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- Brusselaers, Nele, et al.
(författare)
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Tumour staging of oesophageal cancer in the Swedish Cancer Registry : a nationwide validation study
- 2015
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Ingår i: Acta Oncologica. - Stockholm : Karolinska Institutet, Dept of Molecular Medicine and Surgery. - 1651-226X.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Tumour stage was introduced to the Swedish Cancer Registry in 2004, but this key variable for prognostic research has not yet been validated. We validated the tumour stage data in surgically treated oesophageal cancer patients. Material and Methods: Completeness and accuracy of tumour stage according to the TNM system (“Tumour Node Metastasis”) in the Cancer Registry were compared with a cohort study including comprehensive tumour stage data based on the pathological TNM of almost all patients operated for oesophageal cancer in 2006-2010 in Sweden. Results: Of the 397 patients with pathological TNM data in the comparison cohort, the Cancer Registry reported an overall TNM stage in 390 patients (98.2%), which was based on the pathological TNM of 104 patients (26.2%), the clinical TNM of 183 patients (46.1%), and the pathological or clinical TNM (undefined) of 110 patients (27.7%). The completeness for the separate T, N, and M components was 89.4%, 90.9%, and 85.1%, respectively. The concordance with tumour stage was 98.2%, while it was 51.1%, 70.5%, and 80.4% for the separate T, N, and M components, respectively. While the concordance with tumour stage was high for all TNM assessment groups (98.1-98.4%), the concordance of the T and N components was highest when using pathological TNM (82.7% and 95.2%, respectively), and the concordance of the M component was highest when using clinical TNM (88.5%). Conclusion: Although the overall completeness of tumour stage is high, the recording of pathological TNM stage and individual components could be improved within the Swedish Cancer Registry.
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| 3. |
- Hörberger, Filip, et al.
(författare)
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Pencil beam scanning proton therapy for mediastinal lymphomas in deep inspiration breath-hold : a retrospective assessment of plan robustness
- 2024
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Ingår i: Acta oncologica (Stockholm, Sweden). - 1651-226X. ; 63, s. 62-69
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE/BACKGROUND: The aim of this study was to evaluate pencil beam scanning (PBS) proton therapy (PT) in deep inspiration breath-hold (DIBH) for mediastinal lymphoma patients, by retrospectively evaluating plan robustness to the clinical target volume (CTV) and organs at risk (OARs) on repeated CT images acquired throughout treatment. Methods: Sixteen mediastinal lymphoma patients treated with PBS-PT in DIBH were included. Treatment plans (TPs) were robustly optimized on the CTV (7 mm/4.5%). Repeated verification CTs (vCT) were acquired during the treatment course, resulting in 52 images for the entire patient cohort. The CTV and OARs were transferred from the planning CT to the vCTs with deformable image registration and the TPs were recalculated on the vCTs. Target coverage and OAR doses at the vCTs were compared to the nominal plan. Deviation in lung volume was also calculated. RESULTS: The TPs demonstrated high robust target coverage throughout treatment with D98%,CTV deviations within 2% for 14 patients and above the desired requirement of 95% for 49/52 vCTs. However, two patients did not achieve a robust dose to CTV due to poor DIBH reproducibility, with D98%,CTV at 78 and 93% respectively, and replanning was performed for one patient. Adequate OAR sparing was achieved for all patients. Total lung volume variation was below 10% for 39/52 vCTs. CONCLUSION: PBS PT in DIBH is generally a robust technique for treatment of mediastinal lymphomas. However, closely monitoring the DIBH-reproducibility during treatment is important to avoid underdosing CTV and achieve sufficient dose-sparing of the OARs.
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| 4. |
- Wagenius, Gunnar, et al.
(författare)
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First-line Treatment Patterns and Outcomes in Advanced Non-Small Cell Lung Cancer in Sweden : A Population-based Real-world Study with Focus on Immunotherapy
- 2024
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Ingår i: Acta oncologica (Stockholm, Sweden). - 1651-226X. ; 63, s. 198-205
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: The treatment landscape for patients with advanced non-small cell lung cancer (NSCLC) has evolved significantly since the introduction of immunotherapies. We here describe PD-L1 testing rates, treatment patterns, and real-world outcomes for PD-(L)1 inhibitors in Sweden. MATERIALS AND METHODS: Data were obtained from the Swedish National Lung Cancer Registry for patients with advanced NSCLC and Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-2 who initiated first-line -systemic treatment from 01 April 2017 to 30 June 2020. PD-L1 testing was available in the registry from 01 January 2018. Kaplan-Meier was used for overall survival (OS) by type treatment and histology. RESULTS: A total of 2,204 patients with pathologically confirmed unresectable stage IIIB/C or IV NSCLC initiated first-line treatment, 1,807 (82%) with nonsquamous (NSQ) and 397 (18%) with SQ. Eighty-six per cent (NSQ) or 85% (SQ) had been tested for PD-L1 expression, a proportion that increased over time. The use of platinum-based therapy as first-line treatment decreased substantially over time while there was an upward trend for PD-(L)1-based therapy. Among patients with PS 0-1 initiating a first-line PD-(L)1 inhibitor monotherapy, the median OS was 18.6 and 13.3 months for NSQ and SQ NSCLC patients, respectively, while for the PD-(L)1 inhibitor and chemotherapy combination regimen, the median OS was 24.0 months for NSQ and not evaluable for SQ patients. INTERPRETATION: The majority of advanced NSCLCs in Sweden were tested for PD-L1 expression. Real-world OS in patients with PS 0-1 receiving first-line PD-(L)1 inhibitor-based regimens was similar to what has been reported in pivotal clinical trials on PD-(L)1 inhibitors.
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