Acta Oncologica最新文献

{"title":"Adaptation of dose-prescription for vestibular schwannoma radiosurgery taking body contouring method and heterogeneous material into account.","authors":"Marcus Fager, Michael Gubanski, Åsa Carlsson Tedgren, Hamza Benmakhlouf","doi":"10.2340/1651-226X.2025.41924","DOIUrl":"10.2340/1651-226X.2025.41924","url":null,"abstract":"<p><strong>Background: </strong>Majority of vestibular schwannoma (VS) patients have undergone gamma-knife radiosurgery (GKRS) with favorable results. Clinical evidence is derived from doses calculated with a type-a algorithm, which in this case assumes all material to be water. A type-b algorithm (Convolution algorithm [CA]) taking tissue heterogeneity into account is available. Historically, body contour is defined using a 16-point approximation, whereas modern softwares generate the body from Magnetic Resonance Imaging (MRI). The accuracy in dose-calculation algorithms (DCA) and contouring method (CM) will have a significant influence in the relation between clinical outcome and dosimetric data. The objective was to investigate the impact of DCA and CMs on dose distribution while preserving treatment conditions.</p><p><strong>Methods: </strong>Treatment plans for 16 VS patients were recalculated in terms of DCA and CM. The difference in the dose covering 99% of the VS (DVS99%) depending on CM and DCA was estimated. The difference in DVS99% was used to adopt the prescription of new CA-based plans. CA-plans were recalculated to TMR10 to evaluate clinical treatability, as clinical evidence is derived from TMR10-doses.</p><p><strong>Results: </strong>Both CM and DCA had a significant impact on the dose to VS and surrounding structures. CM altered the doses homogenously by 2.1-3.3%, whereas DCA heterogeneously by 5.0-10.7%. An increase of 9.1[8.1, 10.0]% was found for DVS99% and the CA-plans recalculated into TMR10 resulted in clinically treatable plans.</p><p><strong>Interpretation: </strong>We conclude that transferring to more modern algorithms that take tissue heterogeneity into account heterogeneously alter dose distributions. This work establishes a safe pathway to adopt prescription dose for VS while preserving clinical treatability.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"319-325"},"PeriodicalIF":2.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric cancer causing Schnitzler's metastasis: case report and systematic review of the features.","authors":"Huimin Xue, Xiaomei Yang, Qing Shen, Jinglei Qu, Xiujuan Qu, Ying Chen","doi":"10.2340/1651-226X.2025.41296","DOIUrl":"10.2340/1651-226X.2025.41296","url":null,"abstract":"<p><strong>Background: </strong>Rectal metastasis from gastric cancer (GC), also known as Schnitzler's metastasis, is a rare phenomenon. The clinicopathological characteristics, outcomes, and prognostic factors of this condition remain poorly understood.</p><p><strong>Methods: </strong>We describe a case of GC causing Schnitzler's metastasis and present a systematic review on case reports and case series. Data extracted and analyzed include clinicopathological features, treatment modalities received, outcomes, and follow-up.</p><p><strong>Results: </strong>A total of 34 records, including our own, encompassing 41 cases were incorporated into the study. The median age of patients at admission was 59 years, with females accounting for 53.7% of cases. The predominant histological subtype of Schnitzler's metastasis was moderate-to-poorly differentiated adenocarcinoma, representing 31 cases (86.1%). Among the patients in this cohort, 38.9% exhibited signet-ring cell carcinoma. Regarding the initial diagnosis of GC, 28.6% were categorized as stage IIIA, and 28.6% were classified as stage IV. The median overall survival (OS) time was 72 months (95% confidence interval [CI]: 27-NA), while the median OS since the diagnosis of metastatic cancer was 16 months (95% CI: 9-NA).</p><p><strong>Interpretation: </strong>Schnitzler's metastasis presents a challenge in the pathology of colorectal endoscopy and may lead to treatment delays. Imaging features such as increased thickness of the intestinal wall and significant layered enhancement can aid in diagnosis; however, deep core biopsy of intestinal lesions remains the gold standard for diagnosing rectal metastases. Accurately distinguishing rectal metastases from primary rectal cancer is crucial for preventing unnecessary therapeutic interventions.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"312-318"},"PeriodicalIF":2.