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  • 1.
    Kristiansson, Stefan
    et al.
    Department of Otolaryngology, Örebro Universitet Institutionen for Medicinska Vetenskaper, Örebro University Hospital, Örebro, Sweden.
    Reizenstein, Johan
    Department of Otolaryngology, Örebro Universitet Institutionen for Medicinska Vetenskaper, Örebro University Hospital, Örebro, Sweden.
    Von Beckerath, Mathias
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Otolaryngology.
    Landström, Fredrik
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Otolaryngology.
    Long-term follow-up in patients treated with electrochemotherapy for non-melanoma skin cancer in the head and neck area2019In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 139, no 2, p. 195-200Article in journal (Refereed)
    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.

  • 2.
    Landström, Fredrik
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Curative electrochemotherapy in the head and neck area2015Doctoral thesis, comprehensive summary (Other academic)
    List of papers
    1. Electroporation therapy of skin cancer in the head and neck area.
    Open this publication in new window or tab >>Electroporation therapy of skin cancer in the head and neck area.
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    2010 (English)In: Dermatologic Surgery, ISSN 1076-0512, E-ISSN 1524-4725, Vol. 36, no 8, p. 1245-50Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND: Electroporation therapy is a new cancer treatment modality in which a locally applied electrical field enhances cell membrane permeability, allowing greater intracellular accumulation of a chemotherapeutic agent.

    OBJECTIVE: To evaluate the efficacy of electroporation therapy in treating basal cell and squamous cell carcinomas of the skin.

    MATERIALS AND METHODS: Six patients with skin cancer of the head and neck were treated using electroporation therapy with intratumorally injected bleomycin. Orbital growth, facial nerve proximity, or proximity to cartilage of the external meatus complicated four of these tumors. The intention was curative. The follow-up period was 24 months and included biopsies after 8 weeks.

    RESULTS: In four of the six patients, one treatment was enough to eradicate the tumor. In one patient, the tumor persisted even after a second treatment with electroporation therapy. A septal cartilage perforation was the only major complication. The cosmetic results were very satisfactory. One additional recurrence was recorded 6 months after the follow-up period

    CONCLUSION: Electroporation therapy is a promising new cancer treatment that should be further evaluated as an alternative to surgery, especially in complicated skin cancer.

    Keywords
    Electroporation therapy, tumor control, basal cell carcinoma, squamous cell carcinoma, BCC, SCC
    National Category
    Cancer and Oncology
    Research subject
    Oncology
    Identifiers
    urn:nbn:se:oru:diva-37223 (URN)10.1111/j.1524-4725.2010.01617.x (DOI)000280457400005 ()20666812 (PubMedID)2-s2.0-77955152383 (Scopus ID)
    Note

    Funding agencies:

    Orebro County Council  

    Inovio Biomedical Corporation  

    Genetronics, Inc. 

    Genetronics, Inc. provided financial support for this study and has paid Dr. L. Lofgren an honorarium forwork at investigator meetings.

    Available from: 2014-09-29 Created: 2014-09-29 Last updated: 2017-12-05Bibliographically approved
    2. Electroporation therapy for T1 and T2 oral tongue cancer
    Open this publication in new window or tab >>Electroporation therapy for T1 and T2 oral tongue cancer
    Show others...
    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
    3. Electrochemotherapy - possible benefits and limitations to its use in the head and neck region
    Open this publication in new window or tab >>Electrochemotherapy - possible benefits and limitations to its use in the head and neck region
    Show others...
    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
    4. 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
    Show others...
    (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
    5. Electrochemotherapy - evidence for cell-type selectivity in vitro
    Open this publication in new window or tab >>Electrochemotherapy - evidence for cell-type selectivity in vitro
    Show others...
    (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
  • 3.
    Landström, Fredrik
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.
    Ivarsson, M
    Koskela, A
    Magnuson, A
    von Beckerath, Mathias
    Örebro University Hospital.
    Möller, Claes
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.
    Electrochemotherapy - evidence for cell-type selectivity in vitroManuscript (preprint) (Other academic)
  • 4.
    Landström, Fredrik
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Otolaryngology, Örebro University Hospital, Örebro, Sweden.
    Ivarsson, Mikael
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    von Sydow, Anita Koskela
    Örebro University Hospital. Clinical Research Center, Örebro University Hospital, Örebro, Sweden.
    Magnuson, Anders
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden; Clinical Research Center, Örebro University Hospital, Örebro, Sweden.
    von Beckerath, Mathias
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Otolaryngology, Örebro University Hospital, Örebro, Sweden.
    Möller, Claes
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Electrochemotherapy: Evidence for Cell-type Selectivity In Vitro2015In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 35, no 11, p. 5813-5820Article in journal (Refereed)
    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.

