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BETA
Bengtsson, Nils-Olof
Publications (10 of 14) Show all publications
Rosell, J., Nordenskjold, B., Bengtsson, N.-O., Fornander, T., Hatschek, T., Lindman, H., . . . Carstensen, J. (2017). Long-term effects on the incidence of second primary cancers in a randomized trial of two and five years of adjuvant tamoxifen. Acta Oncologica, 56(4), 614-617
Open this publication in new window or tab >>Long-term effects on the incidence of second primary cancers in a randomized trial of two and five years of adjuvant tamoxifen
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2017 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 56, no 4, p. 614-617Article in journal (Refereed) Published
Abstract [en]

Background: Tamoxifen is a well established treatment for breast cancer, but its long-term effects on the incidence of secondary cancers are not fully evaluated.Material and methods: We have studied 4128 postmenopausal patients with early stage breast cancer who were alive and free of breast cancer recurrence after two years of tamoxifen, and who were randomized to receive totally two or five years of therapy.Results: Compared to patients randomized to two years of tamoxifen the incidence of contralateral breast cancer [hazard ratio (HR) 0.73; 95% CI 0.56-0.96] and of lung cancer (HR 0.45; 95% CI 0.27-0.77), especially squamous cell and small cell lung cancer, were reduced in the five-year group, and similar results were seen when restricting the analysis to the 10-year period after treatment stopped. An increased incidence of endometrial cancer was observed in the five-year group, but the excess risk decreased over time.Conclusion: Further studies of the effects of tamoxifen on the risk of different histological types of lung cancer are needed.

National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-134750 (URN)10.1080/0284186X.2016.1273547 (DOI)000399499600016 ()28080180 (PubMedID)
Available from: 2017-05-11 Created: 2017-05-11 Last updated: 2018-06-09Bibliographically approved
Rosell, J., Nordenskjold, B., Bengtsson, N.-O., Fornander, T., Hatschek, T., Lindman, H., . . . Carstensen, J. (2013). Effects of adjuvant tamoxifen therapy on cardiac disease: results from a randomized trial with long-term follow-up. Breast Cancer Research and Treatment, 138(2), 467-473
Open this publication in new window or tab >>Effects of adjuvant tamoxifen therapy on cardiac disease: results from a randomized trial with long-term follow-up
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2013 (English)In: Breast Cancer Research and Treatment, ISSN 0167-6806, E-ISSN 1573-7217, Vol. 138, no 2, p. 467-473Article in journal (Refereed) Published
Abstract [en]

Tamoxifen is associated with a reduced risk of coronary heart disease (CHD). However, there are few reports on long-term effects. Using data from a large Swedish randomized trial of 5 and 2 years of adjuvant tamoxifen in women with early breast cancer, we here present results on morbidity and mortality from cardiac diseases during treatment and long-term after treatment. A total of 4,150 patients were breast cancer recurrence-free after 2 years. Data from the Swedish National Hospital Discharge Registry combined with information from the Swedish Cause of Death Registry were used to define events of disease. Hazard ratios were estimated using Cox regression. Patients assigned to 5 years in comparison with 2 years of postoperative tamoxifen experienced a reduced incidence of CHD [hazard ratio (HR), 0.83; 95 % CI 0.70-1.00], especially apparent during the active treatment period (HR 0.65; 95 % CI 0.43-1.00). The mortality from CHD was significantly reduced (HR 0.72; 95 % CI 0.53-0.97). During the active treatment, the morbidity of other heart diseases was also significantly reduced (HR 0.40; 95 % CI 0.25-0.64) but not after treatment stopped (HR 1.06; 95 % CI 0.87-1.30). Similar results were seen for both heart failure and atrial fibrillation/flutter. As compared to 2 years of therapy, 5 years of postoperative tamoxifen therapy prevents CHD as well as other heart diseases. The risk reduction is most apparent during the active treatment period, and later tends to diminish.

