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- Heggebo, L. C., et al.
(författare)
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Investigating survival, quality of life and cognition in PROton versus photon therapy for IDH-mutated diffuse grade 2 and 3 GLIOmas (PRO-GLIO): a randomised controlled trial in Norway and Sweden
- 2023
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 13:3
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionThe use of proton therapy increases globally despite a lack of randomised controlled trials demonstrating its efficacy and safety. Proton therapy enables sparing of non-neoplastic tissue from radiation. This is principally beneficial and holds promise of reduced long-term side effects. However, the sparing of seemingly non-cancerous tissue is not necessarily positive for isocitrate dehydrogenase (IDH)-mutated diffuse gliomas grade 2-3, which have a diffuse growth pattern. With their relatively good prognosis, yet incurable nature, therapy needs to be delicately balanced to achieve a maximal survival benefit combined with an optimised quality of life.Methods and analysisPRO-GLIO (PROton versus photon therapy in IDH-mutated diffuse grade 2 and 3 GLIOmas) is an open-label, multicentre, randomised phase III non-inferiority study. 224 patients aged 18-65 years with IDH-mutated diffuse gliomas grade 2-3 from Norway and Sweden will be randomised 1:1 to radiotherapy delivered with protons (experimental arm) or photons (standard arm). First intervention-free survival at 2 years is the primary endpoint. Key secondary endpoints are fatigue and cognitive impairment, both at 2 years. Additional secondary outcomes include several survival measures, health-related quality of life parameters and health economy endpoints.Ethics and disseminationTo implement proton therapy as part of standard of care for patients with IDH-mutated diffuse gliomas grade 2-3, it should be deemed safe. With its randomised controlled design testing proton versus photon therapy, PRO-GLIO will provide important information for this patient population concerning safety, cognition, fatigue and other quality of life parameters. As proton therapy is considerably more costly than its photon counterpart, cost-effectiveness will also be evaluated. PRO-GLIO is approved by ethical committees in Norway (Regional Committee for Medical & Health Research Ethics) and Sweden (The Swedish Ethical Review Authority) and patient inclusion has commenced. Trial results will be published in international peer-reviewed journals, relevant conferences, national and international meetings and expert forums.Trial registration numberClinicalTrials.gov Registry (NCT05190172).
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- Andersson, K, et al.
(författare)
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Colloidal rare earth elements in a boreal river: Changing sources and distributions during the spring flood
- 2006
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Ingår i: Geochimica Et Cosmochimica Acta. - : Elsevier BV. - 0016-7037 .- 1872-9533. ; 70:13, s. 3261-3274
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Tidskriftsartikel (refereegranskat)abstract
- Variations in the physico-chemical speciation of the rare earth elements (REE) have been investigated in a subarctic boreal river during an intense spring flood event using prefiltered (< 100 mu m) samples, cross-flow (ultra)filtration (CFF), flow field-flow fractionation (FIFFF), and diffusive gradients in thin films (DGT). This combination of techniques has provided new information regarding the release and transport of the REE in river water. The colloidal material can be described in terms of two fractions dominated by carbon and iron, respectively. These two fractions, termed colloidal carrier phases, showed significant temporal changes in concentration and size distribution. Before the spring flood, colloidal carbon concentrations were low, the colloids being dominated by relatively large iron colloids. Colloidal concentrations increased sharply during the spring flood, with smaller carbon colloids dominating. Following the spring flood, colloidal concentrations decreased again, smaller carbon colloids still dominating. The REE are transported mainly in the particulate and colloidal phases. Before the spring flood, the REE composition of all measured fractions was similar to local till. During the spring flood, the REE concentrations in the colloidal and particulate fractions increased. The increase was most marked for the lighter REE, which therefore showed a strong enrichment when normalized to local till. Following the spring flood, the REE concentrations decreased again and reverted to a distribution similar to local till. These changes in the concentration and distributions of carbon iron and REE are interpreted in terms of changing hydrological flow paths in soil and bedrock which occur during the spring flood. (c) 2006 Elsevier Inc. All rights reserved.
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- Andersson, K. G., et al.
(författare)
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Parametric improvement for the ingestion dose module of the European ARGOS and RODOS decision support systems
- 2011
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Ingår i: Radioprotection. - : EDP Sciences. - 0033-8451 .- 1769-700X. ; 46
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Tidskriftsartikel (refereegranskat)abstract
- The European decision support systems ARGOS and RODOS rely on the ECOSYS model for prognoses of ingestion doses. ECOSYS needs an update of various parameter values to provide reliable estimates. This paper reports on some results of a Nordic initiative to derive parameter values that are specific to Nordic conditions, as well as to improve generic parameter values in ECOSYS, taking into account the host of useful measurement data accumulated since ECOSYS was created. © 2011 EDP Sciences.
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- Boecker, W., et al.
(författare)
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Differentiation and histogenesis of syringomatous tumour of the nipple and low-grade adenosquamous carcinoma: evidence for a common origin
- 2014
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Ingår i: Histopathology. - : Wiley. - 0309-0167 .- 1365-2559. ; 65:1, s. 9-23
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Syringomatous tumour of the nipple and low-grade adenosquamous carcinoma (LGAdSC) of the breast are regarded as distinct entities. To clarify the nature of these two lesions, we compared the expression of different lineage/differentiation markers in 12 syringomatous tumours of the nipple, nine LGAdSCs, and normal breast epithelium. Methods and results: Using triple immunofluorescence labelling and quantitative RT-PCR for keratins, p63, and smooth muscle actin, we demonstrated that syringomatous tumour and LGAdSC contain p63+/K5/14+ tumour cells, K10+ squamous cells, and K8/18+ glandular cells, with intermediary cells being found in both lineages. Identical p63+/K5/14+ cells were also found in the normal breast duct epithelium. Conclusions: Our data provide evidence that syringomatous tumour of the nipple and LGAdSC are identical or nearly identical lesions. They contain p63+/K5/14+ cells as the key cells from which the K10+ squamous lineage and the K8/18+ glandular lineage arise. On the basis of our findings in normal breast tissue and associated benign lesions, we suggest that p63+/K5/14+ cells of the normal breast duct epithelium or early related cells might play a key role in the neoplastic transformation of both syringomatous tumour and LGAdSC. We propose that the differentiation patterns found in both lesions reflect the early ontogenetic stages of the normal breast epithelium.
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