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Nilsson, Anders
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Publikasjoner (10 av 14) Visa alla publikasjoner
Månsson, C., Brahmstaedt, R., Nygren, P., Nilsson, A., Urdzik, J. & Karlson, B.-M. (2019). Percutaneous Irreversible Electroporation as First Line Treatment of Locally Advanced Pancreatic Cancer. Anticancer Research, 39(5), 2509-2512
Åpne denne publikasjonen i ny fane eller vindu >>Percutaneous Irreversible Electroporation as First Line Treatment of Locally Advanced Pancreatic Cancer
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2019 (engelsk)Inngår i: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 39, nr 5, s. 2509-2512Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background/Aim:

Irreversible electroporation (IRE) has recently been used as an experimental ablation treatment following systemic chemotherapy in locally advanced pancreatic cancer (LAPC). The primary aim of this study was to evaluate survival of LAPC patients after IRE prior to chemotherapy. The secondary aim was to examine the complication rates.

Patients and Methods:

Twenty-four patients with LAPC were included and treated with percutaneous ultrasound-guided IRE under general anesthesia. Survival data from the National Quality Registry for Pancreatic and Periampullary Cancer for LAPC during the same period were used for comparison.

Results:

The median survival after diagnosis was 13.3 months in the IRE group compared to 9.9 months in the registry group (p=0.511). Six patients had a severe complication after IRE treatment.

Conclusion:

No obvious gain in survival was observed with IRE as the first line treatment of LAPC and IRE was associated with severe complications. This study does not support percutaneous IRE in this setting.

Emneord
Pancreatic Neoplasms, Electroporation, Interventional Ultrasonography
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-365201 (URN)10.21873/anticanres.13371 (DOI)000469427800032 ()31092446 (PubMedID)
Tilgjengelig fra: 2018-11-11 Laget: 2018-11-11 Sist oppdatert: 2019-06-26bibliografisk kontrollert
Schiza, A., Wenthe, J., Mangsbo, S., Eriksson, E., Nilsson, A., Tötterman, T., . . . Ullenhag, G. (2017). Adenovirus-mediated CD40L gene transfer increases teffector/tregulatory cell ratio and upregulates death receptors in metastatic melanoma patients. Paper presented at 44th Annual Meeting of the Scandinavian-Society-for-Immunology (SSI), OCT 17-20, 2017, Stockholm, SWEDEN. Scandinavian Journal of Immunology, 86(4), 337-337
Åpne denne publikasjonen i ny fane eller vindu >>Adenovirus-mediated CD40L gene transfer increases teffector/tregulatory cell ratio and upregulates death receptors in metastatic melanoma patients
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2017 (engelsk)Inngår i: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 86, nr 4, s. 337-337Artikkel i tidsskrift, Meeting abstract (Annet vitenskapelig) Published
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-346969 (URN)000411865200209 ()
Konferanse
44th Annual Meeting of the Scandinavian-Society-for-Immunology (SSI), OCT 17-20, 2017, Stockholm, SWEDEN
Tilgjengelig fra: 2018-03-28 Laget: 2018-03-28 Sist oppdatert: 2018-03-28bibliografisk kontrollert
Frühling, P., Nilsson, A., Duraj, F., Haglund, U. & Norén, A. (2017). Single-center nonrandomized clinical trial to assess the safety and efficacy of irreversible electroporation (IRE) ablation of liver tumors in humans: Short to mid-term results. European Journal of Surgical Oncology, 43(4), 751-757
Åpne denne publikasjonen i ny fane eller vindu >>Single-center nonrandomized clinical trial to assess the safety and efficacy of irreversible electroporation (IRE) ablation of liver tumors in humans: Short to mid-term results
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2017 (engelsk)Inngår i: European Journal of Surgical Oncology, ISSN 0748-7983, E-ISSN 1532-2157, Vol. 43, nr 4, s. 751-757Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Introduction: A single-center nonrandomized clinical trial was performed to assess the safety and efficacy of IRE ablation of liver tumors in humans.

