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Landström, Fredrik
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Kristiansson, S., Reizenstein, J., Von Beckerath, M. & Landström, F. (2019). Long-term follow-up in patients treated with electrochemotherapy for non-melanoma skin cancer in the head and neck area. Acta Oto-Laryngologica, 139(2), 195-200
Open this publication in new window or tab >>Long-term follow-up in patients treated with electrochemotherapy for non-melanoma skin cancer in the head and neck area
2019 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 139, no 2, p. 195-200Article in journal (Refereed) Published
Abstract [en]

Background: Electrochemotherapy (ECT) is a cancer treatment modality where the intracellular accumulation of chemotherapeutic agents is enhanced by an applied electrical field.

Aims/Objectives: To evaluate the long-term efficacy, safety and functional outcome after ECT treatment in high-risk non-melanoma skin cancer (NMSC) with curative intent.

Materials and methods: Seven patients with SCC or BCC in the head and neck area were treated with ECT with intratumoral bleomycin administration.

Results: Five patients were cured by ECT as a mono-modality treatment after a median 10-year follow-up period. Two patients had recurrences and/or persisting tumors after treatment that required salvage surgery and radiotherapy. In two patients, the eye was spared with no visual impairment. In another patient, full facial nerve function was spared.

Conclusions: ECT can be a curative as well as an organ and function-sparing mono modality treatment in high-risk NMSC.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019
Keywords
Electrochemotherapy, non-melanoma skin cancer, squamous cell carcinoma, basal cell carcinoma
National Category
Otorhinolaryngology
Identifiers
urn:nbn:se:oru:diva-73500 (URN)10.1080/00016489.2018.1543950 (DOI)000461648000014 ()30734631 (PubMedID)2-s2.0-85061282989 (Scopus ID)
Note

Funding Agency:

Örebro County Council

Available from: 2019-04-04 Created: 2019-04-04 Last updated: 2019-04-04Bibliographically approved
Landström, F. (2015). Curative electrochemotherapy in the head and neck area. (Doctoral dissertation). Örebro: Örebro university
Open this publication in new window or tab >>Curative electrochemotherapy in the head and neck area
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Örebro: Örebro university, 2015. p. 94
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 117
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-42215 (URN)978-91-7529-061-4 (ISBN)
Public defence
2015-03-06, Universitetssjukhuset, Bomanssonsalen, Södra Grev Rosengatan, Örebro, 13:00 (English)
Opponent
Supervisors
Available from: 2015-01-26 Created: 2015-01-26 Last updated: 2017-10-17Bibliographically approved
Landström, F., Reizenstein, J., Nilsson, C., von Beckerath, M., Löfgren, L., Adamsson, G.-B. & Möller, C. (2015). Electrochemotherapy - possible benefits and limitations to its use in the head and neck region. Acta Oto-Laryngologica, 135(1), 90-95
Open this publication in new window or tab >>Electrochemotherapy - possible benefits and limitations to its use in the head and neck region
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2015 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 135, no 1, p. 90-95Article in journal (Refereed) Published
Abstract [en]

Conclusion: Electrochemotherapy (ECT) is an efficacious treatment. It should, however, be used with some caution in the treatment of head and neck cancer.

Objectives: To assess local tumor control, safety, survival, and functional outcome after treatment of cancer in the head and neck region with ECT.

Methods: Four patients with primary T2 cancer of the oral cavity or oropharynx and one patient with a metastasis of renal cancer in the masseter muscle were treated with ECT with intratumorally administered bleomycin. Control biopsies were carried out 2 months after treatment. Postoperative radiotherapy was performed based on tumor T-stage and the depth of tumor infiltration. Serious adverse events and treatment malfunctions were recorded. The follow-up time was 24 months for the surviving patients and 20 months overall. The PSS-HN scale was used to assess the functional outcome.

Results: No local recurrence was recorded in any patient during the follow-up. However, only one patient was treated with ECT alone. There were four serious adverse events: one nearly lethal bleeding, two cases of osteoradionecrosis, and a fistula. One patient died from distant metastasis. The other patients were tumor-free both locally and overall at 24 months. The median functional outcome in all parameters was worse 1 year after treatment.

Place, publisher, year, edition, pages
Informa Healthcare, 2015
National Category
Otorhinolaryngology
Identifiers
urn:nbn:se:oru:diva-39848 (URN)10.3109/00016489.2014.947655 (DOI)000346275600013 ()25496181 (PubMedID)2-s2.0-84918592776 (Scopus ID)
Note

Funding agency: Genetronics Inc., San Diego, CA, USA

Available from: 2014-12-16 Created: 2014-12-16 Last updated: 2018-06-26Bibliographically approved
Landström, F., Ivarsson, M., von Sydow, A. K., Magnuson, A., von Beckerath, M. & Möller, C. (2015). Electrochemotherapy: Evidence for Cell-type Selectivity In Vitro. Anticancer Research, 35(11), 5813-5820
Open this publication in new window or tab >>Electrochemotherapy: Evidence for Cell-type Selectivity In Vitro
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2015 (English)In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 35, no 11, p. 5813-5820Article in journal (Refereed) Published
Abstract [en]

Aim: Electrochemotherapy (ECT) is a new cancer treatment modality that uses electroporation to potentiate chemotherapeutic agents, especially bleomycin. ECT causes both a direct toxic effect and an anti-vascular effect. The aim of the present study was to investigate a possible selective effect of ECT on the survival of fibroblasts, endothelial cells (HUVEC) and two squamous cell carcinoma cell lines (CAL-27 and SCC-4).

