Acta Oncologica最新文献

{"title":"Comparative study of lung cancer care and survival outcomes across the Nordic countries.","authors":"Ghida Khalife, Juho Waris, Uffe Bødtger, Johan Isaksson, Kirill Neumann, Hrönn Harðardóttir, Heidi Andersén, Antti Jekunen, Maria Lovén, Tuula Vasankari, Susanna Nurmi-Rantala, Paulus Torkki","doi":"10.2340/1651-226X.2025.42778","DOIUrl":"10.2340/1651-226X.2025.42778","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer (LC) is the leading cause of cancer-related deaths worldwide. Despite societal, economic and genetic similarities, 5-year age-standardized relative survival rate is lower in Finland compared to the other Nordic countries. Previous studies have identified discrepancies in LC guidelines, but research on actual care practices remains limited. We aim to address this knowledge gap by conducting a comprehensive examination of the current care practices for LC patients in the Nordic countries.</p><p><strong>Methods: </strong>We employed a non-interventional, prospective study design. We conducted an expert workshop involving LC specialists from Finland to formulate relevant questions for a structured survey. This survey was distributed to healthcare professionals (HCPs) across Nordic hospitals and primary care units. The survey results were then analyzed, and a follow-up Nordic LC expert workshop was held to identify the most relevant factors potentially influencing LC survival outcomes.</p><p><strong>Results: </strong>Four key differences in care practices between Finland and other Nordic countries were identified: (1) resources available in primary care units, (2) waiting times in primary care, (3) availability of novel treatments and (4) tracking of LC survival and mortality outcomes by the hospital. Finland has the lowest access to computed tomography (CT) from primary care, longest waiting times in primary care, and lacks a national outcome tracking system. Some medical doctors in Finland and Iceland highlighted observed limitations in specific cases involving access to neoadjuvant immunotherapy and chemotherapy.</p><p><strong>Interpretation: </strong>Several factors unrelated to specialized LC care are likely contributing to poorer 5-year survival rates for LC in Finland. These findings may be applicable to other healthcare systems as well.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"734-741"},"PeriodicalIF":2.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223951","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":"Feasibility and outcome of genomics-guided treatment selection in advanced cancer - the MEGALiT explorative clinical trial.","authors":"Lars Ny, Henrik Fagman, Johan Botling, Loviisa Mantovaara, Peter Asplund, Hannah Karlsson, Jennie Aust, Edvard Abel, Mats Hellström, Joakim Crona, Peter Nygren","doi":"10.2340/1651-226X.2025.43366","DOIUrl":"10.2340/1651-226X.2025.43366","url":null,"abstract":"<p><strong>Background: </strong>Precision cancer medicine (PCM) is key to advancing cancer treatment beyond the standard of care. We performed an explorative clinical trial, MEGALiT, to investigate the feasibility, safety, and clinical benefit of genomics-based PCM in advanced cancer.</p><p><strong>Methods: </strong>MEGALiT recruited adult patients with advanced solid tumors refractory to standard treatment. Tumor DNA from newly acquired biopsies or ctDNA were analyzed for alterations targetable with the PD-L1 inhibitor atezolizumab, the MEK inhibitor cobimetinib, the mTOR inhibitor everolimus, or the PARP-inhibitor niraparib. Any other 'in study' treatment was left to the discretion of the physician.</p><p><strong>Results: </strong>Outcome data are reported for 153 patients. The median age was 65 years and the most common diagnoses were colorectal, prostate, and ovarian cancer. The median time from study inclusion to the Molecular Tumor Board was 35 days for tumor sampling by biopsy and 21 days by ctDNA. Of the 44 patients allocated to a study drug, 38 started treatment. The median follow-up was 1.9 years. Of the patients on a study drug and evaluable for tumor response, 6% (2/32) had partial remission, and 25% (8/32) had disease control at 16 weeks. Median overall survival for patients starting a study drug was longer, 7.4 months, compared to 2.7 months for the 61 untreated patients (HR 0.43; log-rank p < 0.0001), but shorter than for the 50 patients receiving treatment of physician's choice, 11.8 months (HR 0.55; log-rank p = 0.012). No significant procedure- or drug-related severe adverse events were observed.</p><p><strong>Interpretation: </strong>Genomics-guided treatment selection in advanced cancer is feasible and safe. However, evidence of patient benefit warrants further investigation.