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[Curative radiotherapy of local advanced non-small-cell lung cancer. Eight years of experience from Odense]

https://arctichealth.org/en/permalink/ahliterature16768
Source
Ugeskr Laeger. 2005 Sep 12;167(37):3497-502
Publication Type
Article
Date
Sep-12-2005
Author
Olfred Hansen
Helene Paarup
Peter Sørensen
Karin Holmskov Hansen
Knud Aage Werenberg
Author Affiliation
Onkologisk Afdeling R, Odense Universitetshospital, Odense C. olfred@dadlnet.dk
Source
Ugeskr Laeger. 2005 Sep 12;167(37):3497-502
Date
Sep-12-2005
Language
Danish
Publication Type
Article
Keywords
Adult
Aged
Carcinoma, Non-Small-Cell Lung - mortality - pathology - radiotherapy
Chemotherapy, Adjuvant
Denmark - epidemiology
English Abstract
Female
Humans
Lung Neoplasms - mortality - radiotherapy
Male
Middle Aged
Neoplasm Staging
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Conformal - adverse effects - methods
Survival Rate
Abstract
INTRODUCTION: No previous reports on 3-D conformal radiotherapy of Danish patients with inoperable local advanced non-small-cell lung cancer have been published. MATERIALS AND METHODS: From 1995 to 2003, 158 patients with inoperable non-small-cell stage III lung cancer received radical radiotherapy in doses of 60-66 Gy in 30-33 fractions. Neoadjuvant chemotherapy was administered to 77 patients. RESULTS: The median survival time was 15.8 months. The one, two-, three-, four-, and five-year survival rates were 61%, 35%, 23%, 19% and 17%, respectively. Gender and age had no influence on survival, while patients in performance status 2 tended to have poorer survival rate than patients in performance status 0-1. The lung function as evaluated byh FEV1 and FVC declined by 8-9% during the first year and was reduced by 9-13% after three years. The cause of death in 90% of the cases was lung cancer. In 50% of all cases, a loco-regional relapse was found, and in 41% distant metastases existed. DISCUSSION: These results show that a significant number of stage III patients treated with modern radiotherapy with curative intent will be long-term survivors.
PubMed ID
16159459 View in PubMed
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Duration of symptoms: impact on outcome of radiotherapy in glottic cancer patients.

https://arctichealth.org/en/permalink/ahliterature17212
Source
Int J Radiat Oncol Biol Phys. 2005 Mar 1;61(3):789-94
Publication Type
Article
Date
Mar-1-2005
Author
Olfred Hansen
Susanne Larsen
Lars Bastholt
Christian Godballe
Karsten Ejsing Jørgensen
Author Affiliation
Department of Oncology R, Odense University Hospital, 5000 Odense C, Denmark. olfred@dadlnet.dk
Source
Int J Radiat Oncol Biol Phys. 2005 Mar 1;61(3):789-94
Date
Mar-1-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell - complications - mortality - radiotherapy
Female
Glottis
Hoarseness - etiology
Humans
Laryngeal Neoplasms - complications - mortality - radiotherapy
Male
Middle Aged
Proportional Hazards Models
Radiotherapy Dosage
Survival Rate
Time Factors
Treatment Outcome
Abstract
PURPOSE: To study the relationship between the durations of symptoms before the start of radiotherapy and treatment outcome in Stage I-III glottic cancer. METHODS AND MATERIALS: From 1965 to 1997, 611 glottic cancer patients from the Southern Region of Denmark were treated with primary radiotherapy. A total of 544 patients fulfilled the criteria for inclusion to the study (Stage I-III glottic cancer, a duration of symptoms less than or equal to 36 months, primary radiotherapy with at least 50 Gy and sufficient data for analysis). The total radiation dose ranged from 50.0 to 71.6 Gy in 22 to 42 fractions, and the median dose per fraction was 2.00 Gy (range, 1.56-2.29 Gy). All patients had 5 years of follow-up, and the 5-year recurrence-free survival rate was used as the primary endpoint. RESULTS: The 5-year recurrence-free survival rate was 74%. In a multivariate Cox regression analysis, duration of symptoms was a significant factor (p
PubMed ID
15708258 View in PubMed
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Five compared with six fractions per week of conventional radiotherapy of squamous-cell carcinoma of head and neck: DAHANCA 6 and 7 randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature18193
Source
Lancet. 2003 Sep 20;362(9388):933-40
Publication Type
Article
Date
Sep-20-2003
Author
Jens Overgaard
Hanne Sand Hansen
Lena Specht
Marie Overgaard
Cai Grau
Elo Andersen
Jens Bentzen
Lars Bastholt
Olfred Hansen
Jørgen Johansen
Lisbeth Andersen
Jan F Evensen
Author Affiliation
Department of Experimental Clinical Oncology, Aarhus University Hospital, Nørrebrogade 44, Building 5, DK-8000 C, Aarhus, Denmark. jens@oncology.dk
Source
Lancet. 2003 Sep 20;362(9388):933-40
Date
Sep-20-2003
Language
English
Publication Type
Article