Materials and Methods: Cells were electroporated using two bleomycin concentrations. The survival rate was assessed 1, 2, 3 and 4 days after treatment, by two different assays.

Results: The survival rate of the fibroblasts was statistically significantly higher than the other cell lines at day 4. The HUVEC survival rate was statistically significantly lower than the other cell types at day 1 after electroporation-alone.

Conclusion: A selective survival effect after ECT was observed in vitro, supporting the anti-vascular effect seen in vivo.

Place, publisher, year, edition, pages
International Institute of Anticancer Research, 2015
Keywords
Electrochemotherapy, bleomycin, head and neck cancer, squamous cell carcinoma, fibroblasts, endothelial cells, selectivity
National Category
Cancer and Oncology
Research subject
Oncology
Identifiers
urn:nbn:se:oru:diva-46832 (URN)000363794900010 ()26504002 (PubMedID)2-s2.0-84946055559 (Scopus ID)
Note

Funding Agency:

Örebro County Council

Available from: 2015-11-27 Created: 2015-11-27 Last updated: 2018-07-02Bibliographically approved
Landström, F., Reizenstein, J., Adamsson, G.-B., von Beckerath, M. & Möller, C. (2015). Long-term follow-up in patients treated with curative electrochemotherapy for cancer in the oral cavity and oropharynx. Acta Oto-Laryngologica, 135(10), 1070-1078
Open this publication in new window or tab >>Long-term follow-up in patients treated with curative electrochemotherapy for cancer in the oral cavity and oropharynx
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2015 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 135, no 10, p. 1070-1078Article in journal (Refereed) Published
Abstract [en]

Conclusion: ECT can be a safe curative mono modality treatment, especially in tongue cancer. The future role for ECT in head and neck cancer needs to be further investigated.

Introduction: Electrochemotherapy (ECT) is a cancer treatment modality that uses electroporation to increase the intracellular accumulation of hydrophilic chemotherapeutic drugs, especially bleomycin.

Objectives: To report the 5-year local tumor control, safety of treatment and survival after ECT, and the 1-year quality-of-life (QoL) data.

Materials and methods: Nineteen patients with primary head and neck cancer were included and treated with ECT with curative intent. All except one patient had squamous cell carcinoma (SCC). Radiotherapy (RT) was performed in all patients with SCC and tumor infiltration ‡5 mm. The EORTC H&N 35 questionnaire was used at baseline and 12 months after treatment. The Wilcoxon signed rank test and McNemar’s test were used for paired data and Mann Whitney U-test and Fishers exact test were used for independent data (sub-group comparison).

Results: There were no local recurrences in the follow-up period. Thirteen patients were treated with adjuvant RT. The six patients that were treated with ECT alone were tumor-free and alive 5 years after treatment. There was one serious adverse event reported; aspiration after treatment of a tongue base tumor. The tumor-specific 5-year survival was 75%. The QoL outcome 1 year after ECT showed a significant increase in problems with senses (taste, smell), speech, mouth opening and xerostomia. The QoL outcome also showed worse outcome in the smoking patients regarding speech, in the patients receiving adjuvant RT regarding mouth dryness and swallowing and in the patients with non-tongue oral cavity cancer regarding need for painkillers.

Keywords
Electrochemotherapy, bleomycin, head and neck cancer, squamous cell carcinoma, quality-of-life, local control, survival
National Category
Cancer and Oncology Otorhinolaryngology
Research subject
Oncology; Oto-Rhino-Laryngology
Identifiers
urn:nbn:se:oru:diva-45506 (URN)10.3109/00016489.2015.1049663 (DOI)000361294200016 ()26061895 (PubMedID)2-s2.0-84938901488 (Scopus ID)
Note

Funding Agencies:

Örebro County Council

Regional Board for Ethical Evaluation in Uppsala

Available from: 2015-08-10 Created: 2015-08-10 Last updated: 2018-07-01Bibliographically approved
von Beckerath, M. P., Reizenstein, J. A., Berner, A. L., Nordqvist, K. W. O., Landström, F. J., Löfgren, A. L. & Möller, C. (2014). Outcome of primary treatment of early laryngeal malignancies using photodynamic therapy. Acta Oto-Laryngologica, 134(8), 852-858
Open this publication in new window or tab >>Outcome of primary treatment of early laryngeal malignancies using photodynamic therapy
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2014 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 134, no 8, p. 852-858Article in journal (Refereed) Published
Abstract [en]

Conclusion: Photodynamic therapy (PDT) is a viable and safe option for early laryngeal cancer that would be less suitably treated with radiation or trans-oral laser surgery (TLS). The cure rates with PDT appear to be comparable to those of conventional therapy, and the voice outcomes are also comparable. In the case of many sarcomas, PDT appears to be an organ- and function-sparing therapy, although it is more costly than other treatments.

