LACK OF PERFUSION ENHANCEMENT AFTER ADMINISTRATION OF NICOTINAMIDE AND CARBOGEN IN PATIENTS WITH GLIOBLASTOMA - A TC-99M-HMPAO SPECT STUDY

Background: Nicotinamide (NAM) and carbogen both have been shown to en hance the radiation effect in rodent tumour models and are currently b eing tested in clinical trials. These agents have demonstrated to act against hypoxia and one of their underlying mechanisms could be an inc rease of tumour blood perfusion.Purpose: To analyse the effect of both agents on normal brain perfusion and tumour perfusion in patients wit h glioblastoma. Materials and methods: Nineteen patients with glioblas toma were studied with (99m)technetium-hexamethylpropyleneamine oxime single photon emission computed tomography (Tc-99m-HMPAO SPECT) before and after administration of carbogen and/or NAM. Another six patients were studied with the same procedure but without any flow modulator a nd were used as controls. Results: Although the variations between pat ients were large, no significant enhancement in mean tumour and normal brain perfusion could be demonstrated with NAM or carbogen compared t o the control patients. Also no consistent changes in the mean perfusi on ratio between tumour and surrounding normal brain were found, sugge sting an absence of a selective perfusion effect. Conclusions: No sign ificant influence of carbogen and/or NAM on tumour perfusion and norma l brain perfusion could be detected with SPECT in patients with gliobl astoma. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.