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population based registry study on large B-cell lymphoma mortality and morbidity in Finland.","authors":"Anna Anttalainen, Liisa Ukkola-Vuoti, Ville Vihervaara, Saija Silvola, Outi Kuittinen","doi":"10.2340/1651-226X.2025.42539","DOIUrl":"10.2340/1651-226X.2025.42539","url":null,"abstract":"<p><strong>Background: </strong>Large B-cell lymphomas (LBCLs) form a notable subgroup of lymphomas; however, their associated long-term comorbidities and mortality rates remain under-researched in real-world settings.</p><p><strong>Material and methods: </strong>This nationwide Finnish population-based matched cohort study included virtually all LBCL patients (N = 7,019) diagnosed from 2008 to 2019, alongside age, sex, and region-matched controls (1:1 ratio) without lymphoma. Diagnoses of LBCLs were obtained from the Finnish Cancer Registry, with data linked to additional nationwide registries. Baseline characteristics were summarised using descriptive statistics. Overall survival (OS) was estimated using the Kaplan-Meier method, while Cox regression was used to analyse factors associated with OS and evaluate the risk and associated factors of comorbidities considering the competing risk of death.</p><p><strong>Results: </strong>The 5-year survival rate for LBCL patients, median age 70.7 years and 52.7% male, was 50.0% (95% Confidence Interval [CI] 48.7% - 51.3%), compared to 82.6% (95% CI 81.5% - 83.6%) for controls. Among LBCL patients, older age and a higher Charlson comorbidity index were associated with increased mortality. Conversely, female sex, later diagnosis year, and radiation therapy were associated with improved survival. Patients with LBCL exhibited an elevated risk of long-term comorbidities, including solid tumours, hematological and skin cancers, lung and thyroid diseases, mental and behavioral disorders, and cardiovascular diseases. After 12 years of follow-up, lymphoma accounted for the primary cause of death in approximately 43% of LBCL patients.</p><p><strong>Interpretation: </strong>Large B-cell lymphomas are linked with significant long-term comorbidities and elevated mortality rates.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"303-311"},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding quality of life in Danish women with metastatic breast cancer undergoing multiple treatments.","authors":"Helle Pappot, Annasofie Jørgensen, Anna Hincheli Bjørum, Christina Bøgh Jakobsen, Camilla Uhre Jørgensen, Beverley Lim Høeg, Pernille Bidstrup, Ann Knop, Line Bentsen","doi":"10.2340/1651-226X.2025.42446","DOIUrl":"10.2340/1651-226X.2025.42446","url":null,"abstract":"<p><strong>Background: </strong>Women with metastatic breast cancer (mBC) may experience several symptoms exacerbated by successive treatments. There is however, a lack of knowledge of the most important symptoms and how these may affect daily life function. This study aims to elucidate the quality of life (QoL), including both symptoms and daily life functions, among mBC women undergoing varied treatments.</p><p><strong>Methodology: </strong>We conducted a cross-sectional electronic questionnaire study enrolling mBC women (≥ stage III) receiving medical cancer treatment through September-December 2023. QoL, symptoms, and daily life function were measured using the European Organization for Research and Treatment of Cancer (EORTC) core questionnaire (QLQ-C30) and the breast cancer module (BR45). Health-related quality of life (HRQoL), defined by the EORTC, covers the subjective perceptions of the positive and negative aspects of cancer patients' symptoms, including physical, emotional, social, and cognitive functions. We examined associations between QoL, treatment line and therapy types, and estimated odds ratios (ORs) and confidence intervals (CIs).</p><p><strong>Results: </strong>Of 359 eligible participants, 111 responded (30.9%). At study commencement, 90.9% of the participants received at least one type of systemic treatment, with 16.2% undergoing chemotherapy, 61.3% anti-hormonal treatment, and 66.6% targeted cancer treatment. QLQ-C30 sum scores were highest in women receiving anti-hormonal treatment (80.7, interquartile range [IQR]: 17.6), followed by targeted cancer treatment (78.8, IQR: 18.4), and lowest with chemotherapy (77.1, IQR: 24.8). Quality of life decreased with subsequent treatment lines (first line: 80.3, IQR: 20.7, fourth line: 67.4, IQR: 11.3). No significant differences were found in the functions or in the individual symptoms according to monotherapy type.</p><p><strong>Interpretation: </strong>Women with mBC experience a substantial symptom burden and reduced functioning, and their QoL differs with successive lines of treatment. This underlines that women living with mBC need support and effective symptom management to maintain QoL.