Methods: 38 malignant liver tumors on 30 patients were treated with IRE between September 2011 and September 2014. Treatment was with curative intent, and the diagnoses were colorectal cancer with liver metastases (CRLM) (n = 23), hepatocellular carcinoma (HCC) (n = 8) and other metastasis (n = 7). Patients were selected when surgery, radiofrequency ablation (RFA) or microwave ablation (MWA) was not an option, and when they met inclusion criteria (tumor size < 3 cm, 1-2 tumors). Patients were followed-up at 1 and 6 months with a contrast-enhanced computed tomography (CE-CT), and contrast-enhanced ultrasound (CE-US) at 3 months.

Results: Ablation success was defined as no evidence of residual tumor in the ablated area as confirmed by CE-CT and CE-US. At 3 months ablation success was 78.9%, and 65.8% at 6 months. There was no statistically significant difference between tumor volume (<5 cm(3) vs >5 cm(3), p = 0.518), and between diagnosis (CRLM vs HCC, p = 0.084) in terms of local recurrence. Complications were classified according to the standardized grading system of Society of Interventional Radiology (SIR). A minor complication occurred in six palients (20%), one patient (3.3%) suffered from a major complication (bile duct dilatation and stricture of the portal vein and bile duct). No mortalities occurred at 30 days.

Conclusions: IRE appears to be a safe treatment modality for a selected group of patients with liver tumors and offers high local tumor control at 3 and 6 months.

Emneord
Liver tumors, Irreversible electroporation, Interventional ultrasonography, Colorectal cancer
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-322839 (URN)10.1016/j.ejso.2016.12.004 (DOI)000399853900020 ()28109674 (PubMedID)
Tilgjengelig fra: 2017-06-08 Laget: 2017-06-08 Sist oppdatert: 2017-06-08bibliografisk kontrollert
Loskog, A., Maleka, A., Mangsbo, S., Svensson, E., Lundberg, C., Nilsson, A., . . . Ullenhag, G. (2016). Immunostimulatory AdCD40L gene therapy combined with low-dose cyclophosphamide in metastatic melanoma patients. British Journal of Cancer, 114(8), 872-880
Åpne denne publikasjonen i ny fane eller vindu >>Immunostimulatory AdCD40L gene therapy combined with low-dose cyclophosphamide in metastatic melanoma patients
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2016 (engelsk)Inngår i: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 114, nr 8, s. 872-880Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BACKGROUND: Current approaches for treating metastatic malignant melanoma (MM) are not effective enough and are associated with serious adverse events. Due to its immunogenicity, melanoma is an attractive target for immunostimulating therapy. In this phase I/IIa study, local AdCD40L immunostimulatory gene therapy was evaluated in patients with MM.

METHODS: AdCD40L is an adenovirus carrying the gene for CD40 ligand. Patients that failed standard treatments were enrolled. Six patients received four weekly intratumoral AdCD40L injections. Next, nine patients received low-dose cyclophosphamide conditioning before the first and fourth AdCD40L injection. The blood samples were collected at multiple time points for chemistry, haematology and immunology evaluations. Radiology was performed at enrolment and repeated twice after the treatment.

RESULTS: AdCD40L was safe with mild transient reactions. No objective responses were recorded by MRI, however, local and distant responses were seen on FDG-PET. The overall survival at 6 months was significantly better when cyclophosphamide was added to AdCD40L. The patients with the best survival developed the highest levels of activated T cells and experienced a pronounced decrease of intratumoral IL8.

CONCLUSIONS: AdCD40L therapy for MM was well tolerated. Local and distant responses along with better survival in the low-dose cyclophosphamide group are encouraging.

HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-295735 (URN)10.1038/bjc.2016.42 (DOI)000374129200004 ()27031851 (PubMedID)
Forskningsfinansiär
Swedish Cancer Society
Tilgjengelig fra: 2016-06-09 Laget: 2016-06-09 Sist oppdatert: 2018-02-20bibliografisk kontrollert
Månsson, C., Nilsson, A., Månsson, D. & Karlson, B.-M. (2015). Response from the authors of the original article. Comment to: Mansson C, Nilsson A, Karlson B-M. Severe complications with irreversible electroporation of the pancreas in the presence of a metallic stent: a warning of a procedure that never should be performed. ACTA RADIOLOGICA OPEN, 4(9), Article ID UNSP 2058460115603876.
Åpne denne publikasjonen i ny fane eller vindu >>Response from the authors of the original article. Comment to: Mansson C, Nilsson A, Karlson B-M. Severe complications with irreversible electroporation of the pancreas in the presence of a metallic stent: a warning of a procedure that never should be performed
2015 (engelsk)Inngår i: ACTA RADIOLOGICA OPEN, ISSN 2058-4601, Vol. 4, nr 9, artikkel-id UNSP 2058460115603876Artikkel i tidsskrift, Editorial material (Annet vitenskapelig) Published
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-276947 (URN)10.1177/2058460115603876 (DOI)000366018500004 ()
Tilgjengelig fra: 2016-02-23 Laget: 2016-02-16 Sist oppdatert: 2016-02-23bibliografisk kontrollert
Månsson, C., Bergenfeldt, M., Brahmstaedt, R., Karlson, B.-M., Nygren, P. & Nilsson, A. (2014). Safety and Preliminary Efficacy of Ultrasound-guided Percutaneous Irreversible Electroporation for Treatment of Localized Pancreatic Cancer. Anticancer Research, 34(1A), 289-293
Åpne denne publikasjonen i ny fane eller vindu >>Safety and Preliminary Efficacy of Ultrasound-guided Percutaneous Irreversible Electroporation for Treatment of Localized Pancreatic Cancer
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2014 (engelsk)Inngår i: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 34, nr 1A, s. 289-293Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background:

Irreversible electroporation (IRE) is a local tumor treatment. Thin needles are placed percutaneously around the tumor under ultrasound guidance. Short pulses of direct current sent through the tissue irreversibly increase cell membrane permeability leading to cell death. We report a phase I study assessing the safety of ultrasound guided percutaneous IRE in patients with localized pancreatic cancer (LPC).

Patients and Methods:

Five patients (three males) with LPC, judged unsuitable for surgery, chemotherapy, or non-resectable after standard oncological treatment, were treated with IRE. The treatment was given under general anesthesia with muscle relaxation.

Results:

No serious treatment-related adverse events were observed. There was no 30-day mortality. One patient went on to laparotomy and had a R0 pancreaticoduodenectomy with portal vein resection. Six months after the treatment, two patients had no signs of recurrence on computed tomography or contrast-enhanced ultrasound.

Conclusion:

IRE for LPC can be safely performed percutaneously under ultrasound guidance, with promising initial results regarding efficacy.

Emneord
Pancreatic cancer, tumor ablation, safety, irreversible electroporation, ultrasound guidance
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-218956 (URN)000329765300037 ()24403476 (PubMedID)
Tilgjengelig fra: 2014-02-20 Laget: 2014-02-20 Sist oppdatert: 2018-11-15bibliografisk kontrollert
Magnusson, A., Geterud, K., Brekkan, E., Lindqvist, K., Dahlman, P., Lönnemark, M., . . . Hellström, M. (2014). Ultraljud vs DT vid uretärsten: svenska rutiner gäller. Läkartidningen, 111(49-50), 2236-2237
Åpne denne publikasjonen i ny fane eller vindu >>Ultraljud vs DT vid uretärsten: svenska rutiner gäller
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2014 (svensk)Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, nr 49-50, s. 2236-2237Artikkel i tidsskrift (Annet vitenskapelig) Published
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-244935 (URN)25584570 (PubMedID)
Tilgjengelig fra: 2015-02-23 Laget: 2015-02-23 Sist oppdatert: 2017-12-04bibliografisk kontrollert
Sällström, J., Peuckert, C., Gao, X., Larsson, E., Nilsson, A., Jensen, B. L., . . . Carlström, M. (2013). Impaired EphA4 signaling leads to congenital hydronephrosis, renal injury, and hypertension. AM J PHYSIOL-RENAL, 305(1), F71-F79
Åpne denne publikasjonen i ny fane eller vindu >>Impaired EphA4 signaling leads to congenital hydronephrosis, renal injury, and hypertension
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2013 (engelsk)Inngår i: AM J PHYSIOL-RENAL, ISSN 1931-857X, Vol. 305, nr 1, s. F71-F79Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Experimental hydronephrosis induced by partial ureteral obstruction at 3 wk of age causes hypertension and renal impairment in adult rats and mice. Signaling by Ephrin receptors (Eph) and their ligands (ephrins) importantly regulates embryonic development. Genetically modified mice, where the cytoplasmic domain of the EphA4 receptor has been substituted by enhanced green fluorescent protein (EphA4(gf/gf)), develop spontaneous hydronephrosis and provide a model for further studies of the disorder. The present study aimed to determine if animals with congenital hydronephrosis develop hypertension and renal injuries, similar to that of experimental hydronephrosis. Ultrasound and Doppler techniques were used to visualize renal impairment in the adult mice. Telemetric blood pressure measurements were performed in EphA4(gf/gf) mice and littermate controls (EphA4(+/+)) during normal (0.7% NaCl)- and high (4% NaCl)-sodium conditions. Renal excretion, renal plasma flow, and glomerular filtration were studied, and histology and morphology of the kidneys and ureters were performed. EphA4(gf/gf) mice developed variable degrees of hydronephrosis that correlated with their blood pressure level. In contrast to EphA4(+/+), the EphA4(gf/gf) mice displayed salt-sensitive hypertension, reduced urine concentrating ability, reduced renal plasma flow, and lower glomerular filtration rate. Kidneys from EphA4(gf/gf) mice showed increased renal injuries, as evidenced by fibrosis, inflammation, and glomerular and tubular changes. In conclusion, congenital hydronephrosis causes hypertension and renal damage, similar to that observed in experimentally induced hydronephrosis. This study further reinforces the supposed causal link between hydronephrosis and later development of hypertension in humans.