Objectives: The aim of this study was to show the results of PDT when it is used as a primary treatment of early laryngeal cancer. Methods: We studied the results of PDT when used as a primary treatment. We looked at survival, effect on tumor, side effects, voice, and costs.

Results: The follow-up period was a median of 59 months. Nine of 10 patients were cured of their laryngeal cancer. PDT alone cured seven patients. All four of the sarcomas were cured using temoporfin. Two of three tumors that involved the anterior commissure were cured using only interstitial illumination with PDT. No serious side effects were noted. The patient's voices were improved after treatment in 5 of 10 cases, and none had a worsened voice.

Keywords
Cancer, larynx, PDT, sarcoma, squamous cell carcinoma, porfimer sodium, temoporfin, voice
National Category
Otorhinolaryngology
Research subject
Oto-Rhino-Laryngology
Identifiers
urn:nbn:se:oru:diva-36374 (URN)10.3109/00016489.2014.906748 (DOI)000340137200013 ()24856450 (PubMedID)2-s2.0-84904327200 (Scopus ID)
Available from: 2014-09-03 Created: 2014-09-03 Last updated: 2018-06-09Bibliographically approved
Landström, F. J., Nilsson, C. O. S., Reizenstein, J. A., Nordqvist, K., Adamsson, G.-B. & Löfgren, L. A. (2011). Electroporation therapy for T1 and T2 oral tongue cancer. Acta Oto-Laryngologica, 131(6), 660-664
Open this publication in new window or tab >>Electroporation therapy for T1 and T2 oral tongue cancer
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2011 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 131, no 6, p. 660-664Article in journal (Refereed) Published
Abstract [en]

Conclusion: Electroporation therapy appears to be a safe treatment achieving excellent local tumor control and very good functional results in our study and it should be further clinically evaluated.

Objectives: The objectives of this study were to assess local tumor control, survival, and effects on speech and eating after treatment of tongue cancer with electroporation therapy, a new local therapeutic modality. In this approach intracellular accumulation of a chemotherapeutic agent is achieved by using a locally applied electrical field.

Methods: Fifteen patients with primary T1 and T2 oral tongue cancer were treated with electroporation therapy with intratumorally administered bleomycin. Postoperative radiotherapy was performed when the tumor infiltration was 5 mm or more. The follow-up time was 24 months for the surviving patients and 20.4 months overall. The effects on eating and speech were assessed using the PSS-HN scale and voice recordings.

Results: No local recurrence was recorded in any patient during the follow-up. Three patients died, two from progressive regional disease. Of the 12 surviving patients, 2 patients had regional recurrence and 10 patients including the 5 patients treated with EPT alone were tumor-free both locally and regionally at the last follow-up. The functional outcome for speech and eating were very good.

Place, publisher, year, edition, pages
Informa Healthcare, 2011
Keywords
Electrochemotherapy, bleomycin, local control, survival, speech
National Category
Otorhinolaryngology
Identifiers
urn:nbn:se:oru:diva-42889 (URN)10.3109/00016489.2010.541937 (DOI)000290571200015 ()21190422 (PubMedID)2-s2.0-79956051975 (Scopus ID)
Note

Funding agency: Örebro County Council; Genetronics Inc.

Available from: 2015-02-23 Created: 2015-02-23 Last updated: 2018-05-07Bibliographically approved
Landström, F., Ivarsson, M., Koskela, A., Magnuson, A., von Beckerath, M. & Möller, C.Electrochemotherapy - evidence for cell-type selectivity in vitro.
Open this publication in new window or tab >>Electrochemotherapy - evidence for cell-type selectivity in vitro
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(English)Manuscript (preprint) (Other academic)
National Category
Otorhinolaryngology
Identifiers
urn:nbn:se:oru:diva-42891 (URN)
Available from: 2015-02-23 Created: 2015-02-23 Last updated: 2017-10-17Bibliographically approved
Landström, F., Reizenstein, J., Adamsson, G.-B., Löfgren, L. A., von Beckerath, M. & Möller, C.Long-term follow-up in patients treated with curative electrochemotherapy.
Open this publication in new window or tab >>Long-term follow-up in patients treated with curative electrochemotherapy
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(English)Manuscript (preprint) (Other academic)
National Category
Otorhinolaryngology
Identifiers
urn:nbn:se:oru:diva-42890 (URN)
Available from: 2015-02-23 Created: 2015-02-23 Last updated: 2017-10-17Bibliographically approved
von Beckerath, M. P., Reizenstein, J. A., Landström, F. J., Adamsson, G.-B. & Möller, C.Outcome of treatment of recurring laryngeal malignancies using photodynamic therapy.
Open this publication in new window or tab >>Outcome of treatment of recurring laryngeal malignancies using photodynamic therapy
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(English)Manuscript (preprint) (Other academic)
National Category
Cancer and Oncology
Research subject
Oncology
Identifiers
urn:nbn:se:oru:diva-38185 (URN)
Available from: 2014-10-27 Created: 2014-10-27 Last updated: 2017-10-17Bibliographically approved
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