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"742-750"},"PeriodicalIF":2.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223952","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":"Therapeutic drug monitoring (TDM) of tyrosine kinase inhibitors (TKI) for optimized outcome in patients with metastatic renal cell carcinoma. The TKI-TDM Trial. Study protocol.","authors":"Jakob N Henriksen, Charlotte U Andersen, Frede Donskov, Elke Hoffmann-Lücke, Eva Greibe, Niels Fristrup","doi":"10.2340/1651-226X.2025.43693","DOIUrl":"10.2340/1651-226X.2025.43693","url":null,"abstract":"<p><strong>Background: </strong>Metastatic renal cell carcinoma (mRCC) is notably resistant to chemotherapy and radiotherapy. However, tyrosine kinase inhibitors (TKIs) and checkpoint immunotherapy have significantly improved outcomes. Still, about 20% of patients experience disease progression as their best response to TKIs, and 16-63% endure severe toxicities, reducing quality of life. Optimizing dosing is therefore essential. Therapeutic drug monitoring (TDM) is a promising strategy for individualizing treatment. The TKI-TDM trial aims to identify a therapeutic plasma concentration range for six TKIs (axitinib, cabozantinib, pazopanib, sorafenib, sunitinib, tivozanib) in mRCC patients.</p><p><strong>Material and methods: </strong>This prospective observational study will enroll mRCC patients with at least 6 months of stable disease or regression on TKI therapy. Blood samples will be collected during routine care. Plasma concentrations of TKIs and metabolites will be measured using validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods. These levels will be correlated with clinical outcomes including objective response rate, progression-free survival, overall survival, and toxicity. Genetic analysis of UGT1A1 polymorphisms will explore their influence on pazopanib metabolism and response.</p><p><strong>Interpretation: </strong>Identifying plasma TKI levels associated with efficacy and reduced toxicity could minimize under- or overdosing, improving outcomes and quality of life. TDM may allow dose adjustments early in therapy, improving therapeutic management and reducing healthcare costs. Findings may also inform treatment of other cancers using TKIs or TKI-immunotherapy combinations. The trial (clinicaltrials.gov NCT04659343) is expected to conclude in 2028, with results in 2029.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"729-733"},"PeriodicalIF":2.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207357","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":"Hedgehog inhibitors exert anti-proliferation effects and synergistically interact with trastuzumab in HER2-positive gastric cancer models.","authors":"Zixin Yang, Ren Niu, Jinzhu Han, Jie Guo, Yingqian Lv","doi":"10.2340/1651-226X.2025.42219","DOIUrl":"10.2340/1651-226X.2025.42219","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (GC) remains a significant health concern with limited therapeutic options. While trastuzumab, a Human Epidermal Growth Factor Receptor 2 (HER2)-targeting antibody, has shown efficacy in HER2-positive GC, its therapeutic response is moderate. Hedgehog (Hh) signalling plays a critical role in the progression of GC.</p><p><strong>Methods: </strong>We evaluated the sensitivity of various GC cell lines to trastuzumab. The HER2-positive HGC-27 cell line was identified as the most sensitive. In addition, the effects of two Hedgehog inhibitors, vismodegib and cyclopamine, were assessed on cell growth by monitoring SMO expression. Both in vitro and in vivo assays were conducted to explore the combination of Hh inhibitors and trastuzumab.</p><p><strong>Results: </strong>Both vismodegib and cyclopamine exerted anti-proliferative effects, and synergistically enhanced the anti-tumour activity of trastuzumab in HER2-positive GC models. Mechanistically, Hh inhibitors inhibited the AKT/mTOR signalling pathway through Smoothened (SMO) depletion, contributing to their anti-growth effects.</p><p><strong>Interpretation: </strong>This study highlights the potential of combining Hh inhibitors with trastuzumab as a therapeutic strategy for HER2-positive GC by targeting the AKT/mTOR pathway.