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"292-302"},"PeriodicalIF":2.7,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11871412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fidelity of the Guided Self-Determination program in the MyHealth study during breast cancer follow-up.","authors":"Sigrid N Biener, Beverley L Høeg, Lena Saltbæk, Susanne O Dalton, Christoffer Johansen, Randi V Karlsen, Federica Belmonte, Vibeke Zoffmann, Pernille E Bidstrup","doi":"10.2340/1651-226X.2025.42253","DOIUrl":"10.2340/1651-226X.2025.42253","url":null,"abstract":"<p><strong>Background and purpose: </strong>MyHealth is a new follow-up program including individual nurse-led sessions based on Guided Self-Determination (GSD), which has been shown to improve health and psychological outcomes in patients after treatment for breast cancer. Fidelity assessment is important to support the implementation of GSD in clinical practice. The purpose of this study was thus to investigate fidelity and acceptance of the GSD program in the MyHealth study and whether sociodemographic and psychological factors were associated with patients' completion of the GSD program and completion of reflection sheets.</p><p><strong>Material and methods: </strong>We assessed fidelity quantitatively by examining patients' completion of the GSD program (i.e. ≥3 sessions), completion of the reflection sheets and their associations with sociodemographic and psychological factors among 239 patients, and nurse-reported acceptance qualitatively through a focus group interview with all five nurses providing the GSD program.</p><p><strong>Results: </strong>A total of 81% of patients completed the GSD program, while 71% of the reflection sheets were completed. Including a relative in a GSD session and lower education were significantly associated with completion of the program. Younger age and including a relative in a GSD session were significantly associated with completion of reflection sheets. Nurses found GSD highly applicable and especially appreciated a values-clarifying GSD reflection sheet and the inclusion of a relative.</p><p><strong>Interpretation: </strong>The GSD program was applied with moderate-to-high fidelity, and the inclusion of relatives is potentially valuable. The GSD program indicates high usability and potential for being translated into clinical practice.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"284-291"},"PeriodicalIF":2.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fine needle aspiration cytology including the analysis of human papilloma virus (HPV) DNA enhances the diagnostic workup of solitary cystic neck lesions in a population with a high incidence of HPV positive oropharyngeal cancer.","authors":"Evelina Jörtsö, Linda Marklund, Martin Harper Hysek, Anders Näsman, Lalle Hammarstedt-Nordenvall, Mathias Von Beckerath, Tina Dalianis, Rusana Bark","doi":"10.2340/1651-226X.2025.42078","DOIUrl":"10.2340/1651-226X.2025.42078","url":null,"abstract":"<p><strong>Background and purpose: </strong>Distinguishing branchial cleft cysts (BrCCs) from cystic metastases of human papillomavirus (HPV) positive tonsillar or base of tongue squamous cell carcinoma and cancer of unknown primary (CUP) is challenging. Fine needle aspiration cytology (FNAC) from cystic metastasis can be nonrepresentative, while reactive squamous cells from BrCC can be atypical. It is unclear whether benign characteristics and the absence of HPV-DNA in FNAC can enhance distinguishing BrCC from a cystic metastasis; therefore, we investigated here.</p><p><strong>Patients/materials and methods: </strong>Morphology and HPV-DNA in FNAC were reevaluated preoperatively and correlated to final diagnosis of 304 BrCC and CUP patients at Karolinska University Hospital during 2016-2023.</p><p><strong>Results and interpretation: </strong>All 176 cases finally diagnosed as BrCC were HPV-DNA negative in the preoperative FNAC. HPV-DNA was present in 100/128 (78.1%) of the FNAC with a solitary cystic neck metastasis and in 3/3 CUPs separately investigated on surgical specimens, which is distributed in 40/58 (69.0%) CUP, 40/41 (97.6%) tonsillar cancer, 21/22 (95.5%) base of tongue cancer, 2/2 uterine cervical cancer, and 0/5 non-HPV-related cancers.</p><p><strong>Interpretation: </strong>All cases with final BrCC diagnosis were HPV-DNA negative in FNAC. HPV-DNA was only present in FNAC of malignant cystic neck masses of HPV-related tumors or CUP. The data suggest that HPV-DNA analysis in FNAC enhances the diagnostics of cystic masses of the neck. A FNAC with a benign morphology and the absence of HPV-DNA indicated a BrCC, while an HPV-DNA positive aspirate irrespective of morphology suggested an HPV-DNA positive cancer or CUP.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"276-283"},"PeriodicalIF":2.