| 1. |
- Hardell, Elin, et al.
(författare)
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Case-control study on perfluorinated alkyl acids (PFAAs) and the risk of prostate cancer
- 2014
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Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 63, s. 35-39
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Tidskriftsartikel (refereegranskat)abstract
- Perfluorinated alkyl acids (PFAAs) are emerging environmental contaminants. Possible health effects for humans include increased risk for cancer but the knowledge is limited. In this study serum concentrations of certain perfluorinated sulfonates (PFHxS and PFOS) and carboxylates (PFOA, PFNA, PFDA, PFUnDA) were analyzed among 201 cases with prostate cancer and 186 population based control subjects. All blood samples were collected during 2007-2011 and no case had been treated with radio- or chemotherapy before enrolment in the study. The blood concentrations did not differ statistically significant between cases and controls except for PFDA with higher concentration among the cases (p = 0.03). Analyses based on Gleason score and prostate specific antigen (PSA) level did not change the results. Heredity was a risk factor for prostate cancer yielding odds ratio (OR) = 1.8, 95% confidence interval (CI) = 1.01-3.1. The analyzed PFAAs yielded statistically significant higher ORs in cases with a first degree relative reporting prostate cancer, e.g., PFOA gave OR = 2.6, 95% CI = 1.2-6.0 and PFOS gave OR = 2.7,95% CI = 1.04-6.8. The results showed a higher risk for prostate cancer in cases with heredity as a risk factor. In further studies interaction between gene and environment should be considered. (C) 2013 Elsevier Ltd. All rights reserved.
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| 2. |
- Hardell, Karin, 1975-, et al.
(författare)
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Concentrations of organohalogen compounds and titres of antibodies to Epstein-Barr virus antigens and the risk for non-Hodgkin lymphoma
- 2009
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Ingår i: Oncology Reports. - Athens, Greece : Spandidos Publications. - 1791-2431 .- 1021-335X. ; 21:6, s. 1567-1576
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Tidskriftsartikel (refereegranskat)abstract
- Exposure to some pesticides and persistent organic pollutants (POPs) has been indicated to be a risk factor for non-Hodgkin's lymphoma (NHL). Epstein-Barr virus (EBV) has been associated with some subgroups of NHL. In a previous study we found an interaction between high concentrations of some POPs and titres of antibodies to EBV early antigen (EA IgG) in relation to NHL. In the present study we measured lipid adjusted plasma concentrations of 35 congeners of polychlorinated biphenyls (PCB). p,p'-dichlorodiphenyldichloroethyelene (p,p'-DDE), hexachlorobenzene (HCB), seven subgroups of chlordanes (cis-heptachlorepoxide, cis-chlordane, trans-chlordane, oxychlordane, MC6, trans-nonachlordane, cis-nonachlordane) and one polybrominated diphenylether (PBDE) congener (no. 47) in 99 cases with NHL and 99 population based controls. Odds ratios (OR) for NHL were estimated. Sum of PCBs > median in the controls gave odds ratio (OR) 2.0, 95% confidence interval (CI) 0.99-3.9. High sum of chlordanes yielded OR 2.3, 95% CI 1.2-4.5. An interaction with EBV EA IgG was found. High sum of PCB gave OR 5.2, 95% CI 1.9-14 in the group with EA IgG > 40. Similarly HCB yielded OR 5.3, 95% CI 1.9-15, pp'-DDE gave OR 3.3, 95% CI 1.4-7.7 and sum of chlordanes yielded OR 6.8, 95% CI 2.3-20, whereas no association was found with PBDE. In summary this study confirmed an association between certain POPs and NHL with all interaction with titre of IgG antibody to EBV EA.
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| 3. |
- Hardell, Lennart, 1944-, et al.
