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Nilsson, Per
Publications (7 of 7) Show all publications
Daşu, A., Toma-Daşu, I., Franzén, L., Widmark, A. & Nilsson, P. (2011). Secondary malignancies from prostate cancer radiation treatment: a risk analysis of the influence of target margins and fractionation patterns. International Journal of Radiation Oncology, Biology, Physics, 79(3), 738-746
Open this publication in new window or tab >>Secondary malignancies from prostate cancer radiation treatment: a risk analysis of the influence of target margins and fractionation patterns
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2011 (English)In: International Journal of Radiation Oncology, Biology, Physics, ISSN 0360-3016, E-ISSN 1879-355X, Vol. 79, no 3, p. 738-746Article in journal (Refereed) Published
Abstract [en]

The results have shown the complex interplay between the risk for secondary malignancies, the details of the treatment delivery, and the patient heterogeneity that may influence comparisons between the long-term effects of various treatment techniques. Nevertheless, absolute risk levels seem very small and comparable to mortality risks from surgical interventions, thus supporting the robustness of radiation therapy as a successful treatment modality for prostate carcinomas.

Keywords
Prostate cancer, Carcinogenesis, Radiation treatment, DVH, Fractionation
Identifiers
urn:nbn:se:umu:diva-39615 (URN)10.1016/j.ijrobp.2009.12.004 (DOI)20472345 (PubMedID)
Available from: 2011-02-02 Created: 2011-02-02 Last updated: 2018-06-08Bibliographically approved
Zackrisson, B., Nilsson, P., Kjellén, E., Johansson, K.-A., Modig, H., Brun, E., . . . Björk-Eriksson, T. (2011). Two-year results from a Swedish study on conventional versus accelerated radiotherapy in head and neck squamous cell carcinoma - The ARTSCAN study. Radiotherapy and Oncology, 100(1), 41-48
Open this publication in new window or tab >>Two-year results from a Swedish study on conventional versus accelerated radiotherapy in head and neck squamous cell carcinoma - The ARTSCAN study
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2011 (English)In: Radiotherapy and Oncology, ISSN 0167-8140, E-ISSN 1879-0887, Vol. 100, no 1, p. 41-48Article in journal (Refereed) Published
Abstract [en]

Background and purpose: Studies on accelerated fractionation (AF) in head and neck cancer have shown increased local control and survival compared with conventional fractionation (CF), while others have been non-conclusive. In 1998 a national Swedish group decided to perform a randomised controlled clinical study of AF.

Materials and methods: Patients with verified squamous cell carcinoma of the oral cavity, oropharynx, larynx (except glottic T1-T2, N0) and hypopharynx were included. Patients with prior chemotherapy or surgery were excluded. Patients were randomised to either CF (2Gy/day, 5days/week for 7 weeks, total dose 68Gy) or to AF (1.1Gy+2.0Gy/day, 5days/week for 4.5weeks, total dose 68Gy). An extensive quality assurance protocol was followed throughout the study. The primary end point was loco-regional tumour control (LRC) at two years after treatment. RESULTS: The study was closed in 2006 when 750 patients had been randomised. Eighty-three percent of the patients had stages III-IV disease. Forty eight percent had oropharyngeal, 21% laryngeal, 17% hypopharyngeal and 14% oral cancers. There were no significant differences regarding overall survival (OS) or LRC between the two regimens. The OS at two years was 68% for AF and 67% for CF. The corresponding figures for LRC were 71% and 67%, respectively. There was a trend towards improved LRC for oral cancers treated (p=0.07) and for large tumours (T3-T4) (p=0.07) treated with AF. The AF group had significantly worse acute reactions, while there was no significant increase in late effects.

Conclusion: Overall the AF regimen did not prove to be more efficacious than CF. However, the trend towards improved results in AF for oral cancers needs to be further investigated.