Place, publisher, year, edition, pages
New York: Springer, 2013
Keywords
Breast cancer, Tamoxifen, Adjuvant treatment, Adverse events, Heart failure, Coronary heart disease
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-70138 (URN)10.1007/s10549-013-2457-6 (DOI)000316821300012 ()
Available from: 2013-05-09 Created: 2013-05-06 Last updated: 2018-06-08Bibliographically approved
Margolin, S., Bengtsson, N.-O., Carlsson, L., Edlund, P., Hellstrøm, M., Karlsson, P., . . . Bergh, J. (2011). A randomised feasibility/phase II study (SBG 2004-1) with dose-dense/tailored epirubicin, cyclophoshamide (EC) followed by docetaxel (T) or fixed dosed dose-dense EC/T versus T, doxorubicin and C (TAC) in node-positive breast cancer.. Acta Oncologica, 50(1), 35-41
Open this publication in new window or tab >>A randomised feasibility/phase II study (SBG 2004-1) with dose-dense/tailored epirubicin, cyclophoshamide (EC) followed by docetaxel (T) or fixed dosed dose-dense EC/T versus T, doxorubicin and C (TAC) in node-positive breast cancer.
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2011 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 50, no 1, p. 35-41Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to evaluate the feasibility of tailored and dose-dense epirubicin and cyclophosphamide followed by docetaxel as adjuvant breast cancer therapy. Material and methods. Patients with node-positive breast cancer received either four cycles of biweekly and tailored EC (epirubicin 38-60-75-90-105-120 mg/m(2), cyclophosphamide 450-600-900-1200 mg/m(2)) followed by four cycles of docetaxel (60-75-85-100 mg/m(2)) (arm A) or the same regimen with fixed doses (E(90)C(600) + 4 → T(75) + 4) (arm B) or docetaxel, doxorubicin and cyclophosphamide (T(75)A(50)C(500)) every three weeks for six cycles (arm C). All patients received G-CSF support and prophylactic ciprofloxacin. Results. One-hundred and twenty-four patients were randomised in the study. In the A, B and C arm, 17% 19% and 3% of the patients had one or more cycles delayed due to side-effects whereas 24%, 5% and 15% experienced a grade 3 infection or febrile neutropenia. After the introduction of an extra week between the EC and T parts in the A and B arms, grade 3 hand-foot-skin reactions were reduced from 5 to 0.2%. Twenty-nine percent (A and B) and 20% (C) of the patients were hospitalised due to side-effects. Discussion. Dose-dense and tailored EC/T can be given with manageable toxicity and is after adjustment presently studied in the phase III Panther trial.

National Category
Cancer and Oncology
Research subject
Oncology
Identifiers
urn:nbn:se:umu:diva-39285 (URN)10.3109/0284186X.2010.535847 (DOI)21174610 (PubMedID)
Available from: 2011-01-20 Created: 2011-01-20 Last updated: 2018-06-08Bibliographically approved
Edlund, P., Ahlgren, J., Bjerre, K., Andersson, M., Bergh, J., Mouridsen, H., . . . Blomqvist, C. (2011). Dose-tailoring of FEC adjuvant chemotherapy based on leukopenia is feasible and well tolerated. Toxicity and dose intensity in the Scandinavian Breast Group phase 3 adjuvant Trial SBG 2000-1. Acta Oncologica, 50(3), 329-337
Open this publication in new window or tab >>Dose-tailoring of FEC adjuvant chemotherapy based on leukopenia is feasible and well tolerated. Toxicity and dose intensity in the Scandinavian Breast Group phase 3 adjuvant Trial SBG 2000-1
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2011 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 50, no 3, p. 329-337Article in journal (Refereed) Published
Abstract [en]