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rising incidence of radiation pneumonitis after adjuvant durvalumab in NSCLC patients treated with concurrent chemoradiotherapy.","authors":"Rutger H Stoffers, Anne G H Niezink, Olga Chouvalova, Jan F Ubbels, Marleen Woltman-van Iersel, T Jeroen N Hiltermann, Lucie B M Hijmering-Kappelle, Gea Douma, Sander M De Hosson, John W G Van Putten, Friso T Zandberg, Lisanne V Van Dijk, Johannes A Langendijk, Robin Wijsman","doi":"10.2340/1651-226X.2025.42384","DOIUrl":"10.2340/1651-226X.2025.42384","url":null,"abstract":"<p><strong>Background and purpose: </strong>Adding adjuvant durvalumab to chemoradiotherapy (CRT) improves overall survival (OS) rates in locally advanced Non-Small-Cell Lung Cancer (NSCLC). However, recent data suggests that this new modality increases the incidence of radiation pneumonitis (RP). The aim of this study was to test the hypothesis that the incidence of RP after CRT and adjuvant durvalumab was higher than after CRT alone among patients with locally advanced NSCLC.</p><p><strong>Materials and methods: </strong>The study population comprised all patients with NSCLC who completed CRT with curative intent between February 2013 and October 2020. From 2018 on, adjuvant durvalumab was administered in selected patients after completion of CRT. Patient and treatment data together with RP data (CTCAEv4.0, scored up to 9 months after CRT), were prospectively collected as part of our standard follow-up program.</p><p><strong>Results: </strong>A total of 284 patients were included, of which 90 (30.5%) received adjuvant durvalumab. Incidence of grade ≥2 RP increased in patients receiving durvalumab compared to CRT only (17.8% vs. 8.8%; p < 0.05), especially between 6 to 9 months after completing CRT. Adjuvant durvalumab and mean lung dose (MLD) were associated with a higher incidence of grade ≥2 RP (odds ratio [OR]: 2.43 and 1.14, respectively; p < 0.05). Current smoking was found to be a protective factor (OR: 0.38; p < 0.05).</p><p><strong>Interpretation: </strong>Adjuvant durvalumab significantly increased the incidence of grade ≥2 RP in this real-world cohort of NSCLC patients. Patients receiving adjuvant durvalumab remain prone to develop grade ≥2 RP longer after completing CRT compared to patients treated with CRT only.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"267-275"},"PeriodicalIF":2.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in cancer incidence and stage during the COVID-19 pandemic in 2020-2021 in the Nordic countries.","authors":"Anna Johansson, Anna Skog, Tom Børge Johannesen, Tor Åge Myklebust, Simon M Kønig, Charlotte Wessel Skovlund, Lina Steinrud Mørch, Søren Friis, Marnar Fríðheim Kristiansen, David Pettersson, Eva María Gudmundsdóttir, Nanna Margrét Kristinsdóttir, Helgi Birgisson, Sandra Irenaeus, Johan Ahlgren, Mats Lambe, Elli Hirvonen, Janne Pitkäniemi, Giske Ursin","doi":"10.2340/1651-226X.2025.42079","DOIUrl":"10.2340/1651-226X.2025.42079","url":null,"abstract":"<p><strong>Background and purpose: </strong>The COVID-19 pandemic impacted substantially on cancer healthcare, including the temporary suspension of screening activities. We compared cancer incidence rates and stage during 2020-2021 to pre-pandemic rates in the Nordic countries.</p><p><strong>Material and methods: </strong>Using data from the national cancer registries in Denmark, Finland, Iceland, Norway, and Sweden, we estimated age-, sex-, and period-adjusted incidence rate ratios, expressed as relative percentage change (%) with 95% confidence intervals (CIs), comparing rates in 2020-2021 to those in 2017-2019 (pre-pandemic).</p><p><strong>Results: </strong>In 2020-2021, 340,675 cancer cases were diagnosed. The incidence rates declined during the first pandemic wave (Q2 2020), ranging from -21.7% [95% CI: -23.3%; -20.2%] (Sweden) to -7.9% [-17.7%; 3.0%] (Iceland). Incidence rates also declined in the second pandemic wave (Q1 2021), ranging from -8.6% [-10.2%; -6.9%] (Sweden) to -2.3% [-4.6%; 0.1%] (Norway), and in Sweden also by -3.1% [-4.8%; -1.3%] in the third pandemic wave (Q4 2021). Stage I breast cancer incidence declined during 2020 in Denmark/Norway/Sweden, with some catch-up in stage II incidence in 2021. Prostate cancer rates declined in Denmark/Finland/Norway/Sweden during 2020-2021, while melanoma rates declined in Finland in 2020. During 2020, colon cancer rates declined in Denmark and Iceland, while rectal cancer rates declined in Denmark, and lung and kidney cancer rates declined in Norway.</p><p><strong>Interpretation: </strong>During 2020-2021, cancer incidence rates declined across the Nordic countries with the largest declines in Sweden. During the third pandemic wave, the incidence rates were mostly similar to pre-pandemic rates. Changes in cancer stage may reflect reduced screening activities.