(författare)
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Decreased survival in pancreatic cancer patients with high concentrations of organochlorines in adipose tissue
- 2007
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Ingår i: Biomedicine and Pharmacotherapy. - : Elsevier BV. - 0753-3322 .- 1950-6007. ; 61:10, s. 659-664
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Tidskriftsartikel (refereegranskat)abstract
- We analysed adipose tissue concentrations of persistent organic pollutants (POPs) in 21 cases with exocrine pancreatic cancer. The comparison group consisted of 59 subjects. Significantly increased concentrations of polychlorinated biphenyls (PCBs), hexachlorobenzene (HCB), sum of chlordanes and polybrominated diphenylethers (PBDEs) were found in the cases. For 1,1,-dichloro-2,2-bis(p-chlorophenyl)-ethylene (p,p'-DDE) no significant difference was seen. For PCBs no odds ratio (OR) could be calculated since all cases had concentration>median in controls used as a cut-off. HCB yielded OR=53.0, 95% confidence interval (CI)=4.64-605 and sum of chlordanes OR=18.4, 95% CI=2.71-124 whereas OR was not significantly increased for p,p'-DDE or PBDEs. Body mass index (BMI) at the time of tissue sampling was significantly lower for the cases. This might have influenced the results. Using BMI one year previously or decreasing the concentrations of POPs with the same percentage as weight loss among the cases did not change the results. Survival of the cases was shorter in the group with the concentration of POPs>median among cases, significantly so for the sum of PCBs (147 vs. 294 days), p,p'-DDE (134 vs. 302 days), and sum of chlordanes (142 vs. 294 days) in the high and low group, respectively. The results were based on a low number of cases and should be interpreted with caution.
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| 4. |
- Behrens, Thomas, et al.
(författare)
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Pesticide exposure in farming and forestry and the risk of uveal melanoma
- 2012
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Ingår i: Cancer Causes and Control. - : Springer. - 0957-5243 .- 1573-7225. ; 23:1, s. 141-151
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Tidskriftsartikel (refereegranskat)abstract
- Since pesticides are disputed risk factors for uveal melanoma, we studied the association between occupational pesticide exposure and uveal melanoma risk in a case-control study from nine European countries.Incident cases of uveal melanoma and population as well as hospital controls were included and frequency-matched by country, 5-year age groups and sex. Self-reported exposure was quantified with respect to duration of exposure and pesticide application method. We calculated the exposure intensity level based on application method and use of personal protective equipment. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated by unconditional logistic regression analyses and adjusted for several potential confounders.293 case and 3,198 control subjects were interviewed. We did not identify positive associations with activities in farming or forestry, pesticide application or pesticide mixing. No consistent positive associations were seen with exposure intensity level scores either. The only statistically significantly raised association in this study was for exposure to chemical fertilizers in forestry (OR = 8.93; 95% CI 1.73-42.13), but this observation was based on only six exposed subjects. Results did not change when we restricted analyses to morphologically verified cases and excluded proxy interviews as well as cancer controls. We did not observe effect modification by sex or eye color.Risk estimates for pesticide exposures and occupational activities in agriculture and forestry were not increased and did not indicate a hormonal mechanism due to these exposures.
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| 5. |
- Carlberg, Michael, et al.
(författare)
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Case-control study on occupational exposure to extremely low-frequency electromagnetic fields and glioma risk
- 2017
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Ingår i: American Journal of Industrial Medicine. - : John Wiley & Sons. - 0271-3586 .- 1097-0274. ; 60:5, s. 494-503
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Exposure to extremely low-frequency electromagnetic fields (ELF-EMF) was in 2002 classified as a possible human carcinogen, Group 2B, by the International Agency for Research on Cancer at WHO.METHODS: Life time occupations were assessed in case-control studies during 1997-2003 and 2007-2009. An ELF-EMF Job-Exposure Matrix was used for associating occupations with ELF exposure (μT). Cumulative exposure (μT-years), average exposure (μT), and maximum exposed job (μT) were calculated.RESULTS: Cumulative exposure gave for astrocytoma grade IV (glioblastoma multiforme) in the time window 1-14 years odds ratio (OR) = 1.9, 95% confidence interval (CI) = 1.4-2.6, p linear trend <0.001, and in the time window 15+ years OR = 0.9, 95%CI = 0.6-1.3, p linear trend = 0.44 in the highest exposure categories 2.75+ and 6.59+ μT years, respectively.CONCLUSION: An increased risk in late stage (promotion/progression) of astrocytoma grade IV for occupational ELF-EMF exposure was found.
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| 6. |
- Carlberg, Michael, et al.
