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  • 1.
    Johansson, Bengt
    et al.
    Örebro University, School of Health and Medical Sciences.
    Karlsson, Leif
    Örebro University, School of Health and Medical Sciences.
    Reizenstein, Johan
    Örebro University, School of Health and Medical Sciences.
    von Beckerath, Mathias
    Örebro University, School of Health and Medical Sciences.
    Hardell, Lennart
    Örebro University, School of Health and Medical Sciences.
    Persliden, Jan
    Örebro University, School of Health and Medical Sciences.
    Long term results from a uniform clinical series on pulsed dose rate brachytherapy as the boost to external beam irradiation in base of tongue cancerManuscript (preprint) (Other academic)
    Abstract [en]

    Background and purpose: To evaluate the long time outcome with regard to local tumour control, side effects and quality of life of a combined pulsed dose rate (PDR) boost and hyperfractionated accelerated external beam radiotherapy (EBRT) for primary base of tongue (BOT) cancers.

    Patients and methods: Between 1994 and 2007 we treated 83 patients, median age 60 (38-82) years, with primary T1-T4 BOT cancers. Seven patients (8 %) were T1-2N0 (AJCC stage I-II) and 76 (92 %) patients were T1-2N+ or T3-4N0-3 (AJCC stage III-IV). The mean estimated primary tumour volume was 15 (1-75) cm3.  EBRT was given with 1.7 Gy twice daily to 40,8 Gy to primary tumour and bilateral neck lymph nodes in 2.5 weeks. A PDR boost of 35 Gy and a neck dissection in clinical node positive cases was performed 2-3 weeks later. The patients were followed for a median of 54 (2-168) months.

    Results: The 2-, 5- and 10-years rates of actuarial local control were 91 %, 89 % and 85 %, overall survival 85 %, 65 % and 44 %, disease free survival 86 %, 80 % and 76 % respectively. The regional contral rate was 95 %. Six patients (7 %) developed distant metastases. Analysis of dosimetry showed a mean treated volume of 58 cm3.  In a review of late complications we found 11 (13 %) minor and 4 (5 %) major soft tissue necroses and 6 (7 %) osteoradionecroses. The patients median subjective SOMA/LENT scoring at last follow up was; grade 0 for pain and trismus, grade 1 for dysphagia and taste alteration and grade 2 for xerostomia. Global visual-analog-scale (VAS) scoring of quality of life was 8.

    Conclusions: Local and regional tumour control rate was excellent in this treatment protocol. The data support that PDR boost is at least as effective as published continuous low dose rate (CLDR) results.

  • 2.
    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.

  • 3.
    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.

  • 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.
    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.

  • 5.
    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.

  • 6.
    Mäkitie, Antti A.
    et al.
    Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
    Keski-Säntti, Harri
    Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
    Markkanen-Leppänen, Mari
    Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
    Bäck, Leif
    Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
    Koivunen, Petri
    Department of Otorhinolaryngology – Head and Neck Surgery, Oulu University Hospital, Oulu, Finland.
    Ekberg, Tomas
    Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    Sandström, Karl
    Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    Laurell, Göran
    Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    Von Beckerath, Mathias
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Otorhinolaryngology – Head and Neck Surgery.
    Nilsson, Johan S.
    Department of Otorhinolaryngology – Head and Neck Surgery, Skåne University Hospital, Lund, Sweden.
    Wahlberg, Peter
    Department of Otorhinolaryngology – Head and Neck Surgery, Skåne University Hospital, Lund, Sweden.
    Greiff, Lennart
    Department of Otorhinolaryngology – Head and Neck Surgery, Skåne University Hospital, Lund, Sweden.
    Spaak, Lena Norberg
    Department of Otorhinolaryngology – Head and Neck Surgery, Umeå University Hospital, Umeå, Sweden.
    Kjaergaard, Thomas
    Department of Otorhinolaryngology – Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark.
    Godballe, Christian
    Department of Otorhinolaryngology – Head and Neck Surgery, Odense University Hospital, Odense, Denmark.
    Rikardsen, Oddveig
    Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital North Norway, Tromsoe, Norway.
    Channir, Hani Ibrahim
    Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
    Rubek, Niclas
    Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
    von Buchwald, Christian
    Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
    Transoral Robotic Surgery in the Nordic Countries: Current Status and Perspectives2018In: Frontiers in Oncology, ISSN 2234-943X, E-ISSN 2234-943X, Vol. 8, article id 289Article in journal (Refereed)
    Abstract [en]

    Background: The five Nordic countries with a population of 27 M people form a rather homogenous region in terms of health care. The management of head and neck cancer is centralized to the 21 university hospitals in these countries. Our aim was to gain an overview of the volume and role of transoral robotic surgery (TORS) and to evaluate the need to centralize it in this area as the field is rapidly developing.

    Materials and Methods: A structured questionnaire was sent to all 10 Departments of Otorhinolaryngology-Head and Neck Surgery in the Nordic countries having an active programme for TORS in December 2017.

    Results: The total cumulative number of performed robotic surgeries at these 10 Nordic centers was 528 and varied between 5 and 240 per center. The median annual number of robotic surgeries was 38 (range, 5-60). The observed number of annually operated cases remained fairly low (<25) at most of the centers.