 

Place, publisher, year, edition, pages
Elsevier, 2011
Keywords
Head and neck cancer, Randomised trial, Radiotherapy, Accelerated fractionation
National Category
Cancer and Oncology
Research subject
Oncology
Identifiers
urn:nbn:se:umu:diva-45326 (URN)10.1016/j.radonc.2010.12.010 (DOI)21295880 (PubMedID)
Available from: 2011-07-04 Created: 2011-07-04 Last updated: 2018-06-08Bibliographically approved
Kristensen, I., Lindh, J., Nilsson, P., Agrup, M., Bergström, P., Björk-Eriksson, T., . . . Karlsson, M. (2009). Telemedicine as a tool for sharing competence in paediatric radiotherapy: implementation and initial experiences from a Swedish project.. Acta oncologica (Stockholm, Sweden), 48(1), 146-52
Open this publication in new window or tab >>Telemedicine as a tool for sharing competence in paediatric radiotherapy: implementation and initial experiences from a Swedish project.
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2009 (English)In: Acta oncologica (Stockholm, Sweden), ISSN 1651-226X, Vol. 48, no 1, p. 146-52Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-18409 (URN)10.1080/02841860802409520 (DOI)18846448 (PubMedID)
Available from: 2009-02-05 Created: 2009-02-05 Last updated: 2018-06-09
Dasu, A., Toma-Dasu, I., Franzén, L., Widmark, A. & Nilsson, P. (2009). The risk for secondary cancers in patients treated for prostate carcinoma: an analysis with completion dose response model. In: O Dössel, W C Schlegel, R Magjarevic (Ed.), Olaf Dössel, Wolfgang C. Schlegel (Ed.), IFMBE Proceedings of the World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany. Paper presented at World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany (pp. 237-240). Springer Verlag
Open this publication in new window or tab >>The risk for secondary cancers in patients treated for prostate carcinoma: an analysis with completion dose response model
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2009 (English)In: IFMBE Proceedings of the World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany / [ed] Olaf Dössel, Wolfgang C. Schlegel, Springer Verlag , 2009, p. 237-240Conference paper, Published paper (Refereed)
Abstract [en]

The risk for radiation-induced cancers has become increasingly important as patient survival following radiotherapy has increased due to the advent of new methods for early detection and advanced treatment. Attempts have been made to quantify the risk of cancer that may be associated with various treatment approaches, but the accuracy of predictions is rather low due to the influence of many confounding factors. It is the aim of this paper to investigate the impact of dose heterogeneity and inter-patient anatomical heterogeneity that may be encountered in a population of patients undergoing radiotherapy and are thought to influence risk predictions. Dose volume histograms from patients treated with radiation for the carcinoma of the prostate have been used to calculate the risk for secondary malignancies using a competition dose-response model previously developed. Biologically-relevant parameters derived from clinical and experimental data have been used for the model. The results suggested that dose heterogeneity plays an important role in predicting the risk for secondary cancer and that it should be taken into account through the use of dose volume histograms. Consequently, dose-response relationships derived for uniform relationships should be used with care to predict the risk for secondary malignancies in heterogeneously irradiated tissues. Inter-patient differences could lead to considerable uncertainties in the shape of the relationship between predicted risk and average tissue dose, as seen in epidemiological studies. They also lead to rather weak correlations between the risk for secondary malignancies and target volumes. The results stress the importance of taking into account the details of the clinical delivery of dose in radiotherapy for treatment plan evaluation or for retrospective analyses of the induction of secondary cancers. Nevertheless, the levels of risks are generally low and they could be regarded as the price of success for the advances in the radiotherapy of the prostate.