(författare)
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Decreased Survival of Glioma Patients with Astrocytoma Grade IV (Glioblastoma Multiforme) Associated with Long-Term Use of Mobile and Cordless Phones
- 2014
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 11:10, s. 10790-10805
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Tidskriftsartikel (refereegranskat)abstract
- On 31 May 2011 the WHO International Agency for Research on Cancer (IARC) categorised radiofrequency electromagnetic fields (RF-EMFs) from mobile phones, and from other devices that emit similar non-ionising electromagnetic fields, as a Group 2B, i.e., a "possible", human carcinogen. A causal association would be strengthened if it could be shown that the use of wireless phones has an impact on the survival of glioma patients. We analysed survival of 1678 glioma patients in our 1997-2003 and 2007-2009 case-control studies. Use of wireless phones in the >20 years latency group (time since first use) yielded an increased hazard ratio (HR) = 1.7, 95% confidence interval (CI) = 1.2-2.3 for glioma. For astrocytoma grade IV (glioblastoma multiforme; n = 926) mobile phone use yielded HR = 2.0, 95% CI = 1.4-2.9 and cordless phone use HR = 3.4, 95% CI = 1.04-11 in the same latency category. The hazard ratio for astrocytoma grade IV increased statistically significant per year of latency for wireless phones, HR = 1.020, 95% CI = 1.007-1.033, but not per 100 h cumulative use, HR = 1.002, 95% CI = 0.999-1.005. HR was not statistically significant increased for other types of glioma. Due to the relationship with survival the classification of IARC is strengthened and RF-EMF should be regarded as human carcinogen requiring urgent revision of current exposure guidelines.
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| 7. |
- Carlberg, Michael, et al.
(författare)
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Evaluation of Mobile Phone and Cordless Phone Use and Glioma Risk Using the Bradford Hill Viewpoints from 1965 on Association or Causation
- 2017
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Ingår i: BioMed Research International. - : Hindawi Publishing Corporation. - 2314-6133 .- 2314-6141. ; 2017
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Forskningsöversikt (refereegranskat)abstract
- Objective: Bradford Hill's viewpoints from 1965 on association or causation were used on glioma risk and use of mobile or cordless phones.Methods: All nine viewpoints were evaluated based on epidemiology and laboratory studies.Results: Strength: meta-analysis of case-control studies gave odds ratio (OR) = 1.90, 95% confidence interval (CI) = 1.31-2.76 with highest cumulative exposure. Consistency: the risk increased with latency, meta-analysis gave in the 10+ years' latency group OR = 1.62, 95% CI = 1.20-2.19. Specificity: increased risk for glioma was in the temporal lobe. Using meningioma cases as comparison group still increased the risk. Temporality: highest risk was in the 20+ years' latency group, OR = 2.01, 95% CI =1.41-2.88, for wireless phones. Biological gradient: cumulative use of wireless phones increased the risk. Plausibility: animal studies showed an increased incidence of glioma and malignant schwannoma in rats exposed to radiofrequency (RF) radiation. There is increased production of reactive oxygen species (ROS) from RF radiation. Coherence: there is a change in the natural history of glioma and increasing incidence. Experiment: antioxidants reduced ROS production from RF radiation. Analogy: there is an increased risk in subjects exposed to extremely low-frequency electromagnetic fields.Conclusion: RF radiation should be regarded as a human carcinogen causing glioma.
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| 8. |
- Carlberg, Michael, et al.
(författare)
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On the association between glioma, wireless phones, heredity and ionising radiation
- 2012
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Ingår i: Pathophysiology. - : Elsevier. - 0928-4680 .- 1873-149X. ; 19:4, s. 243-252
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Tidskriftsartikel (refereegranskat)abstract
- We performed two case–control studies on brain tumours diagnosed during 1 January 1997 to 30 June 2000 and 1 July 2000 to 31 December 2003, respectively. Living cases and controls aged 20–80 years were included. An additional study was performed on deceased cases with a malignant brain tumour using deceased controls. Pooled results for glioma yielded for ipsilateral use of mobile phone odds ratio (OR)=2.9, 95% confidence interval (CI)=1.8–4.7 in the >10 years latency group. The corresponding result for cordless phone was OR=3.8, 95% CI=1.8–8.1. OR increased statistically significant for cumulative use of wireless phones per 100h and per year of latency. For high-grade glioma ipsilateral use of mobile phone gave OR=3.9, 95% CI=2.3–6.6 and cordless phone OR=5.5, 95% CI=2.3–13 in the >10 years latency group. Heredity for brain tumour gave OR=3.4, 95% CI=2.1–5.5 for glioma. There was no interaction with use of wireless phones. X-ray investigation of the head gave overall OR=1.3, 95% CI=1.1–1.7 for glioma without interaction with use of wireless phones or heredity. In conclusion use of mobile and cordless phone increased the risk for glioma with highest OR for ipsilateral use, latency >10 years and third tertile of cumulative use in hours. In total, the risk was highest in the age group <20 years for first use of a wireless phone.