    Conclusions: The present results showing a limited volume of performed surgeries call for considerations to further centralize TORS in the Nordic countries.

  • 7.
    von Beckerath, Mathias
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Photodynamic therapy in the head and neck2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Photodynamic therapy, PDT, is a method to diagnose and treat cancer. In PDT a sensitizer is administered to the patient and this sensitizer is accumulated in tumors. If the sensitizer-containing tumor is subjected to a laser of a specific wavelength the tumor is fluorescing allowing diagnostics. If other wavelengths are used a process involving reactive oxygen species and singlet oxygen is started and the tumor cells are killed. This process thus requires oxygen as well.

    This thesis investigates how UV-induced damage of the skin and different physiological factors of the skin influences the uptake of 5- aminolevulinic acid, ALA, and its conversion to the active sensitizer protoporphyrin IX, PpIX. It shows that UV-induced damage affects both the uptake and production of PpIX. UV-induced damage lowers the PpIX produced after ALA application both if the damage is acute and in chronically UV-affected skin.

    The PpIX production differs inter and intra individually. When looking how different physiological factors affect the PpIX production after topically applied ALA the thesis shows that an increase of temperature increases the production. No correlation between the formation of PpIX and the density of hair follicles was found and a weak correlation was seen comparing the epidermal and total dermal thickness and PpIX production

    The thesis also shows how PDT is used in treating laryngeal malignancies. It shows that it is possible to cure laryngeal tumors (both squamous cell carcinomas and sarcomas) using PDT primarily, and that the cure rate as well as outcome of voice and patient safety is comparable to the conventional treatment modalities.

    PDT can also be used as a function and organ sparing treatment for recurring laryngeal cancers, both squamous cell carcinomas and sarcomas.

    List of papers
    1. The influence of UV exposure on 5-aminolevulinic acid-induced protoporphyrin IX production in skin
    Open this publication in new window or tab >>The influence of UV exposure on 5-aminolevulinic acid-induced protoporphyrin IX production in skin
    Show others...
    2001 (English)In: Photochemistry and Photobiology, ISSN 0031-8655, E-ISSN 1751-1097, Vol. 74, no 6, p. 825-828Article in journal (Refereed) Published
    Abstract [en]

    The skin of nude mice was exposed to erythemogenic doses of UV radiation, which resulted in erythema with edema. An ointment containing 5-aminolevulinic acid (ALA) was topically applied on mouse and human skin. Differences in the kinetics of protoporphyrin accumulation were investigated in normal and UV-exposed skin. At 24 and 48 h after UV exposure, skin produced significantly less protoporphyrin IX (PpIX) than skin unexposed to UV. Human skin on body sites frequently exposed to solar radiation (the lower arm) also produced less PpIX than skin exposed more rarely to the sun (the upper arm). It is concluded that UV radiation introduces persisting changes in the skin, relevant to its capability of producing PpIX from ALA. The observed differences in ALA-induced PpIX fluorescence may be the result of altered penetration of ALA through the stratum corneum or altered metabolizing ability of normal and UV-exposed skin (or both).

    National Category
    Medical Biotechnology (with a focus on Cell Biology (including Stem Cell Biology), Molecular Biology, Microbiology, Biochemistry or Biopharmacy)
    Research subject
    Molecular Cellbiology; Microbiology
    Identifiers
    urn:nbn:se:oru:diva-38179 (URN)10.1562/0031-8655(2001)0740825TIOUEO2.0.CO2 (DOI)000172863800012 ()11783939 (PubMedID)2-s2.0-0035790603 (Scopus ID)
    Note

    The present work was supported by the Research Foundation of the Norwegian Radium Hospital and by the Örebro Medical Center Hospital. The authors are thankful to Even Angell-Petersen and Saulius Bagdonas for their help during the experiment.

    Available from: 2014-10-27 Created: 2014-10-27 Last updated: 2017-12-05Bibliographically approved
    2. Influence of physiological parameters on the production of protoporphyrin IX in human skin by topical application of 5-aminolevulinic acid and its hexylester
    Open this publication in new window or tab >>Influence of physiological parameters on the production of protoporphyrin IX in human skin by topical application of 5-aminolevulinic acid and its hexylester
    Show others...
    2006 (English)In: Journal of Medical Sciences, ISSN 1682-4474, E-ISSN 1812-5727, Vol. 6, no 4, p. 546-553Article in journal (Refereed) Published
    Abstract [en]

    Formation of protoporphyrin IX (PpIX) after topical application of 5-aminolevulinic acid (ALA) and its hexylester derivative (ALA-Hex) was studied on healthy human skin. Temperature, density of hair follicles, epidermal and skin thickness were measured on the application sites. The skin temperature was found to be the strongest determinant for PpIX formation. The PpIX fluorescence increase was about 25% per degree Celsius. Formation of PpIX was found to be independent of the density of hair follicles. A weak correlation was found between the PpIX fluorescence and the thickness of epidermis and skin. Sun exposure seems to reduce the production of PpIX slightly.