Keywords
Adult
Aged
Carcinoma, Squamous Cell - radiotherapy
Comparative Study
Denmark
Dose Fractionation
Dose-Response Relationship, Radiation
Female
Follow-Up Studies
Head and Neck Neoplasms - radiotherapy
Humans
Male
Middle Aged
Nimorazole - therapeutic use
Proportional Hazards Models
Radiation-Sensitizing Agents - therapeutic use
Radiotherapy Dosage - standards
Research Support, Non-U.S. Gov't
Survival Rate
Treatment Outcome
Abstract
BACKGROUND: Although head and neck cancer can be cured by radiotherapy, the optimum treatment time for locoregional control is unclear. We aimed to find out whether shortening of treatment time by use of six instead of five radiotherapy fractions per week improves the tumour response in squamous-cell carcinoma. METHODS: We did a multicentre, controlled, randomised trial. Between January, 1992, and December, 1999, of 1485 patients treated with primary radiotherapy alone, 1476 eligible patients were randomly assigned five (n=726) or six (n=750) fractions per week at the same total dose and fraction number (66-68 Gy in 33-34 fractions to all tumour sites except well-differentiated T1 glottic tumours, which were treated with 62 Gy). All patients, except those with glottic cancers, also received the hypoxic radiosensitiser nimorazole. Analysis was by intention to treat. FINDINGS: More than 97% of the patients received the planned total dose. Median overall treatment times were 39 days (six-fraction group) and 46 days (five-fraction group). Overall 5-year locoregional control rates were 70% and 60% for the six-fraction and five-fraction groups, respectively (p=0.0005). The whole benefit of shortening of treatment time was seen for primary tumour control (76 vs 64% for six and five fractions, p=0.0001), but was non-significant for neck-node control. Six compared with five fractions per week improved preservation of the voice among patients with laryngeal cancer (80 vs 68%, p=0.007). Disease-specific survival improved (73 vs 66% for six and five fractions, p=0.01) but not overall survival. Acute morbidity was significantly more frequent with six than with five fractions, but was transient. INTERPRETATION: The shortening of overall treatment time by increase of the weekly number of fractions is beneficial in patients with head and neck cancer. The six-fractions-weekly regimen has become the standard treatment in Denmark.
Notes
Erratum In: Lancet. 2003 Nov 8;362(9395):1588
PubMed ID
14511925 View in PubMed
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Hypopharyngeal cancer: results of treatment based on radiation therapy and salvage surgery.

https://arctichealth.org/en/permalink/ahliterature18966
Source
Laryngoscope. 2002 May;112(5):834-8
Publication Type
Article
Date
May-2002
Author
Christian Godballe
Karsten Jørgensen
Olfred Hansen
Lars Bastholt
Author Affiliation
Department of Otorhinolaryngology, Head and Neck Surgery, Odense University Hospital, Denmark. godballe@dadlnet.dk
Source
Laryngoscope. 2002 May;112(5):834-8
Date
May-2002
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell - mortality - pathology - radiotherapy - surgery
Combined Modality Therapy
Denmark
Female
Humans
Hypopharyngeal Neoplasms - mortality - pathology - radiotherapy - surgery
Male
Middle Aged
Neoplasm Staging
Prognosis
Retrospective Studies
Salvage Therapy
Survival Rate
Abstract
OBJECTIVES: The purpose of this study is to present the treatment results and to identify possible prognostic indicators in patients with hypopharyngeal squamous cell carcinoma (HPC). STUDY DESIGN: A consecutively admitted series of 110 patients was analyzed retrospectively. The female male ratio was 29: 81. The sites of the tumors were: pyriform fossa (72%), postcricoid area (18%), and posterior pharyngeal wall (10%). T-status was T1: 15%, T2: 26%, T3: 28%, and T4: 37%. N-status was N0: 27%, N1: 33%, N2: 26%, and N3: 14%. METHODS: One hundred three patients (94%) were treated with curative intent. Two of these received primary surgery; the remaining 101 patients had primary radiotherapy. Seven patients (6%) received no or only palliative treatment. RESULTS: The 5- and 10-year estimates for crude survival (CS) were 16% and 7% and disease-specific survival (DSS) 28% and 23%, respectively. In the group of patients treated with curatively intended radiotherapy, 71 recurrences were observed at the time of analysis. The 5- and 10-year RFS estimates were both 17%. The values for CS were 18% and 8% and the values for DSS were 31% and 26%, respectively. Univariate survival analyses of age, sex, T-status, N-status, and TNM staging did not show any significant influence on survival. CONCLUSIONS: We conclude that the survival of patients with HPC treated with primary radiotherapy and salvage surgery is poor and that other treatment modalities have to be considered.