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| 9. |
- Carlberg, Michael, et al.
(författare)
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Pooled analysis of Swedish case-control studies during 1997-2003 and 2007-2009 on meningioma risk associated with the use of mobile and cordless phones
- 2015
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Ingår i: Oncology Reports. - : Spandidos. - 1021-335X .- 1791-2431. ; 33:6, s. 3093-3098
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Tidskriftsartikel (refereegranskat)abstract
- A pooled analysis of two case-control studies on meningioma with patients diagnosed during 1997-2003 and 2007-2009 was conducted. Both genders were included, aged 20-80 and 18-75 years, respectively, at the time of diagnosis. Population-based controls, matched according to age and gender, were enrolled. Exposure was assessed by questionnaire. In the entire study, cases with all brain tumor types were included. The whole reference group was used in the unconditional logistic regression analysis on meningioma, with adjustments for gender, age, year of diagnosis and socioeconomic index (SEI). In total, 1,625 meningioma cases and 3,530 controls were analyzed. Overall no association with use of mobile or cordless phones was found. In the fourth quartile of use (>1,436 h) somewhat increased risk was found for mobile phones yielding an odds ratio (OR)=1.2, 95% confidence intervals (CI)=0.9-1.6 and cordless phones OR=1.7, 95% CI=1.3-2.2. Higher risk was calculated in the highest decile (>3,358 h), OR=1.5, 95% CI=0.99-2.1 and OR=2.0, 95% CI=1.4-2.8, respectively. In addition, the longest latency time gave somewhat increased risk for both phone types although the result was not statistically significant. There was no association for ipsilateral use or anatomical tumor location. The present study showed a somewhat increased risk among heavy users of mobile and cordless phones. Since meningioma is generally a slow-growing tumor, longer latency period is necessary for definitive conclusions.
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| 10. |
- Hardell, Lennart, 1944-
(författare)
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Effects of Mobile Phones on Children's and Adolescents' Health : A Commentary
- 2017
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Ingår i: Child Development. - : John Wiley & Sons. - 0009-3920 .- 1467-8624. ; 89:1, s. 137-140
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Tidskriftsartikel (refereegranskat)abstract
- The use of digital technology has grown rapidly during the last couple of decades. During use, mobile phones and cordless phones emit radiofrequency (RF) radiation. No previous generation has been exposed during childhood and adolescence to this kind of radiation. The brain is the main target organ for RF emissions from the handheld wireless phone. An evaluation of the scientific evidence on the brain tumor risk was made in May 2011 by the International Agency for Research on Cancer at World Health Organization. The scientific panel reached the conclusion that RF radiation from devices that emit nonionizing RF radiation in the frequency range 30 kHz-300 GHz is a Group 2B, that is, a "possible" human carcinogen. With respect to health implications of digital (wireless) technologies, it is of importance that neurological diseases, physiological addiction, cognition, sleep, and behavioral problems are considered in addition to cancer. Well-being needs to be carefully evaluated as an effect of changed behavior in children and adolescents through their interactions with modern digital technologies.
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| 11. |
- Hardell, Lennart, 1944-, et al.