    Place, publisher, year, edition, pages
    A N S I Network, 2006
    Keywords
    5-aminolevulinic acid esters, Epidermal thickness, Fluorescence, Hair follicles, Skin physiology, Skin thickness, Spectroscopy, Temperature, aminolevulinic acid, aminolevulinic acid hexyl ester, protoporphyrin, adult, article, controlled study, correlation analysis, density, epidermis, fluorescence analysis, hair follicle, human, human experiment, male, normal human, ointment, protein synthesis, skin temperature, skinfold thickness, sun exposure, volunteer
    National Category
    Medical Biotechnology (with a focus on Cell Biology (including Stem Cell Biology), Molecular Biology, Microbiology, Biochemistry or Biopharmacy)
    Research subject
    Microbiology; Molecular Cellbiology
    Identifiers
    urn:nbn:se:oru:diva-38183 (URN)10.3923/jms.2006.546.553 (DOI)- ()- (PubMedID)2-s2.0-33750387149 (Scopus ID)
    Available from: 2014-10-27 Created: 2014-10-27 Last updated: 2018-02-20Bibliographically approved
    3. Outcome of primary treatment of early laryngeal malignancies using photodynamic therapy
    Open this publication in new window or tab >>Outcome of primary treatment of early laryngeal malignancies using photodynamic therapy
    Show others...
    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
    4. 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
    Show others...
    (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
  • 8.
    von Beckerath, Mathias
    et al.
    The Head and Neck Oncology Center, Örebro University Hospital, Örebro, Sweden.
    Juzenas, Petras
    Department of Radiation Biology, The Norwegian Radium Hospital, Oslo, Norway.
    Löfgren, Lennart
    The Head and Neck Oncology Center, Örebro University Hospital, Örebro, Sweden.
    Ma, Li-Wei
    Department of Radiation Biology, The Norwegian Radium Hospital, Oslo, Norway.
    Iani, Vladimir
    Department of Radiation Biology, The Norwegian Radium Hospital, Oslo, Norway.
    Malik, Zvi
    Department of Life Sciences, Bar Han University, Ramat-Gan, Israel.
    Moan, Johan
    Department of Radiation Biology, The Norwegian Radium Hospital, Oslo, Norway.
    Influence of physiological parameters on the production of protoporphyrin IX in human skin by topical application of 5-aminolevulinic acid and its hexylester2006In: Journal of Medical Sciences, ISSN 1682-4474, E-ISSN 1812-5727, Vol. 6, no 4, p. 546-553Article in journal (Refereed)
    Abstract [en]

    Formation of protoporphyrin IX (PpIX) after topical application of 5-aminolevulinic acid (ALA) and its hexylester derivative (ALA-Hex) was studied on healthy human skin. Temperature, density of hair follicles, epidermal and skin thickness were measured on the application sites. The skin temperature was found to be the strongest determinant for PpIX formation. The PpIX fluorescence increase was about 25% per degree Celsius. Formation of PpIX was found to be independent of the density of hair follicles. A weak correlation was found between the PpIX fluorescence and the thickness of epidermis and skin. Sun exposure seems to reduce the production of PpIX slightly.

  • 9.
    von Beckerath, Mathias
    et al.
    Department of Otolaryngology, Örebro Medical Center Hospital, Örebro, Sweden.
    Juzenas, Petras
    Biophysics Department, The Norwegian Radium Hospital, Oslo, Norway; 3Laser Research Center, Vilnius University, Vilnius, Lithuania.
    Ma, Li-Wei
    Biophysics Department, The Norwegian Radium Hospital, Oslo, Norway.
    Iani, Vladimir
    Biophysics Department, The Norwegian Radium Hospital, Oslo, Norway.
    Lofgren, Lennart
    Department of Otolaryngology,Örebro Medical Center Hospital, Örebro, Sweden.
    Moan, Johan
    Biophysics Department, The Norwegian Radium Hospital, Oslo, Norway.
    The influence of UV exposure on 5-aminolevulinic acid-induced protoporphyrin IX production in skin2001In: Photochemistry and Photobiology, ISSN 0031-8655, E-ISSN 1751-1097, Vol. 74, no 6, p. 825-828Article in journal (Refereed)
    Abstract [en]

    The skin of nude mice was exposed to erythemogenic doses of UV radiation, which resulted in erythema with edema. An ointment containing 5-aminolevulinic acid (ALA) was topically applied on mouse and human skin. Differences in the kinetics of protoporphyrin accumulation were investigated in normal and UV-exposed skin. At 24 and 48 h after UV exposure, skin produced significantly less protoporphyrin IX (PpIX) than skin unexposed to UV. Human skin on body sites frequently exposed to solar radiation (the lower arm) also produced less PpIX than skin exposed more rarely to the sun (the upper arm). It is concluded that UV radiation introduces persisting changes in the skin, relevant to its capability of producing PpIX from ALA. The observed differences in ALA-induced PpIX fluorescence may be the result of altered penetration of ALA through the stratum corneum or altered metabolizing ability of normal and UV-exposed skin (or both).

  • 10.
    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.

  • 11.
    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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