The SBG 2000-1 trial is a randomised study that investigates if dose-tailored adjuvant FEC therapy based on the individual's leukocyte nadir value can improve outcome. The study has included 1535 women with medium and high-risk breast cancer. Patients and methods. After a first standard dosed FEC course (5-fluorouracil 600 mg/m2, epirubicin 60 mg/mg2 and cyclophosphamide 600 mg/m2), patients who did not reach leukopenia grade III or IV were randomised to standard doses (group standard) or doses tailored to achieve grade III leukopenia (group tailored) at courses 2–7. Patients who achieved leukopenia grade III or more after the first course were not randomised but continued on standard doses (group registered). Results. Both planned and actually delivered number of courses (seven) were the same in all three arms. The relative dose intensity was increased by a factor of 1.31 (E 1.22, C 1.43) for patients in the tailored arm compared to the expected on standard dose. Ninety percent of the patients in the tailored arm achieved leukopenia grade III–IV compared with 29% among patients randomised to standard dosed therapy. Dose tailoring was associated with acceptable acute non-haematological toxicity with more total alopecia, nausea, vomiting and fatigue. Conclusion. Dose tailoring according to leukopenia was feasible. It led to an increased dose intensity and was associated with acceptable excess of acute non-haematological toxicity.Read More: http://informahealthcare.com/doi/abs/10.3109/0284186X.2011.554435

Place, publisher, year, edition, pages
Informa Healthcare, 2011
Identifiers
urn:nbn:se:umu:diva-45486 (URN)10.3109/0284186X.2011.554435 (DOI)21299448 (PubMedID)
Available from: 2011-07-05 Created: 2011-07-05 Last updated: 2018-06-08Bibliographically approved
McGale, P., Darby, S. C., Hall, P., Adolfsson, J., Bengtsson, N.-O., Bennet, A. M., . . . Ewertz, M. (2011). Incidence of heart disease in 35,000 women treated with radiotherapy for breast cancer in Denmark and Sweden. Radiotherapy and Oncology, 100(2), 167-175
Open this publication in new window or tab >>Incidence of heart disease in 35,000 women treated with radiotherapy for breast cancer in Denmark and Sweden
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2011 (English)In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 100, no 2, p. 167-175Article in journal (Refereed) Published
Abstract [en]

Purpose: To study incidence of radiation-related heart disease in a large population of breast cancer patients followed for up to 30 years.

Material and methods: 72,134 women diagnosed with breast cancer in Denmark or Sweden during 1976-2006 and followed prospectively. Radiation-related risk was studied by comparing women with left-sided and right-sided tumours.

Results: 34,825 women (48%) received radiotherapy. Among unirradiated women tumour laterality had little relevance to heart disease. Among irradiated women mean dose to the whole heart was 6.3 Gy for left-sided tumours and 2.7 Gy for right-sided tumours. Mortality was similar in irradiated women with left-sided and right-sided tumours, but incidence ratios, left-sided versus right-sided, were raised: acute myocardial infarction 1.22 (95% CI 1.06-1.42), angina 1.25 (1.05-1.49), pericarditis 1.61 (1.06-2.43), valvular heart disease 1.54 (1.11-2.13). Incidence ratios for all heart disease were as high for women irradiated since 1990 (1.09 [1.00-1.19]) as for women irradiated during 1976-1989 (1.08 [0.99-1.17]), and were higher for women diagnosed with ischaemic heart disease prior to breast cancer than for other women (1.58 [1.19-2.10] versus 1.08 [1.01-1.15], p for difference = 0.01).