(författare)
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Increasing rates of brain tumours in the swedish national inpatient register and the causes of death register
- 2015
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 12:4, s. 3793-3813
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Tidskriftsartikel (refereegranskat)abstract
- Radiofrequency emissions in the frequency range 30 kHz-300 GHz were evaluated to be Group 2B, i.e., "possibly", carcinogenic to humans by the International Agency for Research on Cancer (IARC) at WHO in May 2011. The Swedish Cancer Register has not shown increasing incidence of brain tumours in recent years and has been used to dismiss epidemiological evidence on a risk. In this study we used the Swedish National Inpatient Register (IPR) and Causes of Death Register (CDR) to further study the incidence comparing with the Cancer Register data for the time period 1998-2013 using joinpoint regression analysis. In the IPR we found a joinpoint in 2007 with Annual Percentage Change (APC) +4.25%, 95% CI +1.98, +6.57% during 2007-2013 for tumours of unknown type in the brain or CNS. In the CDR joinpoint regression found one joinpoint in 2008 with APC during 2008-2013 +22.60%, 95% CI +9.68, +37.03%. These tumour diagnoses would be based on clinical examination, mainly CT and/or MRI, but without histopathology or cytology. No statistically significant increasing incidence was found in the Swedish Cancer Register during these years. We postulate that a large part of brain tumours of unknown type are never reported to the Cancer Register. Furthermore, the frequency of diagnosis based on autopsy has declined substantially due to a general decline of autopsies in Sweden adding further to missing cases. We conclude that the Swedish Cancer Register is not reliable to be used to dismiss results in epidemiological studies on the use of wireless phones and brain tumour risk.
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| 12. |
- Hardell, Lennart, 1944-, et al.
(författare)
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Long-Term Mobile Phone Use and Acoustic Neuroma
- 2014
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Ingår i: Epidemiology. - : Lippincott Williams & Wilkins. - 1044-3983 .- 1531-5487. ; 25:5, s. 778-778
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Tidskriftsartikel (refereegranskat)
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| 13. |
- Hardell, Lennart, 1944-, et al.
(författare)
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Mobile phone and cordless phone use and the risk for glioma : Analysis of pooled case-control studies in Sweden, 1997-2003 and 2007-2009
- 2015
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Ingår i: Pathophysiology : the official journal of the International Society for Pathophysiology. - : Elsevier. - 0928-4680. ; 22:1, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- We made a pooled analysis of two case-control studies on malignant brain tumours with patients diagnosed during 1997-2003 and 2007-2009. They were aged 20-80 years and 18-75 years, respectively, at the time of diagnosis. Only cases with histopathological verification of the tumour were included. Population-based controls, matched on age and gender, were used. Exposures were assessed by questionnaire. The whole reference group was used in the unconditional regression analysis adjusted for gender, age, year of diagnosis, and socio-economic index. In total, 1498 (89%) cases and 3530 (87%) controls participated. Mobile phone use increased the risk of glioma, OR=1.3, 95% CI=1.1-1.6 overall, increasing to OR=3.0, 95% CI=1.7-5.2 in the >25 year latency group. Use of cordless phones increased the risk to OR=1.4, 95% CI=1.1-1.7, with highest risk in the >15-20 years latency group yielding OR=1.7, 95% CI=1.1-2.5. The OR increased statistically significant both per 100h of cumulative use, and per year of latency for mobile and cordless phone use. Highest ORs overall were found for ipsilateral mobile or cordless phone use, OR=1.8, 95% CI=1.4-2.2 and OR=1.7, 95% CI=1.3-2.1, respectively. The highest risk was found for glioma in the temporal lobe. First use of mobile or cordless phone before the age of 20 gave higher OR for glioma than in later age groups.
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| 14. |
- Hardell, Lennart, 1944-, et al.
