Carbogen (95% Oxygen, 5% Carbon Dioxide) Inhalation in Cancer Treatment
DESCRIPTION
Carbogen is a mixture of 95% oxygen and 5% carbon dioxide and is inhaled as an adjunct to treatment for various oncologic applications. Tumors are generally hypoxic in nature and researchers theorize that increasing the tumor oxygenation during administration of treatments, such as radiotherapy or chemotherapy, make the tumor more susceptible to the therapy being administered.
POLICY
Carbogen inhalation as an adjunct for the treatment of cancer is considered investigational.
IMPORTANT REMINDER
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
ADDITIONAL INFORMATION
No controlled studies were found in the published literature that validates the application of carbogen inhalation as an adjunct for the treatment of cancer.
SOURCES
Alonzi, R., Padhani, A. R., Maxwell, R. J., Taylor, N. J., Stirling, J. J., Wilson, J. I., et al. (2009). Carbogen breathing increases prostate cancer oxygenation: A translational MRI study in murine xenografts and humans. British Journal of Cancer, 100 (4), 644-648.
Carpenter, C. M., Rakow-Penner, R., Jiang, S., Daniel, B. L., Poque, B. W., Glover, G. H., et al. (2010). Inspired gas-induced vascular change in tumors with magnetic-resonance-guided near-infrared imaging: Human breast pilot study. Journal of Biomedical Optics, 15 (3), 036026-1-036026-5. (Level 4 Evidence - Independent study)
Gupta, N., Saleem, A., Kotz, B., Osman, S., Aboagye, E. O., Phillips, R., et al. (2006). Carbogen and nicotinamide increase blood flow and 5-fluorouracil delivery but not 5-fluorouracil retention in colorectal cancer metastases in patients. Clinical Cancer Research, 12 (10), 3115-3123. (Level 4 Evidence - Independent study)
Khan, N., Mupparaju, S., Hekmatyar, S. K., Hou, H., Lariviere, J. P., Demidenko, E., et al. (2010). Effect of hyperoxygenation on tissue pO2 and its effect on radiotherapeutic efficacy of orthotopic F98 gliomas. International Journal of Radiation Oncology, Biology, Physics, 78 (4), 1193-1200.
Khan, N., Li, H., Hou, H., Lariviere, J. P., Gladstone, D. J., Demidenko, E., et al. (2009). Tissue pO2 of orthotopic 9L and C6 gliomas and tumor-specific response to radiotherapy and hyperoxygenation. International Journal of Radiation Oncology, Biology, Physics, 73 (3), 878-885.
ORIGINAL EFFECTIVE DATE: 4/1/2001
MOST RECENT REVIEW DATE: 1/12/2012
ID_BT
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