| 1. |
- Nyholm, Tufve, et al.
(author)
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A national approach for automated collection of standardized and population-based radiation therapy data in Sweden
- 2016
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In: Radiotherapy and Oncology. - : Elsevier BV. - 0167-8140 .- 1879-0887. ; 119:2, s. 344-350
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Journal article (peer-reviewed)abstract
- Purpose: To develop an infrastructure for structured and automated collection of interoperable radiation therapy (RT) data into a national clinical quality registry. Materials and methods: The present study was initiated in 2012 with the participation of seven of the 15 hospital departments delivering RT in Sweden. A national RT nomenclature and a database for structured unified storage of RT data at each site (Medical Information Quality Archive, MIQA) have been developed. Aggregated data from the MIQA databases are sent to a national RT registry located on the same IT platform (INCA) as the national clinical cancer registries. Results: The suggested naming convention has to date been integrated into the clinical workflow at 12 of 15 sites, and MIQA is installed at six of these. Involvement of the remaining 3/15 RT departments is ongoing, and they are expected to be part of the infrastructure by 2016. RT data collection from ARIA (R), Mosaiq (R), Eclipse (TM), and Oncentra (R) is supported. Manual curation of RT-structure information is needed for approximately 10% of target volumes, but rarely for normal tissue structures, demonstrating a good compliance to the RT nomenclature. Aggregated dose/volume descriptors are calculated based on the information in MIQA and sent to INCA using a dedicated service (MIQA2INCA). Correct linkage of data for each patient to the clinical cancer registries on the INCA platform is assured by the unique Swedish personal identity number. Conclusions: An infrastructure for structured and automated prospective collection of syntactically inter operable RT data into a national clinical quality registry for RT data is under implementation. Future developments include adapting MIQA to other treatment modalities (e.g. proton therapy and brachytherapy) and finding strategies to harmonize structure delineations. How the RT registry should comply with domain-specific ontologies such as the Radiation Oncology Ontology (ROO) is under discussion.
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| 2. |
- Rögnvaldsson, Thorsteinn, 1963-, et al.
(author)
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ARC13 – Assessment of Research and Coproduction : Reports from the assessment of all research at Halmstad University 2013
- 2014
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Reports (pop. science, debate, etc.)abstract
- During 2013, an evaluation of all the research conducted at Halmstad University was carried out. The purpose was to assess the quality of the research, coproduction, and collaboration in research, as well as the impact of the research. The evaluation was dubbed the Assessment of Research and Coproduction 2013, or ARC13. (Extract from Executive Summary)
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| 3. |
- Friman, Styrbjörn, 1948, et al.
(author)
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Kidney transplantation--a 46-year experience from the Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden.
- 2011
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In: Clinical transplants. - 0890-9016. ; , s. 119-25
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Journal article (peer-reviewed)abstract
- The limiting factor in organ transplantation is the availability of organs. Ongoing work to improve donation rates both at the public and the organizational level in donating hospitals is essential. We also think that encouragement of live donation is important, and the possibility of ABO incompatible transplantation has increased the number of LD transplantations. The one-year graft survival rate is excellent and focus has shifted towards achieving long-term results to reduce the attrition rate. There is also an increasing interest in studying and working to reduce comorbidities on a long-term basis and thus, improve survival rates and recipient quality of life.
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| 4. |
- Lundstedt, Dan, 1970, et al.
(author)
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Long-term symptoms after radiotherapy of supraclavicular lymph nodes in breast cancer patients.