(författare)
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Mobile Phones and Cancer : Next Steps
- 2014
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Ingår i: Epidemiology. - : Lippincott Williams & Wilkins. - 1044-3983 .- 1531-5487. ; 25:4, s. 617-618
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Tidskriftsartikel (refereegranskat)
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| 15. |
- Hardell, Lennart, 1944-
(författare)
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World Health Organization, radiofrequency radiation and health : a hard nut to crack (Review)
- 2017
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Ingår i: International journal of oncology. - : Spandidos Publications. - 1791-2423 .- 1019-6439. ; 51:2, s. 405-413
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In May 2011 the International Agency for Research on Cancer (IARC) evaluated cancer risks from radiofrequency (RF) radiation. Human epidemiological studies gave evidence of increased risk for glioma and acoustic neuroma. RF radiation was classified as Group 2B, a possible human carcinogen. Further epidemiological, animal and mechanistic studies have strengthened the association. In spite of this, in most countries little or nothing has been done to reduce exposure and educate people on health hazards from RF radiation. On the contrary ambient levels have increased. In 2014 the WHO launched a draft of a Monograph on RF fields and health for public comments. It turned out that five of the six members of the Core Group in charge of the draft are affiliated with International Commission on Non-Ionizing Radiation Protection (ICNIRP), an industry loyal NGO, and thus have a serious conflict of interest. Just as by ICNIRP, evaluation of non-thermal biological effects from RF radiation are dismissed as scientific evidence of adverse health effects in the Monograph. This has provoked many comments sent to the WHO. However, at a meeting on March 3, 2017 at the WHO Geneva office it was stated that the WHO has no intention to change the Core Group.
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| 16. |
- Johansson, Bengt, 1958-, et al.
(författare)
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Long term results from a uniform clinical series on pulsed dose rate brachytherapy as the boost to external beam irradiation in base of tongue cancer
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background and purpose: To evaluate the long time outcome with regard to local tumour control, side effects and quality of life of a combined pulsed dose rate (PDR) boost and hyperfractionated accelerated external beam radiotherapy (EBRT) for primary base of tongue (BOT) cancers.Patients and methods: Between 1994 and 2007 we treated 83 patients, median age 60 (38-82) years, with primary T1-T4 BOT cancers. Seven patients (8 %) were T1-2N0 (AJCC stage I-II) and 76 (92 %) patients were T1-2N+ or T3-4N0-3 (AJCC stage III-IV). The mean estimated primary tumour volume was 15 (1-75) cm3. EBRT was given with 1.7 Gy twice daily to 40,8 Gy to primary tumour and bilateral neck lymph nodes in 2.5 weeks. A PDR boost of 35 Gy and a neck dissection in clinical node positive cases was performed 2-3 weeks later. The patients were followed for a median of 54 (2-168) months.Results: The 2-, 5- and 10-years rates of actuarial local control were 91 %, 89 % and 85 %, overall survival 85 %, 65 % and 44 %, disease free survival 86 %, 80 % and 76 % respectively. The regional contral rate was 95 %. Six patients (7 %) developed distant metastases. Analysis of dosimetry showed a mean treated volume of 58 cm3. In a review of late complications we found 11 (13 %) minor and 4 (5 %) major soft tissue necroses and 6 (7 %) osteoradionecroses. The patients median subjective SOMA/LENT scoring at last follow up was; grade 0 for pain and trismus, grade 1 for dysphagia and taste alteration and grade 2 for xerostomia. Global visual-analog-scale (VAS) scoring of quality of life was 8.Conclusions: Local and regional tumour control rate was excellent in this treatment protocol. The data support that PDR boost is at least as effective as published continuous low dose rate (CLDR) results.
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| 17. |
- Johansson, Bengt, 1958-, et al.
(författare)
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Long term results of PDR brachytherapy for lip cancer
- 2011
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Ingår i: Journal of Contemporary Brachytherapy. - : Termedia Publishing House. - 1689-832X .- 2081-2841. ; 3:2, s. 65-69
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the long time outcome with regard to local tumour control and side effects of a pulsed dose rate (PDR) monobrachytherapy of primary or recurrent cancer of the lip.Material and methods: Between 1995 and 2007 we treated 43 patients with primary or recurrent clinical T1-T3N0 lip cancers. There were 22 T1 patients (51%), 16 T2 (37%) and 5 T3 cases (12%). A median dose of 60 (55-66) Gy was given, depending on the tumour volume. The PDR treatment was delivered with 0.83 Gy/pulse every second hour for 5.5-6.5 days. The patients were followed for a median of 55 (1-158) months.Results: The 2-, 5- and 10-year rates of actuarial local control were 97.6%, 94.5% and 94.5%, overall survival 88.0%, 58.9% and 39.1%, disease free survival 92.7%, 86.4% and 86.4% respectively. The regional control rate was 93%. One patient (2%) developed distant metastases. A dosimetrical analysis showed a mean treated volume of 14.9 (3.0-56.2) cm(3). Long-term side effects were mild and the cosmetic outcome excellent, except for 1 case (2%) of soft tissue necrosis and 1 case (2%) of osteoradionecrosis.Conclusions: Local outcome is excellent and similar to other published studies of continuous low dose rate (cLDR) brachytherapy.
