone on the side effects of nicotinamide and its pharmacokinetic profile. PATIENTS AND METHODS: In 22 patients blood plasma nicotinamide levels were determined after intake of 60 mg/kg nicotinamide. A next group of 87 patients received 60 mg/kg nicotinamide in combination with domperidone. In ten of these patients blood plasma nicotinamide levels were also determined. A full pharmacokinetic profile was constructed over the first 24 h after intake of the first drug dose. Furthermore, daily plasma levels at 1 h after nicotinamide intake was determined in the first and last weeks of radiotherapy. All patients were treated according to the ARCON schedule. RESULTS AND DISCUSSION: CONCLUSION: The currently used dose of 60 mg/kg nicotinamide results in a 30% reduction in peak plasma concentrations compared with 80 mg/kg nicotinamide. If nicotinamide was given in combination with domperidone, 86% of the patients continued the nicotinamide medication until the end of the treatment period.
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Authors | Johan Bussink, Michael R L Stratford, Albert J van der Kogel, Lisa K Folkes, Johannes H A M Kaanders |
Journal | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
(Radiother Oncol)
Vol. 63
Issue 3
Pg. 285-91
(Jun 2002)
ISSN: 0167-8140 [Print] Ireland |
PMID | 12142092
(Publication Type: Comparative Study, Journal Article)
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Copyright | Copyright 2002 Elsevier Science Ireland Ltd. |
Chemical References |
- Radiation-Sensitizing Agents
- Carbon Dioxide
- Niacinamide
- Domperidone
- carbogen
- Oxygen
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Carbon Dioxide
(administration & dosage)
- Carcinoma
(metabolism, radiotherapy)
- Domperidone
(pharmacology, therapeutic use)
- Dose Fractionation, Radiation
- Female
- Humans
- Male
- Middle Aged
- Nausea
(chemically induced)
- Niacinamide
(adverse effects, blood, pharmacokinetics)
- Oropharyngeal Neoplasms
(metabolism, radiotherapy)
- Oxygen
(administration & dosage)
- Radiation-Sensitizing Agents
(administration & dosage)
- Vomiting
(chemically induced)
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