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"257-266"},"PeriodicalIF":2.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating tumor DNA for surveillance in high-risk melanoma patients: a study protocol.","authors":"Magnús P B Obinah, Sarah A Al-Halafi, Karin Dreisig, Tim S Poulsen, Christoffer Johansen, Thomas Litman, Stig E Bojesen, Estrid Høgdall, Annette H Chakera, Lisbet R Hölmich","doi":"10.2340/1651-226X.2025.42515","DOIUrl":"10.2340/1651-226X.2025.42515","url":null,"abstract":"<p><strong>Background and purpose: </strong>Melanoma is one of the deadliest skin cancers and challenges clinicians worldwide due to rising incidence, potential aggressiveness, and propensity for metastasis, necessitating comprehensive follow-up programs after primary treatment. Circulating tumor DNA (ctDNA) is a promising biomarker that may indicate disease progression earlier than traditional surveillance methods, including 18F-FDG PET-CT, ultrasound, and clinical examination. This study examines ctDNA detection in blood as a minimally invasive method for early identification of progression following primary treatment of melanoma. The aim is to overcome the limitations of current methods, potentially improving prognosis and survival.</p><p><strong>Patients/material and methods: </strong>Patients with high risk of recurrence following primary treatment of melanoma are offered inclusion. Blood sampling is performed at each follow-up visit. In case of recurrence, patient-specific mutations are identified through next-generation sequencing (NGS) of formalin and paraffin embedded tissue from diagnostic routine. Detection of mutation-specific ctDNA is performed on blood using digital droplet polymerase chain reaction (ddPCR) or NGS. This allows determination of the value and sensitivity of ctDNA for early detection of recurrence.</p><p><strong>Results and interpretation: </strong>For validation purposes, we conducted a small pilot study using blood samples from 10 patients who had experienced recurrence and had a clinically confirmed BRAF V600E mutation. Detection of BRAF V600E ctDNA using ddPCR varied from 0/5 (0%) in DNA harvested from 4 mL plasma, to 3/5 (60%) in DNA from 8 mL of plasma. These results show promise and highlight the importance of high sensitivity and sampling volumes to ensure accurate detection of low levels of ctDNA.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"229-233"},"PeriodicalIF":2.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Receipt of specialized palliative care and health care utilization at the end of life in hematological cancer patients - the Stockholm experience.","authors":"Lena Von Bahr, Peter Strang, Torbjörn Schultz, Per Fürst","doi":"10.2340/1651-226X.2025.42189","DOIUrl":"10.2340/1651-226X.2025.42189","url":null,"abstract":"<p><strong>Background: </strong>The treatments of hematological malignancies tend to be intense, and compared with solid tumors, less is known about the health care consumption during end of life (EOL). Therefore, the aim was to study the receipt of specialized palliative care (SPC) and how it affects health care utilization, in relation to sex, age, socioeconomics, and frailty risk (Hospital Frailty Risk Score [HFRS]).</p><p><strong>Methods: </strong>In a retrospective, observational registry study, all patients who died of a hematological malignancy during the years 2015-2021 in the Stockholm County were included and analyzed with descriptive statistics and logistic regression models.</p><p><strong>Results: </strong>Of the 2,858 included patients (mean age 76 years, 41% women), 38% had myeloid malignancies, 41% lymphocytic malignancies, and 21% had myeloma. During the last 3 months of life, 56% received SPC, with an overrepresentation of women, aOR 1.35 (1.16-1.58, p < 0.0001), whereas persons with risk of frailty (HFRS) were underrepresented, aOR 0.74 (0.63-0.86, p < 0.0001). Unplanned ER visits were more likely in persons aged over 80 years (p = 0.004) and in persons with frailty risk (p < 0.0001). Patients receiving SPC had a substantially reduced likelihood of ER visits, aOR 0.34 (0.29-0.40, p < 0.0001). Emergency hospitals as place of death was positively associated with frailty risk, aOR 1.50 (1.23-1.83, p < 0.0001) but negatively associated with age over 80 years (p < 0.0001) and especially with receipt of SPC, aOR 0.05 (0.04-0.06, p < 0.0001).</p><p><strong>Interpretation: </strong>Receipt of SPC could possibly reduce the need for emergency care in the end of life and the Stockholm model might facilitate referral to SPC for hematological patients.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"234-240"},"PeriodicalIF":2.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11833331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}