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"715-728"},"PeriodicalIF":2.7,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155536","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":"Impact of the risk-adapted Nordic anal cancer group consensus guidelines on the contouring of the elective clinical target volume in anal cancer.","authors":"Marcus Johnsson, Sara Alkner, Anders Johnsson, Martin Nilsson","doi":"10.2340/1651-226X.2025.42723","DOIUrl":"10.2340/1651-226X.2025.42723","url":null,"abstract":"<p><strong>Background and purpose: </strong>The recently published Nordic anal cancer group (NOAC) contouring guidelines aim for improved oncological outcomes and reduced toxicity in anal cancer patients treated with radiotherapy. The present work describes how the elective clinical target volume (CTVe) would change when applying the NOAC guidelines instead of the previous Australasian standard. According to the Australasian guidelines, the cranial border of the CTVe is at the common iliac bifurcation for all patients, and the external iliac region as well as the ischiorectal fossa are always included.</p><p><strong>Materials and methods: </strong>Retrospectively, 166 anal cancer patients treated with curative radiotherapy according to Australasian guidelines between 2009 and 2017 were studied in a single-center analysis. Pretherapeutic scans, and clinical information were used to categorize patients according to the NOAC guidelines for a comparison with the Australasian guidelines.</p><p><strong>Results: </strong>Applying the risk-adapted alternative of the NOAC guidelines had the external iliac region omitted in 41.0% of the patients. The cranial border was lowered from the common iliac bifurcation in 27.7% and elevated in 12.7% of the patients. Elderly patients (≥70 years) more often had the external iliac region omitted than younger patients (60.9% vs. 33.3%; p = 0.001). The entire ischiorectal fossa was included in 23.7% of the patients due to tumor extension beyond the levator ani muscles or external sphincter.</p><p><strong>Interpretation: </strong>Contouring according to the NOAC risk-adapted guidelines changed, and mainly reduced, the CTVe in about half of all patients. Prospective follow-up is needed to determine if this is clinically beneficial.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"708-714"},"PeriodicalIF":2.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148801","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":"European practice on neurovascular late effects after pediatric radiotherapy: considerations on dose planning and follow-up - a HARMONIC/SIOPE ROWG survey.","authors":"Laura Toussaint, Louise Tram Henriksen, Karen Van Beek, Stephanie Bolle, Charlotte Demoor-Goldschmidt, Jenny Gains, Morten Høyer, Geert O Janssens, Rolf-Dieter Kortmann, Catia Martins Pedro, Beate Timmermann, Katrin Scheinemann, Yasmin Lassen-Ramshad","doi":"10.2340/1651-226X.2025.43028","DOIUrl":"10.2340/1651-226X.2025.43028","url":null,"abstract":"<p><strong>Background and purpose: </strong>The risk of developing neurovascular late effects after radiotherapy is an area of concern when treating pediatric brain tumor patients. However, knowledge is sparse regarding best practice for clinical management during the radiotherapy (RT) planning process and follow-up examinations. This study therefore aimed at mapping how the risk of neurovascular late effects is considered for pediatric brain or skull base tumor patients treated with radiotherapy in Europe.</p><p><strong>Materials and methods: </strong>Two web-based surveys ‑ a RT and a pediatric oncology (PO) survey - were distributed to members of the SIOPE radiotherapy working group or PANCARE and SIOPE brain tumor group, respectively.</p><p><strong>Results: </strong>The RT survey was completed by 47 participants from 18 different European countries and the PO survey by 33 participants (mostly pediatric (neuro)oncologists) from 15 countries. Overall, the answers highlighted that neurovascular late effects are currently not well included in European clinical practice, neither at the time of radiotherapy nor in the follow-up process.</p><p><strong>Interpretation: </strong>There is a need for raising general awareness about the topic, as well as for potential risk-stratified prevention measures and follow-up guidelines.