PubMed ID
12150614 View in PubMed
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Pattern of loco-regional failure after definitive radiotherapy for non-small cell lung cancer.

https://arctichealth.org/en/permalink/ahliterature257607
Source
Acta Oncol. 2014 Mar;53(3):336-41
Publication Type
Article
Date
Mar-2014
Author
Tine Schytte
Tine Bjørn Nielsen
Carsten Brink
Olfred Hansen
Author Affiliation
Department of Oncology, Odense University Hospital , Odense , Denmark.
Source
Acta Oncol. 2014 Mar;53(3):336-41
Date
Mar-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung - mortality - pathology - radiotherapy
Denmark
Female
Humans
Kaplan-Meier Estimate
Lung Neoplasms - mortality - pathology - radiotherapy
Lymph Nodes - pathology
Male
Middle Aged
Radiotherapy Dosage
Treatment Failure
Treatment Outcome
Tumor Burden
Abstract
Non-small cell lung cancer (NSCLC) is associated with poor survival even though patients are treated with curatively intended radiotherapy. Survival is affected negatively by lack of loco-regional tumour control, but survival is also influenced by comorbidity caused by age and smoking, and occurrence of distant metastasis. It is challenging to evaluate loco-regional control after definitive radiotherapy for NSCLC since it is difficult to distinguish between radiation-induced damage to the lung tissue and tumour progression/recurrence. In addition it may be useful to distinguish between intrapulmonary failure and mediastinal failure to be able to optimize radiotherapy in order to improve loco-regional control even though it is not easy to discriminate between the two sites of failure.
This study is a retrospective analysis of 331 NSCLC patients treated with definitive radiotherapy from 2002 to 2011. The patients were treated consecutively at the Department of Oncology, Odense University Hospital, Denmark with at least 60 Gy. All patients were followed in a planned follow-up schedule and no patients were lost for follow-up.
At the time of the analysis 93 patients had loco-regional failure only. Of these patients, 68 had intrapulmonary failure only, one patient had failure in mediastinum only, and 24 patients had intrapulmonary failure as well as mediastinal failure. Of the patients which had lung failure only, 78% had mediastinal involvement at treatment start. The only covariate with significant impact on developing intrapulmonary failure only was gross tumour volume. Median survival for the total group of 331 patients was 19 months. The median survival for patients with intrapulmonary failure only was 19 months, and it was 20 months for the patients with mediastinal relapse.
We conclude that focus should be on increasing doses to intrapulmonary tumour volume, when dose escalation is applied to improve local tumour control in NSCLC patients treated with definitive radiotherapy, since most recurrences are located here.
PubMed ID
24369735 View in PubMed
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Planned FDG PET-CT Scan in Follow-Up Detects Disease Progression in Patients With Locally Advanced NSCLC Receiving Curative Chemoradiotherapy Earlier Than Standard CT.

