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Sökning: WFRF:(Glimelius Bengt) > (2005-2009)

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1.
  • Ask, Anders, et al. (författare)
  • The potential of proton beam radiation therapy in gastrointestinal cancer.
  • 2005
  • Ingår i: Acta Oncologica. - Taylor & Francis. - 1651-226X. ; 44:8, s. 896-903
  • Tidskriftsartikel (refereegranskat)abstract
    • A group of Swedish oncologists and hospital physicists have estimated the number of patients in Sweden suitable for proton beam therapy. The estimations have been based on current statistics of tumour incidence, number of patients potentially eligible for radiation treatment, scientific support from clinical trials and model dose planning studies and knowledge of the dose-response relations of different tumours and normal tissues. In gastrointestinal cancers, it is assessed that at least 345 patients, mainly non-resectable rectal cancers, oesophageal and liver cancers, are eligible. Great uncertainties do however exist both in the number of patients with gastrointestinal cancers suitable for radiation therapy, and in the proportion of those where proton beams may give sufficiently better results.
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2.
  • Glimelius, Bengt, et al. (författare)
  • Number of patients potentially eligible for proton therapy
  • 2005
  • Ingår i: Acta Oncol. - 0284-186X (Print). ; 44:8, s. 836-49
  • Tidskriftsartikel (refereegranskat)abstract
    • A group of Swedish radiation oncologists and hospital physicists have estimated the number of patients in Sweden suitable for proton beam therapy in a facility where one of the principal aims is to facilitate randomized and other studies in which the advantage of protons can be shown and the magnitude of the differences compared with optimally administered conventional radiation treatment, also including intensity-modulated radiation therapy (IMRT) and brachytherapy, can be shown. The estimations have been based on current statistics of tumour incidence in Sweden, number of patients potentially eligible for radiation treatment, scientific support from clinical trials and model dose planning studies and knowledge of the dose-response relations of different tumours together with information on normal tissue complication rates. In Sweden, it is assessed that between 2200 and 2500 patients annually are eligible for proton beam therapy, and that for these patients the potential therapeutic benefit is so great as to justify the additional expense of proton therapy. This constitutes between 14-15% of all irradiated patients annually.
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3.
  • Johansson, Bengt, et al. (författare)
  • The potential of proton beam radiation therapy in prostate cancer, other urological cancers and gynaecological cancers
  • 2005
  • Ingår i: Acta Oncologica. - Taylor & Francis. - 1651-226X. ; 44:8, s. 890-895
  • Tidskriftsartikel (refereegranskat)abstract
    • A group of Swedish oncologists and hospital physicists have estimated the number of patients in Sweden suitable for proton beam therapy. The estimations have been based on current statistics of tumour incidence, number of patients potentially eligible for radiation treatment, scientific support from clinical trials and model dose planning studies and knowledge of the dose-response relations of different tumours and normal tissues. In prostate cancer it is estimated that annually about 300 patients and in gynaecological cancer about 50 patients, are candidates for proton beam therapy. Owing to major uncertainties, it has not been possible to give an estimate of the number of potential patients with urinary bladder cancer.
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4.
  • Lundkvist, Jonas, et al. (författare)
  • Cost-effectiveness of proton radiation in the treatment of childhood medulloblastoma
  • 2005
  • Ingår i: Cancer. - 0008-543X .- 1097-0142. ; 103:4, s. 793-801
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Radiation therapy is an important component in the treatment of medulloblastoma; however, in many patients, it is associated with risk of late adverse events. Proton radiation therapy has potential to reduce the risk of adverse events compared with conventional radiation, but it is associated with a higher treatment cost. The objective of the current study was to assess the cost-effectiveness of proton therapy compared with conventional radiation therapy in the treatment of childhood medulloblastoma. METHODS: The consequences of radiation therapy were evaluated using a Markov simulation model. Children age 5 years with medulloblastoma were followed. The patients were at risk of several types of adverse events, including hearing loss, intelligence quotient (IQ) loss, hypothyroidism, growth hormone deficiency (GHD), osteoporosis, cardiac disease, and secondary malignancies. The patients also were at risk of death and were divided into risk groups for normal death, death due to tumor recurrence, treatment-related cardiac death, treatment-related subsequent tumor death, or treatment-related other death. A review of the literature was conducted to estimate the parameters in the model. RESULTS: The base-case results showed that proton therapy was associated with 23,600 in cost savings and 0.68 additional quality-adjusted life-years per patient. The analyses showed that reductions in IQ loss and GHD contributed to the greatest part of the cost savings and were the most important parameters for cost-effectiveness. CONCLUSIONS: The results of the current study indicated that proton radiation therapy can be cost-effective and cost-saving compared with conventional radiation therapy in the treatment of children with medulloblastoma if the appropriate patients are selected for the therapy. However, there have been few long-term follow-up studies, and more much information on the long-term consequences of radiation therapy is needed.