Conclusions: Breast cancer radiotherapy has, at least until recently, increased the risk of developing ischaemic heart disease, pericarditis and valvular disease. Women with ischaemic heart disease before breast cancer diagnosis may have incurred higher risks than others. (C) 2011 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 100 (2011) 167-175

Place, publisher, year, edition, pages
Amsterdam: Elsevier, 2011
Keywords
Breast cancer, Radiotherapy, Heart disease
National Category
Cancer and Oncology Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-48214 (URN)10.1016/j.radonc.2011.06.016 (DOI)000295067600003 ()
Available from: 2011-10-11 Created: 2011-10-10 Last updated: 2018-06-08Bibliographically approved
Chadda, S., Larkin, M., Jones, C., Sykes, D., Barber, B., Zhao, Z., . . . Bengtsson, N.-O. (2011). The impact of infusion reactions associated with monoclonal antibodies in metastatic colorectal cancer: a european perspective. Value in Health, 14(3), A173-A173
Open this publication in new window or tab >>The impact of infusion reactions associated with monoclonal antibodies in metastatic colorectal cancer: a european perspective
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2011 (English)In: Value in Health, ISSN 1098-3015, E-ISSN 1524-4733, Vol. 14, no 3, p. A173-A173Article in journal (Refereed) Published
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-52674 (URN)000299105001213 ()
Note

ISPOR 16th Annual International Meeting Research Abstracts

Available from: 2012-03-06 Created: 2012-02-28 Last updated: 2018-06-08Bibliographically approved
Rosell, J., Nordenskjöld, B., Bengtsson, N.-O., Fornander, T., Hatschek, T., Lindman, H., . . . Carstensen, J. (2011). Time dependent effects of adjuvant tamoxifen therapy on cerebrovascular disease: results from a randomised trial. British Journal of Cancer, 104(6), 899-902
Open this publication in new window or tab >>Time dependent effects of adjuvant tamoxifen therapy on cerebrovascular disease: results from a randomised trial
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2011 (English)In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 104, no 6, p. 899-902Article in journal (Refereed) Published
Abstract [en]

Background:  

Tamoxifen has been associated with an increased risk of stroke. There is, however, little information on the effect in the post-treatment period. Using data from the Swedish Breast Cancer Group adjuvant trial of 5 vs 2 years of tamoxifen treatment, we now report both short-term and long-term effects on morbidity as well as mortality because of cerebrovascular disease.

Methods:  

Data from the Swedish National Hospital Discharge Registry combined with information from the Swedish Cause of Death Registry was used to define events of disease. Hazard ratios (HRs) were estimated using Cox regression.

Results:  

Comparing patients randomised to 5 years of tamoxifen with patients randomised to 2 years of tamoxifen, the incidence of cerebrovascular diseases was increased (HR 1.70, 95% CI 1.05–2.75) during the active treatment phase and reduced after the active treatment period (HR 0.78, 95% CI 0.63–0.96), and the difference in HR between the two time-periods was significant (P=0.0033). The mortality from cerebrovascular diseases was increased during the treatment period (HR 3.18, 95% CI 1.03–9.87) and decreased during the post-treatment period (HR 0.60, 95% CI 0.40–0.90) with a significant difference in HR between the two periods of follow-up (P=0.0066). Similar results were seen for subgroups of cerebrovascular diseases, such as stroke and ischaemic stroke.

Conclusion:  

In an adjuvant setting, tamoxifen was associated with an increased risk of cerebrovascular disease during treatment, but a decreased risk in the post-treatment period.

Place, publisher, year, edition, pages
Nature Publishing Group, 2011
Keywords
breast cancer, tamoxifen, adjuvant treatment, adverse events, cerebrovascular disease
Identifiers
urn:nbn:se:umu:diva-45487 (URN)10.1038/bjc.2011.45 (DOI)21343938 (PubMedID)
Available from: 2011-07-05 Created: 2011-07-05 Last updated: 2018-06-08Bibliographically approved
Sjöström-Mattson, J., Von Boguslawski, K., Bengtsson, N.-O., Mjaaland, I., Salmenkivi, K. & Blomqvist, C. (2009). The expression of p53, bcl-2, bax, fas and fasL in the primary tumour and lymph node metastases of breast cancer.. Acta oncologica (Stockholm, Sweden), 48(8), 1137-1143
Open this publication in new window or tab >>The expression of p53, bcl-2, bax, fas and fasL in the primary tumour and lymph node metastases of breast cancer.
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2009 (English)In: Acta oncologica (Stockholm, Sweden), ISSN 1651-226X, Vol. 48, no 8, p. 1137-1143Article in journal (Refereed) Published
Abstract [en]

