BlueCross BlueShield of Tennessee Medical Policy Manual

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.

Carbogen is also called Meduna's Mixture after its inventor Ladislas Meduna. Meduna's original formula was 30% CO2 and 70% oxygen.

POLICY

IMPORTANT REMINDERS

ADDITIONAL INFORMATION  

Controlled studies continue to be lacking in published literature that would help validate 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. (Level 4 evidence)

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)

Rademakers, S., Hoogsteen, I., Rijken, P., Terhaard, C., Doornaert, P., Langendijk, j. et. al. (2015, February) Prognostic value of the proliferation marker Ki-67 in laryngeal carcinoma: results of the accelerated radiotherapy with carbogen breathing and nicotinamide phase III randomized trial. Head and Neck; 37(2):171-6. Abstract retrieved January 31, 2017 from PubMed database.

Yip, K., & Alonzi, R. (2013). Carbogen gas and radiotherapy outcomes in prostate cancer. Therapeutic Advances in Urology, 5 (1), 25-34. (Level 4 evidence)

ORIGINAL EFFECTIVE DATE:  4/1/2001

MOST RECENT REVIEW DATE:  3/8/2018  

ID_BT

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