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5.
  • Lundkvist, Jonas, et al. (författare)
  • Economic evaluation of proton radiation therapy in the treatment of breast cancer
  • 2005
  • Ingår i: Radiotherapy and Oncology. - 0167-8140 .- 1879-0887. ; 75:2, s. 179-85
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND AND PURPOSE: Proton beam therapy offers potential clinical advantages compared with conventional radiation therapy for many cancer patients. The benefits are mainly a result of a more favourable dose distribution. The treatment cost with proton radiation is higher than for conventional radiation, mainly due to the large investment cost of building a proton therapy facility. It is therefore important to evaluate whether the medical benefits of proton therapy are large enough to justify the higher treatment costs, compared with conventional radiation therapy. PATIENTS AND METHODS: The cost-effectiveness of proton therapy in the treatment of 55-year old women with left-sided breast cancer was assessed. A Markov cohort simulation model was used to simulate the life of patients diagnosed with breast cancers and treated with radiation. Cost and quality adjusted life years (QALYs) were the primary outcome measures. RESULTS: The study found a cost per QALY gained of 67,000 Euro for the base case analysis of an average breast cancer patient. The cost per QALY gained would, however, be considerably lower if a population with high-risk of developing cardiac disease was treated. Sensitivity analyses showed that the results were stable and that the risk of cardiac disease was the most important parameter. CONCLUSIONS: The results indicate that proton therapy for breast cancer can be cost-effective if appropriate risk groups are chosen as targets for the therapy.
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6.
  • Lundkvist, Jonas, et al. (författare)
  • Proton therapy of cancer : potential clinical advantages and cost-effectiveness
  • 2005
  • Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 44:8, s. 850-61
  • Tidskriftsartikel (refereegranskat)abstract
    • Proton therapy may offer potential clinical advantages compared with conventional radiation therapy for many cancer patients. Due to the large investment costs for building a proton therapy facility, however, the treatment cost with proton radiation is higher than with conventional radiation. It is therefore important to evaluate whether the medical benefits of proton therapy are large enough to motivate the higher costs. We assessed the cost-effectiveness of proton therapy in the treatment of four different cancers: left-sided breast cancer, prostate cancer, head and neck cancer, and childhood medulloblastoma. A Markov cohort simulation model was created for each cancer type and used to simulate the life of patients treated with radiation. Cost and quality adjusted life years (QALYs) were used as primary outcome measures. The results indicated that proton therapy was cost-effective if appropriate risk groups were chosen. The average cost per QALY gained for the four types of cancer assessed was about pounds 10,130. If the value of a QALY was set to pounds 55,000, the total yearly net benefit of treating 925 cancer patients with the four types of cancer was about pounds 20.8 million. Investment in a proton facility may thus be cost-effective. The results must be interpreted with caution, since there is a lack of data, and consequently large uncertainties in the assumptions used.
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7.
  • Arving, Cecilia, et al. (författare)
  • Four weeks of daily assessments of anxiety, depression and activity compared to a point assessment with the Hospital Anxiety and Depression Scale
  • 2008
  • Ingår i: Quality of Life Research. - 0962-9343 .- 1573-2649. ; 17:1, s. 95-104
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives To explore to what extent the daily reporting of anxiety, depression and activity in a diary mirrors scores on point assessments with the Hospital Anxiety and Depression scale ( HADS). Methods In a randomized intervention study consecutive breast cancer patients ( n = 179) about to start adjuvant therapy were included. The HADS questionnaires were sent to patients 3 and 12 months after inclusion. Daily reporting of anxiety, depression and activity on Visual Analogue Scales ( VAS) were completed during 4 weeks surrounding the HADS assessments. Results The results showed moderate correlations ( r = -0.36 to -0.67, P < 0.01) at both assessments. The daily reports were consistent over 4 weeks and did not differ between assessments. Mean scores on the HAD-Anxiety were 4.00 at the 3 months and 5.07 at the 12 months assessment. For the HAD-Depression the mean scores at the same assessment points were 3.61 and 3.23, respectively. The daily reports put more strain on the respondents and produced a larger attrition rate than the HADS. Conclusion A point assessment with the HADS captures the situation of breast cancer patients' equivalent to 4 weeks assessment in a diary, but is easier to complete and is therefore preferable to the diary.