- 2012
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In: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. - : Elsevier BV. - 1879-0887. ; 103:2, s. 155-160
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Journal article (peer-reviewed)abstract
- BACKGROUND AND PURPOSE: Irradiation of the supraclavicular lymph nodes has historically increased the risk of brachial plexopathy. We report long-term symptoms after modern radiotherapy (based on 3D dose planning) in breast cancer patients with or without irradiation of the supraclavicular lymph nodes. MATERIAL AND METHODS: We collected information from 814 women consecutively treated with adjuvant radiotherapy for breast cancer. The women had breast surgery with axillary dissection (AD) or sentinel node biopsy (SNB). The breast area was treated to 50Gy in 2.0Gy fractions. Women with >three lymph node metastases had regional radiotherapy (RRT) to the supraclavicular lymph nodes. Three to eight years after radiotherapy, they received a questionnaire asking about paraesthesia, oedema, pain, and strength in the upper limb. RESULTS: Paraesthesia was reported by 38/192 (20%) after AD with RRT compared to 68/505 (13%) after AD without RRT (relative risk [RR] 1.47; 95% confidence interval [CI] 1.02-2.11) and by 9/112 (8%) after SNB without RRT (RR 2.46; 95% CI 1.24-4.90). Corresponding risks adjusted for oedema (RR 1.28; 95% CI 0.93-1.76) and (RR 1.75; 95% CI 0.90-3.39). In women ⩽49years with AD and RRT, 27% reported paraesthesia. No significant pain or decreased strength was reported after RRT. CONCLUSION: Radiotherapy to the supraclavicular lymph nodes after axillary dissection increases the occurrence of paraesthesia, mainly among younger women. When adjusted for oedema the contribution from radiotherapy is no longer formally statistically significant indicating that there is also an indirect effect mediated by the oedema.
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| 5. |
- Lundstedt, Dan, 1970, et al.
(author)
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Radiation Therapy to the Plexus Brachialis inBreast Cancer Patients: Analysis of Paresthesia in Relation to Dose and Volume.
- 2015
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In: International journal of radiation oncology, biology, physics. - : Elsevier BV. - 1879-355X .- 0360-3016. ; 92:2, s. 277-283
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Journal article (peer-reviewed)abstract
- To investigate predictors of paresthesia after irradiation of the brachial plexus, we compared women treated for breast cancer with and women treated without irradiation of the brachial plexus. The plexus was delineated on dose-planning computerized tomography. The women answered a questionnaire 3 to 8 years after radiation therapy. Irradiated volumes and doses were related to the occurrence of paresthesia in the hand. Our results indicate a correlation between larger irradiated volumes of the brachial plexus and paresthesia.
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| 6. |
- Lundstedt, Dan, 1970, et al.
(author)
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Risk Factors of Developing Long-Lasting Breast Pain After Breast Cancer Radiotherapy.
- 2012
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In: International journal of radiation oncology, biology, physics. - : Elsevier BV. - 1879-355X .- 0360-3016. ; 83:1, s. 71-78
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Journal article (peer-reviewed)abstract
- PURPOSE: Postoperative radiotherapy decreases breast cancer mortality. However, studies have revealed a long-lasting breast pain among some women after radiotherapy. The purpose of this study was to identify risk factors that contribute to breast pain after breast cancer radiotherapy. METHODS AND MATERIALS: We identified 1,027 recurrence-free women in two cohorts of Swedish women treated for breast cancer. The women had breast-conserving surgery and postoperative radiotherapy, the breast was treated to 48 Gy in 2.4-Gy fractions or to 50 Gy in 2.0-Gy fractions. Young women received a boost of up to 16 Gy. Women with more than three lymph node metastases had locoregional radiotherapy. Systemic treatments were given according to health-care guidelines. Three to 17 years after radiotherapy, we collected data using a study-specific questionnaire. We investigated the relation between breast pain and potential risk modifiers: age at treatment, time since treatment, chemotherapy, photon energy, fractionation size, boost, loco-regional radiotherapy, axillary surgery, overweight, and smoking. RESULTS: Eight hundred seventy-seven women (85%) returned the questionnaires. Among women up to 39 years of age at treatment, 23.1% had breast pain, compared with 8.7% among women older than 60 years (RR 2.66; 95% CI 1.33-5.36). Higher age at treatment (RR 0.96; 95% CI 0.94-0.98, annual decrease) and longer time since treatment (RR 0.93; 95% CI 0.88-0.98, annual decrease) were related to a lower occurrence of breast pain. Chemotherapy increased the occurrence of breast pain (RR 1.72; 95% CI 1.19-2.47). In the multivariable model only age and time since treatment were statistically significantly related to the occurrence of breast pain. We found no statistically significant relation between breast pain and the other potential risk modifiers. CONCLUSIONS: Younger women having undergone breast-conserving surgery with postoperative radiotherapy report a higher occurrence of long-lasting breast pain compared to older women. Time since treatment may decrease the occurrence of pain.