Place, publisher, year, edition, pages
Springer Verlag, 2009
Series
IFMBE Proceedings, ISSN 1680-0737 ; 25/3
Keywords
radiation induced cancers, risk estimations, radiation treatment, prostate cancer, heterogeneity
Identifiers
urn:nbn:se:umu:diva-46098 (URN)10.1007/978-3-642-03902-7_67 (DOI)
Conference
World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany
Available from: 2011-08-26 Created: 2011-08-26 Last updated: 2018-06-08Bibliographically approved
Dasu, A., Toma-Dasu, I., Franzen, L., Widmark, A. & Nilsson, P. (2009). The risk of secondary cancers in patients treated for prostate carcinoma: an analysis with competition dose response model. In: IFMBE Proceedings. Paper presented at World Congress on Medical Physics and Biomedical Engineering 2009 (pp. 237-240). Berlin: Springer
Open this publication in new window or tab >>The risk of secondary cancers in patients treated for prostate carcinoma: an analysis with competition dose response model
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2009 (English)In: IFMBE Proceedings, Berlin: Springer , 2009, p. 237-240Conference paper, Published paper (Refereed)
Abstract [en]

The risk for radiation-induced cancers has become increasingly important as patient survival following radiotherapy has increased due to the advent of new methods for early detection and advanced treatment. Attempts have been made to quantify the risk of cancer that may be associated with various treatment approaches, but the accuracy of predictions is rather low due to the influence of many confouding factors. It is the aim of this paper to investigate the impact of dose heterogeneity and inter-patient anatomical heterogeneity that may be encountered in a population of patients undergoing radiotheray and are thought to influence risk predictions. Dose volume histograms from patients treated with radiation for the carcinoma of the prostate have been used to calculate the risk for secondary malignancies using a competition dose-response model previously developed. Biologically-relevant parameters derived from clinical and experimental data have been used for the model. The results suggested that dose heterogeneity plays an important role in predicting the risk for secondary cancer and that it should be taken into account throught the use of dose volume histograms. Consequently, dose-response relationships derived for uniform relationships should be used with care to predict the risk for secondary malignancies in heterogeneously irradiated tissues. Inter-patient differences could lead to considerable uncertainties in the shape of the relationship between predicted risk and average tissue dose, as seen in epidemiological studies. They also lead to rather weak correlations between the risk for secondary malignancies and target volumes. The results stress the importance of taking into account the details of the clinical delivery of dose in radiotherapy plan evaluation or for retrospective analyses of the induction of secondary cancers. Nevertheless, the levels of risks are generally low and they could be regarded as teh price of success for the advances in the radiotherapy of the prostate.

Place, publisher, year, edition, pages
Berlin: Springer, 2009
Series
IFMBE Proceedings, ISSN 1680-0737 ; 25/III
Keywords
Radiation induced cancers, risk estimations, radiation treatment, prostate cancer, heterongeneity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-35103 (URN)10.1007/978-3-642-03902-7 (DOI)978-3-642-03901-0 (ISBN)
Conference
World Congress on Medical Physics and Biomedical Engineering 2009
Available from: 2010-07-09 Created: 2010-07-09 Last updated: 2018-06-08Bibliographically approved
Kristensen, I., Johansson, M., Lindh, J., Nilsson, P. & Karlsson, M. (2006). Barnradioterapi på distans. Läkartidningen, 103(15-16), 1188-1190
Open this publication in new window or tab >>Barnradioterapi på distans
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2006 (Swedish)In: Läkartidningen, Vol. 103, no 15-16, p. 1188-1190Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-13465 (URN)
Available from: 2007-02-26 Created: 2007-02-26 Last updated: 2018-06-09Bibliographically approved
Karlsson, M., Björk-Eriksson, T., Mattsson, O., Mattsson, S., Montelius, A., Nilsson, P. & Zackrisson, B. (2006). Distributed proton radiation therapy - A new concept for advance competence support. Acta Oncologica, 45(8), 1094-1101
Open this publication in new window or tab >>Distributed proton radiation therapy - A new concept for advance competence support
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2006 (English)In: Acta Oncologica, ISSN 0284-186X, Vol. 45, no 8, p. 1094-1101Article in journal (Refereed) Published
Identifiers
urn:nbn:se:umu:diva-15739 (URN)doi:10.1080/02841860600897876 (DOI)17118845 (PubMedID)
Available from: 2007-02-26 Created: 2007-02-26 Last updated: 2018-06-09Bibliographically approved
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