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"703-707"},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118517","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":"Simultaneous integrated boost intensity-modulated radiotherapy for treatment of bone metastases: analysis of a breast cancer cohort.","authors":"Fabio Marazzi, Valeria Masiello, Alessandra Fabi, Stefania Manfrida, Barbara Corvari, Valentina Lancellotta, Ciro Mazzarella, Silvia Longo, Martina De Angeli, Francesca Moschella, Alba Di Leone, Armando Orlandi, Serena Bracci, Giuseppe Ferdinando Colloca, Mariangela Massaccesi, Luca Boldrini, Luca Tagliaferri, Emilio Bria, Riccardo Masetti, Gianluca Franceschini, Vincenzo Valentini, Maria Antonietta Gambacorta, Francesco Cellini","doi":"10.2340/1651-226X.2025.42933","DOIUrl":"10.2340/1651-226X.2025.42933","url":null,"abstract":"<p><strong>Background: </strong>Bone metastases occur in up to 75% of metastatic breast cancer (MBC) cases. Advances in imaging now allow earlier detection, even during the oligometastatic phase. Radiotherapy (RT) is increasingly used in asymptomatic patients with ≤5 bone lesions, however standardised guidelines for dose and target volumes remain lacking. This study evaluates the outcomes of a simultaneous integrated boost (SIB) using intensity-modulated radiotherapy (IMRT) to deliver ablative doses to macroscopic bone lesions.</p><p><strong>Methods: </strong>This retrospective study analysed MBC patients treated with SIB-IMRT for bone metastases between January 2014 and January 2022. The primary endpoint was freedom from local progression (FFLP); secondary endpoints included disease progression after radiotherapy (DP-AR) and overall survival (OS). Subgroup analyses were performed according to age, immunophenotype, and line of therapy.</p><p><strong>Results: </strong>Among 954 patients treated with RT, 85 received SIB-IMRT (6-8 Gy per fraction, 5 fractions). Median follow-up was 41 months. Nineteen patients (22.4%) had a single bone metastasis, 23.5% were oligometastatic, and 54.1% were plurimetastatic. Median FFLP was 17 months; only 7% experienced local relapse at the SIB site. While DP-AR was 13.2 months, median OS reached 82.7 months. No significant correlation was found between local relapse and age, immunophenotype, or systemic therapy. Immunophenotype significantly influenced DP-AR (p = 0.002), while DP-AR and OS were not significantly associated with local progression.</p><p><strong>Interpretation: </strong>SIB-IMRT for bone metastases in MBC is feasible and effective, with encouraging local control and minimal toxicity. Prospective studies are warranted to optimise dose escalation and explore synergistic effects with systemic therapies.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"685-692"},"PeriodicalIF":2.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092060","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":"Quantifying the dosimetric impact of online daily adaptation for MR-guided RT in cervical cancer.","authors":"Amerah Alshamrani, Robert Chuter, Marianne Aznar, Peter Hoskin, Claire Nelder, Ananya Choudhury, Lisa Barraclough, Cynthia L Eccles","doi":"10.2340/1651-226X.2025.42898","DOIUrl":"10.2340/1651-226X.2025.42898","url":null,"abstract":"<p><strong>Purpose: </strong>This study assessed the inter- and intra-fractional dosimetric impact of MR-Linac-based adaptive radiotherapy for cervical cancer (CC).</p><p><strong>Methods: </strong>A retrospective analysis of five node-negative, locally advanced cervical cancer patients treated under the MOMENTUM study (NCT04075305) using adapt-to-shape (ATS) on an Elekta Unity MR-Linac. Assessing the dosimetric impact of daily online adaptations: (1) comparing dose between daily adapted (MR-adapted) and non-adapted (MR-guided) plans, by quantifying dose differences relative to reference plans (by 2 and 5%) and evaluating adaptation frequency; (2) performing intra-fraction dose evaluations. Dose metrics for targets and organs at risk (OARs) were evaluated following EMBRACE II guidelines.</p><p><strong>Results: </strong>MR-adapted plans improved target coverage or reduced OAR dose in 82-100% of fractions at a 2% dose deviation (and in 25-84% at a 5% deviation), compared to MR-guided plans. Dose reductions for OARs ranged from 2 to 8% for D0.1%, 4.77-16.70% for V4000cGy and 2.10-14.00% for V3000cGy. Intra-fraction analysis showed that the difference between daily planned and delivered doses in all target structures was not clinically significant, ranging from 0.08 to 2.20%, except two fractions that experienced higher deviations (5%) in ITV45. Treatment was well-tolerated, with no Grade 2 or 3 toxicities reported.</p><p><strong>Interpretation: </strong>MR-guided plans required adaptation in 25-100% of the fractions when compared to MR-adapted plans. MR-adapted plans demonstrated enhanced target dose consistency and reduced OAR dose for all patients, highlighting the benefits of daily adaptation. Despite longer treatment times, dose accuracy was preserved. Toxicity results for MRgART in CC appear promising.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"693-702"},"PeriodicalIF":2.