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| 18. |
- Johansson, Bengt, 1958-, et al.
(författare)
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Pulsed dose rate brachytherapy as the boost in combination with external beam irradiation in base of tongue cancer : Long-term results from a uniform clinical series
- 2011
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Ingår i: Journal of Contemporary Brachytherapy. - Poznan, Poland : Termedia Publishing House. - 1689-832X .- 2081-2841. ; 3:1, s. 11-17
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate long time outcome with regard to local tumour control, side effects and quality of life of combined pulsed dose rate (PDR) boost and hyperfractionated accelerated external beam radiotherapy (EBRT) for primary base of tongue (BOT) cancers.Material and methods: Between 1994 and 2007, the number of 83 patients were treated with primary T1-T4 BOT cancers. Seven patients (8%) were T1-2N0 (AJCC stage I-II) and 76 (92%) patients were T1-2N+ or T3-4N0-2 (AJCC stage III-IV). The mean estimated primary tumour volume was 15.4 (1-75) cm(3). EBRT was given with 1.7 Gy bid to 40.8 Gy to primary tumour and bilateral neck lymph nodes in 2.5 weeks. PDR boost of 35 Gy and a neck dissection in clinical node positive case was performed 2-3 weeks later. The patients were followed for a median of 54 (2-168) months.Results: The 2-, 5- and 10-years rates of actuarial local control were 91%, 89% and 85%, overall survival 85%, 65% and 44%, disease free survival 86%, 80% and 76%, respectively. The regional control rate was 95%. Six patients (7%) developed distant metastases. A dosimetric analysis showed a mean of 100% isodose volume of 58.2 (16.7-134) cm(3). In a review of late complications 11 cases of minor (13%) and 5 of major soft tissue necroses (6%), as well as 6 cases of osteoradionecroses (7%) were found. The patients median subjective SOMA/LENT scoring at last follow up was as follow: grade 0 for pain and trismus, grade 1 for dysphagia and taste alteration, and grade 2 for xerostomia. Global visual-analogue-scale (VAS) scoring of quality of life was 8.Conclusion: Local and regional tumour control rate was excellent in this treatment protocol. The data shows the PDR boost as at least as effective as published continuous low dose rate (CLDR) results.
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| 19. |
- Johansson, Bengt, 1958-, et al.
(författare)
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Pulsed dose rate brachytherapy as the sole adjuvant radiotherapy after breast-conserving surgery of T1-T2 breast cancer : first long time results from a clinical study
- 2009
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Ingår i: Radiotherapy and Oncology. - Amsterdam : Elsevier. - 0167-8140 .- 1879-0887. ; 90:1, s. 30-35
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: To evaluate the long time outcome with regard to local tumour control, cosmetic outcome and side effects of a short (5 days) accelerated interstitial brachytherapy treatment delivered to the surroundings of the operated sector. PATIENTS AND METHODS: Between 1993 and 2003 we treated 50 women with early T1 and T2 breast cancer. Radical sector resection was performed and followed later with an interstitial pulsed dose rate (PDR) brachytherapy of 50Gy in 5 days. The treatment was centred on the tumour with a margin of 30mm. One patient was treated bilaterally. The patients were followed for a median of 86 (32-126) months. RESULTS: Ipsilateral breast cancer recurrence was seen in 3 patients (6%). Two of them occurred outside the treated volume. The 5- and 7-year rates of actuarial local control were 96% and 96%, respectively, overall survival 88% and 85%, disease free survival 88% and 88%, respectively. A dosimetrical analysis showed that the partial breast irradiation covered a median of 31% of the total breast volume. Fat necrosis was seen in 12% and local (moderate-strong) fibrosis in 26% of the patients. Independent cosmetic scoring showed good or excellent result in 56% of the patients. CONCLUSIONS: Local outcome is favourable and very similar to other published studies of accelerated partial breast irradiation. Our long time cosmetic results are lower than other published results.