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| 7. |
- Andersson, Hans, et al.
(author)
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Complete regioselective addition of grignard reagents to pyrazine N-oxides, toward an efficient enantioselective synthesis of substituted piperazines.
- 2010
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In: Organic letters. - : American Chemical Society (ACS). - 1523-7052 .- 1523-7060. ; 12:2, s. 284-6
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Journal article (peer-reviewed)abstract
- A conceptually new one-pot strategy for the synthesis of protected substituted piperazines via the addition of Grignard reagents to pyrazine N-oxides is presented. This strategy is high yielding (33-91% over three steps), step-efficient, and fast. The synthesized N,N-diprotected piperazines are convenient to handle and allow for orthogonal deprotection at either nitrogen for selective transformations. In addition, this is a synthetic route to enantiomerically enriched piperazines by using a combination of phenyl magnesium chloride and (-)-sparteine, which resulted in enantiomeric excesses up to 83%.
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| 8. |
- Chakarova, Roumiana, et al.
(author)
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Superficial dose distribution in breast for tangential radiation treatment, Monte Carlo evaluation of Eclipse algorithms in case of phantom and patient geometries.
- 2011
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In: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. - : Elsevier BV. - 1879-0887.
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Journal article (peer-reviewed)abstract
- PURPOSE: The aim of this study is to examine experimentally and by the Monte Carlo method the accuracy of the Eclipse Pencil Beam Convolution (PBC) and Analytical Anisotropic Algorithm (AAA) algorithms in the superficial region (0-2cm) of the breast for tangential photon beams in a phantom case as well as in a number of patient geometries. The aim is also to identify differences in how the patient computer tomography data are handled by the treatment planning system and in the Monte Carlo simulations in order to reduce influences of these effects on the evaluation. MATERIALS AND METHODS: Measurements by thermoluminescent dosimeters and gafchromic film are performed for six MV tangential irradiation of the cylindrical solid water phantom. Tangential treatment of seven patients is investigated considering open beams. Dose distributions are obtained by the Eclipse PBC and AAA algorithms. Monte Carlo calculations are carried out by BEAMnrc/DOSXYZnrc code package. Calculations are performed with a calculation grid of 1.25×1.25×5mm(3) for PBC and 2×2×5mm(3) for AAA and Monte Carlo, respectively. Dose comparison is performed in both dose and spatial domains by the normalized dose difference method. RESULTS: Experimental profiles from the surface toward the geometrical center of the cylindrical phantom are obtained at the beam entrance and exit as well as laterally. Full dose is received beyond 2mm in the lateral superficial region and beyond 7mm at the beam entrance. Good agreement between experimental, Monte Carlo and AAA data is obtained, whereas PBC is seen to underestimate the entrance dose the first 3-4mm and the lateral dose by more than 5% up to 8mm depth. In the patient cases considered, AAA and Monte Carlo show agreement within 3% dose and 4mm spatial tolerance. PBC systematically underestimates the dose at the breast apex. The dimensions of region out of tolerance vary with the local breast shape. Different interpretations of patient boundaries in Monte Carlo and the Eclipse are found to influence the evaluation. Computer tomography marker wire may introduce local disturbance effects on the comparison as well. These factors are not related to the accuracy of the calculation algorithms and their effect is taken into account in the evaluation. CONCLUSIONS: The accuracy of AAA in the case of the solid water phantom is comparable with that of the Monte Carlo method. The AAA-Monte Carlo differences in the patient cases considered are within 3%, 4mm tolerance. The PBC algorithm does not give equivalent results. In the phantom case, PBC underestimates the lateral dose by more than 5% up to 8mm depth. The PBC-Monte Carlo differences in the patient cases are outside the tolerance at the breast apex. The dimension of region varies with the breast shape being typically 8-10mm long and 6-8mm deep.
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