https://arctichealth.org/en/permalink/ahliterature269978
Source
Medicine (Baltimore). 2015 Oct;94(43):e1863
Publication Type
Article
Date
Oct-2015
Author
Yi Pan
Carsten Brink
Tine Schytte
Henrik Petersen
Yi-Long Wu
Olfred Hansen
Source
Medicine (Baltimore). 2015 Oct;94(43):e1863
Date
Oct-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung - mortality - radiography - radionuclide imaging - therapy
Chemoradiotherapy
Denmark - epidemiology
Disease Progression
Disease-Free Survival
Female
Fluorodeoxyglucose F18
Humans
Lung Neoplasms - mortality - radiography - radionuclide imaging - therapy
Male
Middle Aged
Positron-Emission Tomography
Abstract
The role of positron emission tomography-computed tomography (PET-CT) in surveillance of patients with nonsmall cell lung cancer (NSCLC) treated with curatively intended chemoradiotherapy remains controversial. However, conventional chest X-ray and computed tomography (CT) are of limited value in discriminating postradiotherapy changes from tumor relapse. The aim of this study was to evaluate the clinical value of PET-CT scan in the follow-up for patients with locally advanced (LA) NSCLC receiving concomitant chemoradiotherapy (CCRT).Between 2009 and 2013, eligible patients with stages IIB-IIIB NSCLC were enrolled in the clinical trial NARLAL and treated in Odense University Hospital (OUH). All patients had a PET-CT scan scheduled 9 months (PET-CT9) after the start of the radiation treatment in addition to standard follow-up (group A). Patients who presented with same clinical stage of NSCLC and received similar treatment, but outside protocol in OUH during this period were selected as control group (group B). Patients in group B were followed in a conventional way without PET-CT9. All patients were treated with induction chemotherapy followed by CCRT.Group A included 37 and group B 55 patients. The median follow-up was 16 months. Sixty-six (72%) patients were diagnosed with progression after treatment. At the time of tumor progression, patients in group A had better performance status (PS) than those in group B (P?=?0.02). Because of death (2 patients), poor PS (3) or retreatment of relapse (9), only 23 patients had PET-CT9 in group A. Eleven (48%) patients were firstly diagnosed with progression by PET-CT9 without any clinical symptoms of progression. The median progression-free survival (PFS) was 8.8 months in group A and 12.5 months in group B (P?=?0.04). Hazard function PFS showed that patients in group A had higher risk of relapse than in group B.Additional FDG PET-CT scan at 9 months in surveillance increases probability of early detection of disease progression in advanced NSCLC patients treated with curatively intended CCRT.
PubMed ID
26512597 View in PubMed
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Salvage laryngectomy and pharyngocutaneous fistulae after primary radiotherapy for head and neck cancer: a national survey from DAHANCA.

https://arctichealth.org/en/permalink/ahliterature18222
Source
Head Neck. 2003 Sep;25(9):711-6
Publication Type
Article
Date
Sep-2003
Author
Cai Grau
Lars Vendelbo Johansen
Hanne Sand Hansen
Elo Andersen
Christian Godballe
Lisbeth Juhler Andersen
Jesper Hald
Henrik Møller
Marie Overgaard
Lars Bastholt
Ole Greisen
Grethe Harbo
Olfred Hansen
Jens Overgaard
Author Affiliation
Department of Oncology, Aarhus University Hospital, 8000 Aarhus C, Denmark. caigrau@dadlnet.dk
Source
Head Neck. 2003 Sep;25(9):711-6
Date
Sep-2003
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cutaneous Fistula - etiology
Denmark
Female
Head and Neck Neoplasms - radiotherapy - surgery
Health Care Surveys
Humans
Laryngectomy - adverse effects
Male
Middle Aged
Postoperative Complications
Salvage Therapy
Societies, Medical
Abstract
OBJECTIVE: In 1998, the Danish Society for Head and Neck Oncology decided to conduct a nationwide survey at the five head and neck oncology centers with the aim of evaluating the surgical outcome of salvage laryngectomy after radiotherapy with special emphasis on identifying factors that could contribute to the development of pharyngocutaneous fistulae. PATIENTS: A total of 472 consecutive patients undergoing postirradiation salvage laryngectomy in the period July 1, 1987-June 30, 1997 were recorded at the five head and neck oncology centers in Denmark. Age ranged from 36 to 84 years, median 63 years, 405 men and 67 women. Primary tumor site was glottic larynx (n = 242), supraglottic larynx (n = 149), other larynx (n = 45), pharynx (n = 27), and other (n = 9). All patients had received prior radiotherapy. RESULTS: Median time between radiotherapy and laryngectomy was 10 months (range, 1-348 months). A total of 89 fistulae lasting at least 2 weeks were observed, corresponding to an overall average fistulae risk of 19%. The number of performed laryngectomies per year decreased linearly (from 58 to 37), whereas the annual number of fistulae increased slightly (from 7 to 11), which meant that the corresponding estimated fistulae risk increased significantly from 12% in 1987 to 30% in 1997. Other significant risk factors for fistulae in univariate analysis included younger patient age, primary advanced T and N stage, nonglottic primary site, resection of hyoid bone, high total radiation dose, and large radiation fields. Multiple logistic regression analysis of these parameters suggested that nonglottic tumor site, late laryngectomy period (1987-1992 vs 1993-1997), and advanced initial T stage were independent prognostic factors for fistulae risk. Surgical parameters like resection of thyroid/tongue base/trachea or radiotherapy parameters like overall treatment time or fractions per week did not influence fistulae risk. CONCLUSIONS: The risk of fistulae is especially high in patients initially treated with radiotherapy for nonglottic advanced stage tumors. A significant decrease in the number of performed salvage laryngectomies over the 10 years was seen. Over the same time period, the annual number of fistulae remained almost constant. The resulting more than doubling of fistulae rate could thus in part be explained by less surgical routine.