PURPOSE. It is unknown to what extent lymph node metastases differ from primary tumours of breast cancer. Our aim was to investigate the similarity between primary breast tumours and the matching lymph node metastases in 59 breast cancer patients. EXPERIMENTAL DESIGN. Immunohistochemical stainings of p53, bax, bc-l2, fas and fasL were performed in primary tumours and the parallel lymph node metastases. RESULTS. When using a cut point of 10%, the concordance between primary tumours and parallel lymph node metastases in the expression of p53 was 85%, bcl-2 79%, bax 69%, fas 59% and fasL 43%. In most tumours the staining status of p53, bcl-2 and bax in the primary tumour and the corresponding lymph node did not change more than 20%. However, these variables could fluctuate in both directions. In 15-25% of the cases, nodal expression was more than 20% lower than in the primary tumours, while in 10-17% of the cases, nodal expression was more than 20% higher than in the primary tumours. In half of the tumours, fas status did not change. Most fasL positive tumours lost positivity in the lymph node metastases or showed positively staining cancer cells only in the peripheral region of the node. A phenotype analysis of combined information of tumour fas/tumour fasL/nodal fas/nodal fasL expression (+/ - ) was assessed. The most frequently observed phenotype was tumour fas - /tumour fasL + /nodal fas - /nodal fasL- (22% of the tumours), although almost all combinations were seen. CONCLUSIONS. The expression of p53, bax, bcl - 2, fas and fasL is not maintained in the matching lymph node metastases of breast cancer. Large studies comparing the expression of relevant tumour biology factors in primary tumours and parallel lymph node metastases and their impact on therapy outcome, especially in the adjuvant setting, are warranted.

Identifiers
urn:nbn:se:umu:diva-27720 (URN)19863221 (PubMedID)
Available from: 2009-11-17 Created: 2009-11-17 Last updated: 2018-06-08
Ejlertsen, B., Mouridsen, H. T., Jensen, M.-B., Bengtsson, N.-O., Bergh, J., Cold, S., . . . Nielsen, D. L. (2006). Similar efficacy for ovarian ablation compared with cyclophosphamide, methotrexate, and fluorouracil: from a randomized comparison of premenopausal patients with node-positive, hormone receptor-positive breast cancer. J Clin Oncol, 24(31), 4956-4962
Open this publication in new window or tab >>Similar efficacy for ovarian ablation compared with cyclophosphamide, methotrexate, and fluorouracil: from a randomized comparison of premenopausal patients with node-positive, hormone receptor-positive breast cancer
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2006 (English)In: J Clin Oncol, ISSN 1527-7755, Vol. 24, no 31, p. 4956-4962Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-14004 (URN)doi:10.1200/jco.2005.05.1235 (DOI)17075113 (PubMedID)
Available from: 2006-11-08 Created: 2006-11-08 Last updated: 2018-06-09Bibliographically approved
Villman, K., Sjöström, J., Heikkilä, R., Hultborn, R., Malmström, P., Bengtsson, N.-O., . . . Blomqvist, C. (2006). TOP2A and HER2 gene amplification as predictors of response to anthracycline treatment in breast cancer. Acta Oncol, 45(5), 590-596
Open this publication in new window or tab >>TOP2A and HER2 gene amplification as predictors of response to anthracycline treatment in breast cancer
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2006 (English)In: Acta Oncol, ISSN 0284-186X, Vol. 45, no 5, p. 590-596Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-13846 (URN)doi:10.1080/02841860500543182 (DOI)16864174 (PubMedID)
Available from: 2006-11-07 Created: 2006-11-07 Last updated: 2018-06-09Bibliographically approved
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