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12108135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101034","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":"Sociodemographic disparities in incidence rates of advanced and low-risk prostate cancer as a proxy for diagnostic activity.","authors":"Ulf Strömberg, Carl Bonander, Hans Garmo, Mats Lambe, Pär Stattin, Ola Bratt","doi":"10.2340/1651-226X.2025.43399","DOIUrl":"10.2340/1651-226X.2025.43399","url":null,"abstract":"<p><strong>Background: </strong>Inequity in prostate cancer detection can be assessed by relating the diagnostic intensity to the incidence rate of advanced disease in different population groups, according to factors such as socioeconomic status or ethnicity.</p><p><strong>Methods: </strong>We used nationwide Swedish register data from Prostate Cancer data Base Sweden 5.0 and Statistics Sweden, which enabled us to estimate incidence rates of low-risk prostate cancer (a proxy for diagnostic activity) and advanced disease (locally advanced and/or metastatic) across population groups according to household income, country of birth, and neighborhood-level characteristics.</p><p><strong>Results: </strong>We found a gradient in the age-standardized incidence of low-risk prostate cancer across income groups, from 60 per 100,000/year in men with high to 34 per 100,000/year in men with low household income: adjusted incidence rate ratio (IRR) 0.65 (95% confidence interval [CI] 0.59-0.71). The gradient in the incidence of advanced disease had the opposite direction, from 44 to 60 per 100,000/year, IRR 1.43 (95% CI 1.31-1.56). Immigrants from a non-Nordic country (nearly 40% from Asia) had lower incidence rates of both low-risk (IRR 0.47, 95% CI 0.42-0.53) and advanced disease (IRR 0.65, 95% CI 0.58-0.73) than men born in a Nordic country. Neighborhood-level analysis considering economic standard, share of immigrants, and degree of urbanization did not clearly differentiate the incidence of advanced disease.</p><p><strong>Interpretation: </strong>Our results suggest that measures to facilitate early detection of prostate cancer should be targeted to men with a low income. A low diagnostic activity for prostate cancer among immigrants from countries with low background risk may not imply unjustified social disparity.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"677-684"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075233","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":"Gender differences in palliative care needs among Swedish cancer patients prior to specialist palliative care referral.","authors":"Karin Boo Hammas, Juliet Jacobsen, Rebecca Selberg, Sanjoy Mahajan, Jenny Klintman","doi":"10.2340/1651-226X.2025.43308","DOIUrl":"10.2340/1651-226X.2025.43308","url":null,"abstract":"<p><strong>Background and purpose: </strong>Few studies, in Sweden or internationally, have examined gender differences regarding the use of palliative care. This study investigates gender differences in palliative care needs prior to referral in a regional cohort of Swedish cancer patients. Patient/material and methods: Adult cancer patients who died throughout 1 year and were referred to a specialized palliative care service in southern Sweden during their last 3 years of life (n = 192) were included. Information on gender, age, diagnosis, performance status, admissions to hospital, and serious illness conversations was collected through chart review.</p><p><strong>Results: </strong>Ninety-nine (52%) women and 93 (48%) men were included. Survival from diagnosis until death was comparable (p = 0.27) for women (341.0 days, IQR 77.0-902.0) and men (463.0 days, IQR 141.0-1035.0), as was survival from palliative care referral (p = 0.06) (women 48.0 days, IQR 19.0‑107.5; men 36.0 days, IQR 17.0‑85.0). Performance status at the time of referral was also comparable (p = 0.59). Gender differences were observed in healthcare utilization with fewer hospitalizations and emergency department visits for women in the 6 months prior to referral (p = 0.03) and significantly more men among those with the highest healthcare utilization (≥4 hospitalizations and emergency department visits) (p = 0.005). During the month before referral, women were more likely to have a serious illness conversation (p = 0.01).</p><p><strong>Interpretation: </strong>Compared to women, men have more hospitalizations and fewer serious illness conversations prior to referral to specialized palliative care, suggesting greater unmet palliative care needs.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"672-676"},"PeriodicalIF":2.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075327","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}