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- Ebbeskog, B, et al.
(författare)
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A follow-up study of leg ulcer patients in south Stockholm
- 1999
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Ingår i: Journal of wound care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 8:4, s. 170-4
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to follow up patients with leg ulcers, previously identified in an epidemiological study in South Stockholm. Rate of healing, non-healing, recurrence, amputation and mortality were recorded. A total of 254 patients were identified for follow-up after 18 months, using a questionnaire; at the time of the follow-up study, 61% of the ulcers were healed, 29% of the patients still had open ulcers, and 8% of the ulcers had recurred after healing. During this period, 20% of the patients had died, with arterial disease (39%) being more common than venous insufficiency. A further objective was to investigate 21 patients with non-healed venous leg ulcers by means of a structured assessment instrument, and to study if wound healing could be encouraged by using a triple-layer bandage for three months. Patients with non-healed venous leg ulcers treated in community care were recruited for assessment by means of a standardised form and given a triple-layer bandaging treatment for a three-month period. Two ulcers had healed and nine ulcers had improved and were healing. In the group of patients with healed or improved ulcers, five had normal mobility. Venous aetiology was also more common than arterial aetiology
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- Lindholm, C-E, et al.
(författare)
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Prognostic factors for tumour response and skin damage to combined radiotherapy and hyperthermia in superficial recurrent breast carcinomas
- 1995
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Ingår i: International Journal of Hyperthermia. - : Informa UK Limited. - 0265-6736 .- 1464-5157. ; 11:3, s. 337-355
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Tidskriftsartikel (refereegranskat)abstract
- Prognostic factors for complete tumour response and acute skin damage to combined hyperthermia and radiotherapy were analysed in material of patients with breast cancer, recurrent in previously irradiated areas. Radiotherapy was given daily to a total absorbed dose of 30.0 Gy in 2 weeks or 34.5 Gy in 3 weeks. The first radiotherapy schedule was combined with heat twice weekly, a total of four heat treatments (schedule A). The second radiotherapy schedule was combined with heat either once or twice a week resulting in a total of three (schedule B) or six (schedule C) heat treatments. Heat was induced with microwaves (2450, 915 or 434 MHz) via external applicators and always given after the radiotherapy fraction. The complete response (CR) rate in evaluable patients was 71% (49/69). There was no significant difference in CR rate between the three different hyperthermia schedules. The CR rates were 74% (14/19), 65% (15/23) and 74% (20/27) for schedules A, B and C respectively. The only factor predicting CR, evaluated both uni- and multivariately, was the CRE-value for the present radiotherapy dose (p = 0.02). If only tumours treated with 915 MHz were taken into account, however, then the highest minimum temperature at a given heat session predicted complete response (p = 0.03). This was true also in a multivariate analysis of this subgroup of tumours. A Kaplan-Meier analysis (log rank test) showed no significant difference in duration of CR between the different treatment schedules. Cox's proportional hazards method revealed three significant factors: tumour size (negatively correlated, p = 0.007), the time interval between the diagnosis of the primary tumour and the present treatment (p = 0.02) and the average temperature (0.03). Maximum acute skin reactions in the treatment field were scored according to an ordinal scale of 0-8, modified after WHO 1979. Twenty-six treatment areas (32%) expressed more severe skin damage (score > or = 5) in terms of desquamation with blisters (14%) and necrosis or ulceration (19%). Factors correlated with skin damage were the size of the lesion area (p = 0.011), the highest average maximum temperature during a given heat session (p = 0.03) and the fractionation schedule of hyperthermia (p = 0.05). The extent of previous radiotherapy absorbed dose, previous surgery in the treated area or previous chemotherapy had no significant influence on the acute skin reactions.
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