  • 5.
    Landström, Fredrik J.
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital, Örebro, Sweden.
    Nilsson, Christer O. S.
    Örebro University Hospital, Örebro, Sweden.
    Reizenstein, Johan A.
    Örebro University Hospital, Örebro, Sweden.
    Nordqvist, Kent
    Örebro University Hospital, Örebro, Sweden.
    Adamsson, Gun-Britt
    Örebro University Hospital, Örebro, Sweden.
    Löfgren, Lennart A.
    Dept Head & Neck, Center for Oncology, Örebro Univ Hospital, Örebro, Sweden.
    Electroporation therapy for T1 and T2 oral tongue cancer2011In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 131, no 6, p. 660-664Article in journal (Refereed)
    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.

  • 6.
    Landström, Fredrik
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.
    Reizenstein, Johan
    Örebro University Hospital.
    Adamsson, Gun-Britt
    Örebro University Hospital.
    Löfgren, Lennart A
    Örebro University Hospital.
    von Beckerath, Mathias
    Örebro University Hospital.
    Möller, Claes
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Long-term follow-up in patients treated with curative electrochemotherapyManuscript (preprint) (Other academic)
  • 7.
    Landström, Fredrik
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Otolaryngology, Örebro University Hospital, Örebro, Sweden.
    Reizenstein, Johan
    Department of Oncology, Örebro University Hospital, Örebro, Sweden.
    Adamsson, Gun-Britt
    Department of Otolaryngology, Örebro University Hospital, Örebro, Sweden.
    von Beckerath, Mathias
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Otolaryngology, Örebro University Hospital, Örebro, Sweden.
    Möller, Claes
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Department of Audiology, Örebro University Hospital, Örebro, Sweden.
    Long-term follow-up in patients treated with curative electrochemotherapy for cancer in the oral cavity and oropharynx2015In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 135, no 10, p. 1070-1078Article in journal (Refereed)
    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.

  • 8.
    Landström, Fredrik
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital, Örebro, Sweden.
    Reizenstein, Johan
    Örebro University Hospital, Örebro, Sweden.
    Nilsson, Christer
    Örebro University Hospital, Örebro, Sweden.
    von Beckerath, Mathias
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Löfgren, Lennart
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Adamsson, Gun-Britt
    Örebro University Hospital, Örebro, Sweden.
    Möller, Claes
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Electrochemotherapy - possible benefits and limitations to its use in the head and neck region2015In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 135, no 1, p. 90-95Article in journal (Refereed)
    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.

  • 9.
    von Beckerath, Mathias P.
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Dept Otolaryngol & Head & Neck Surg, Örebro University Hospital, Örebro, Sweden.
    Reizenstein, Johan A.
    Dept Oncol, Örebro Univ Hosp, Örebro, Sweden.
    Berner, Attila L.
    Dept Otolaryngol & Head & Neck Surg, Örebro Univ Hosp, Örebro, Sweden.
    Nordqvist, Kent W. O.
    Dept Logoped & Phoniatr, Örebro Univ Hosp, Örebro, Sweden.
    Landström, Fredrik J.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Dept Otolaryngol & Head & Neck Surg, Örebro Univ Hosp, Örebro, Sweden.
    Löfgren, Axel Lennart
    Örebro University, Department of Clinical Medicine. Dept Otolaryngol & Head & Neck Surg, Örebro Univ Hosp, Örebro, Sweden.
    Möller, Claes
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Audiology Reseach Center, Örebro University Hospital, Örebro, Sweden.
    Outcome of primary treatment of early laryngeal malignancies using photodynamic therapy2014In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 134, no 8, p. 852-858Article in journal (Refereed)
    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.

  • 10.
    von Beckerath, Mathias P.
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Otolaryngology and Head and Neck Surgery, Örebro University Hospital, Örebro, Sweden.
    Reizenstein, Johan A.
    Department of Oncology, Örebro University Hospital, Örebro, Sweden.
    Landström, Fredrik J.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Otolaryngology, Örebro University Hospital , Örebro, Sweden.
    Adamsson, Gun-Britt
    Department of Otolaryngology and Head and Neck Surgery.
    Möller, Claes
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. 5Audiological Research Center, Örebro University Hospital, Örebro, Sweden.
    Outcome of treatment of recurring laryngeal malignancies using photodynamic therapyManuscript (preprint) (Other academic)
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