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| 20. |
- Johansson, Bengt, 1958-, et al.
(författare)
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Pulsed dose rate monobrachytherapy for cancer of the lip : first long time results from a clinical study
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background and purpose: To evaluate the long time outcome with regard to local tumour control and side effects of a pulsed dose rate (PDR) monobrachytherapy of primary or recurrent cancr of the lip.Patients and methods: Between 1995 and 2007 we treated 43 patients with primary or recurrent T1-T3 lip cancers. The clinical stage was T1N0 for 22 patients (51 %), T2N0 for 16 patients (37 %) and T3N0 for 5 patients (12 %). A median dose of 60 (55-66) Gy was given, depending on the tumour volume. The PDR treatment was given with 0.83 Gy/pulse every second hour for 5.5-6.5 days. The patients were followed for a median of 55 (1-158) months.Results: The 2-, 5- and 10-years rates of actuarial local control were 97.6 %, 94.5 % and 94.5 %, overall survival 88.0 %, 58.9 % and 39.1 %, disease free survival 92.7 %, 86.4 % and 86.4 % respectively. The regional control rate was 93 %. One patient (2 %) developed distant metastases. A dosimetrical analysis showed a mean treated volume of 14.9 (3.0-56.2) cm3. In a review of late complications we found 1 (2 %) soft tissue necrosis and 1 (2 %) osteoradionecrosis. Long-term side effects were very mild and the cosmetic outcome excellent.Conclusions: Local outcome is excellent and very similar to other published studies of continuous low dose rate (cLDR) brachytherapy.
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| 21. |
- Karlsson, Mats G., 1960-, et al.
(författare)
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No association between immunohistochemical expression of p53, c-erbB-2, Ki-67, estrogen and progesterone receptors in female papillary thyroid cancer and ionizing radiation
- 1997
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Ingår i: Cancer Letters. - Clare, Ireland : Elsevier. - 0304-3835 .- 1872-7980. ; 120:2, s. 173-177
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Tidskriftsartikel (refereegranskat)abstract
- An association has previously been reported between exposure to medical diagnostic ionizing radiation and papillary thyroid cancer in women. To further evaluate potential mechanisms in carcinogenesis, the expression of p53, c-erbB-2, as well as Ki-67, estrogen and progesterone receptors were analyzed by immunohistochemistry in 19 women exposed to X-rays and for comparison in nine women without such reported exposure. They all had papillary thyroid cancer. No difference was found between these groups. The results of this study showed that p53, c-erbB-2, Ki-67, estrogen and progesterone receptors are not involved in papillary thyroid cancer associated with exposure to medical diagnostic ionizing radiation.
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| 22. |
- Söderqvist, Fredrik, et al.
(författare)
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Biomarkers in volunteers exposed to mobile phone radiation
- 2015
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Ingår i: Toxicology Letters. - : Elsevier BV. - 0378-4274 .- 1879-3169. ; 235:2, s. 140-146
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Tidskriftsartikel (refereegranskat)abstract
- For some time it has been investigated whether low-intensity non-thermal microwave radiation from mobile phones adversely affects the mammalian blood-brain barrier (BBB). All such studies except one have been either in vitro or experimental animal studies. The one carried out on humans showed a statistically significant increase in serum transthyretin (TTR) 60 min after finishing of a 30-min microwave exposure session. The aim of the present study was to follow up on the finding of the previous one using a better study design. Using biomarkers analyzed in blood serum before and after the exposure this single blinded randomized counterbalanced study, including 24 healthy subjects aged 18-30 years that all underwent three exposure conditions (SAR(10G) = 2 W/kg, SAR(10G) = 0.2 W/kg, sham), tested whether microwaves from an 890-MHz phone-like signal give acute effects on the integrity of brain-shielding barriers. Over time, statistically significant variations were found for two of the three biomarkers (TTR; beta-trace protein); however, no such difference was found between the different exposure conditions nor was there any interaction between exposure condition and time of blood sampling. In conclusion this study failed to show any acute clinically or statistically significant effect of short term microwave exposure on the serum levels of S100 beta, TTR and b-trace protein with a follow up limited to two hours. The study was hampered by the fact that all study persons were regular wireless phone users and thus not naive as to microwave exposure.
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