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8.
  • Arving, Cecilia, et al. (författare)
  • Individual psychosocial support for breast cancer patients : A randomized study of nurse vs. psychologist interventions and standard care
  • 2007
  • Ingår i: Cancer Nursing. - 0162-220X .- 1538-9804. ; 30:3, s. E10-E19
  • Tidskriftsartikel (refereegranskat)abstract
    • In a prospective, randomized study, an individual psychosocial support intervention performed by specially trained oncology nurses, or psychologists, were compared with standard care. Consecutive primary breast cancer patients about to start adjuvant therapy (n = 179) were included. Data were supplied by the questionnaires European Organisation for Research and Treatment of Cancer Quality of Life Study Group Core Quality of life questionnaire with 30 questions (EORTC QLQ-C30) and Breast Cancer Module with 23 questions (BR23), the Hospital Anxiety and Depression Scale, Spielberger's State-Trait Anxiety Inventory, and the Impact of Event Scale before randomization and 1, 3, and 6 months later. Patient files provided data on utilization of psychosocial support offered in routine care. Global quality of life/health status, nausea and vomiting, and systemic therapy side effects were the subscales showing significant Group by Time interactions, favoring the interventions. Intervention groups improved statistically significantly more than the standard care group regarding insomnia, dyspnea, and financial difficulties. Nurse patients experienced less intrusion compared with the standard care group. All groups showed statistically and clinically significant improvements with time on several subscales. The intervention groups, however, improved to a greater extent. Fewer patients in the intervention groups used psychosocial hospital support compared with the standard care group. In conclusion, psychosocial support by specially trained nurses using techniques derived from cognitive behavioral therapy is beneficial for breast cancer patients and may be a realistic alternative in routine cancer care.
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9.
  • Arving, Cecilia, et al. (författare)
  • Satisfaction, utilisation and perceived benefit of individual psychosocial support for breast cancer patients : A randomised study of nurse versus psychologist interventions
  • 2006
  • Ingår i: Patient Education and Counseling. - 0738-3991 .- 1873-5134. ; 62:2, s. 235-243
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: In a prospective, randomised study, individual psychosocial support performed by: (1) specially trained oncology nurses (INS) or (2) psychologists (IPS) were compared with respect to utilisation, satisfaction and perceived benefit.Methods: Between December 1997 and December 1999, consecutive breast cancer patients (n = 120) were included at start of adjuvant therapy (chemo-, endocrine and/or loco-regional radiotherapy). Data were collected by an extended version of the 'IPS-patient satisfaction questionnaire' within I week after termination of the support intervention. Questionnaires were also mailed to all patients 6, 12 and 18-24 months after inclusion. Levels of distress were collected with the Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale (IES) questionnaires.Results: The patients were highly satisfied with the individual psychosocial support intervention they received, irrespective of which profession provided the support. However, the patients in the INS group reported higher levels of benefit regarding disease-related problems, regardless if the patients at baseline reported low or high levels of distress.Conclusions: Patients were highly satisfied with an individual psychosocial support intervention. In areas dealing with somatic aspects, the group intervened by nurses were more satisfied than the one by psychologists.Practice implications: Individual psychosocial support by specially trained nurses is a realistic alternative in routine cancer care.
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10.
  • Ask, Anders, et al. (författare)
  • The potential of proton beam radiation therapy in head and neck cancer.
  • 2005
  • Ingår i: Acta oncologica (Stockholm, Sweden). - 0284-186X. ; 44:8, s. 876-80
  • Tidskriftsartikel (refereegranskat)abstract
    • A group of Swedish oncologists and hospital physicists have estimated the number of patients in Sweden suitable for proton beam therapy. The estimations have been based on current statistics of tumour incidence, number of patients potentially eligible for radiation treatment, scientific support from clinical trials and model dose planning studies and knowledge of the dose-response relations of different tumours and normal tissues. In head and neck cancer, including thyroid cancer, it is assessed that at least 300 patients annually will gain sufficiently from proton beam therapy, both to improve tumour control and to decrease toxicity to compensate for the increased treatment costs using protons.
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