PubMed ID
12953306 View in PubMed
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Stromal CD8+ T Cell Density - A Promising Supplement to TNM staging in Non-Small Cell Lung Cancer.

https://arctichealth.org/en/permalink/ahliterature260596
Source
Clin Cancer Res. 2015 Feb 13;
Publication Type
Article
Date
Feb-13-2015
Author
Tom Donnem
Sigurd M Hald
Erna-Elise Paulsen
Elin Richardsen
Samer Al-Saad
Thomas K Kilvaer
Odd T Brustugun
Aslaug Helland
Marius Lund-Iversen
Mette Poehl
Karen Ege Olsen
Henrik J Ditzel
Olfred Hansen
Khalid Ibrahim Al-Shibli
Yury Kiselev
Torkjel M Sandanger
Sigve Andersen
Francesco Pezzella
Roy Martin Bremnes
Lill-Tove Rasmussen Busund
Source
Clin Cancer Res. 2015 Feb 13;
Date
Feb-13-2015
Language
English
Publication Type
Article
Abstract
Purpose: Immunoscore is a prognostic tool defined to quantify in situ immune cell infiltrates, which appears to be superior to the TNM classification in colorectal cancer. In non-small cell lung cancer (NSCLC) no immunoscore has been established, but in situ tumor immunology is recognized as highly important. We have previously evaluated the prognostic impact of several immunological markers in NSCLC, yielding the density of stromal CD8+ tumor infiltrating lymphocytes (TILs) as the most promising candidate. Hence, we validate the impact of stromal CD8+ TIL density as an immunoscore in NSCLC. Experimental Design: The prognostic impact of stromal CD8+ TILs was evaluated in four different cohorts from Norway and Denmark consisting of 797 stage I-IIIA NSCLC patients. The Tromso cohort (n=155) was used as training set and the results was further validated in the cohorts from Bodo (n=169), Oslo (n=295), and Denmark (n=178). Tissue microarrays (TMAs) and clinical routine CD8 staining was used for all cohorts. Results: Stromal CD8+ TILs density was an independent prognostic factor in the total material (n=797) regardless of the endpoint; disease-free survival (P
PubMed ID
25680376 View in PubMed
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Trends in lung cancer in elderly in Denmark, 1980-2012.

https://arctichealth.org/en/permalink/ahliterature276560
Source
Acta Oncol. 2016;55 Suppl 1:46-51
Publication Type
Article
Date
2016
Author
Charlotte Kristiansen
Tine Schytte
Karin Holmskov Hansen
Eva Holtved
Olfred Hansen
Source
Acta Oncol. 2016;55 Suppl 1:46-51
Date
2016
Language
English
Publication Type
Article
Keywords
Age Distribution
Aged
Aged, 80 and over
Denmark - epidemiology
Female
Humans
Incidence
Lung Neoplasms - epidemiology - mortality
Male
Prevalence
Registries
Risk factors
Sex Distribution
Abstract
Lung cancer is an increasing problem in the older patient population due to the improvement in life expectation of the Western population. In this study we examine trends in lung cancer incidence and mortality in Denmark from 1980 to 2012 with special focus on the elderly.
Lung cancer was defined as ICD-10 codes C33-34. Data derived from the NORDCAN database with comparable data on cancer incidence, mortality, prevalence, and relative survival in the Nordic countries, where the Danish data were delivered from the Danish Cancer Registry and the Danish Cause of Death Registry with follow-up for death or emigration until the end of 2013.
In 2012, about 50% of lung cancers were diagnosed among persons aged 70 years or more. For men and women older than 75 years the incidence rates have been increasing and for those aged 80-84 years, the rates have doubled since 1980. Due to the poor survival, similar trends were seen in mortality rates. Over the period, the one-year relative survival rates almost doubled in patients aged 70 years or more, but still only 25% of the patients aged 80-89 years survived their lung cancer for one year.
The incidence of lung cancer is closely linked to the pattern of tobacco smoking with the differences between gender and age groups reflecting smoking behavior in birth cohorts. Elderly patients with lung cancer are a heterogeneous group in whom treatment should be offered according to comorbidity and a geriatric assessment.
PubMed ID
26769559 View in PubMed
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9 records – page 1 of 1.