Emneord
ephrin, gene modified mice, human disorder, receptor, ureteral obstruction
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-206655 (URN)10.1152/ajprenal.00694.2012 (DOI)000321193500009 ()
Tilgjengelig fra: 2013-09-03 Laget: 2013-09-02 Sist oppdatert: 2013-09-03bibliografisk kontrollert
Norlén, O., Nilsson, A., Krause, J., Stålberg, P., Hellman, P. & Sundin, A. (2012). 11C-5-hydroxytryptophan positron emission tomography after radiofrequency ablation of neuroendocrine tumor liver metastases. Nuclear Medicine and Biology, 39(6), 883-890
Åpne denne publikasjonen i ny fane eller vindu >>11C-5-hydroxytryptophan positron emission tomography after radiofrequency ablation of neuroendocrine tumor liver metastases
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2012 (engelsk)Inngår i: Nuclear Medicine and Biology, ISSN 0969-8051, E-ISSN 1872-9614, Vol. 39, nr 6, s. 883-890Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Aim: The aim was to assess the feasibility of C-11-5-hydroxy-tryptophan positron emission tomography ( C-11-5-HTP-PET) in the follow-up after radiofrequency ablation (RFA) of liver metastases from neuroendocrine tumors (NETS). Background: Contrast-enhanced computed tomography (CECT) and contrast-enhanced ultrasound (CEUS) are commonly used to evaluate the liver after RFA of NETs. In general, C-11-5-HTP-PET is more sensitive in the visualization of NETs, but no studies have investigated its role after RFA.

Methods: Six consecutive patients with liver metastases from NETs were subjected to RFA treatment. All patients underwent baseline imaging before RFA and on two occasions (1-2 and 6-11 months) after RFA. The imaging consisted of C-11-5-HTP-PET, CEUS and CECT on all three occasions.

Results: Thirty RFA areas were evaluated, and residual tumors (RTs) were depicted in eight areas (22%). C-11-5-HTP-PET depicted RTs after RFA with maximum sensitivity (100%) and specificity (100%), using radiological follow-up as the gold standard. C-11-5-HTP-PET detected five out of eight RTs earlier than CECT or CEUS. In general, the sensitivity of C-11-5-HTP-PET exceeded that of CECT and CEUS for early visualization of NET liver metastases.

Conclusion: C-11-5-HTP-PET can be used in the follow-up after RFA for the purpose of detecting RT, and it provides additional information to CEUS and CECT by detecting new lesions.

HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-181929 (URN)10.1016/j.nucmedbio.2011.12.013 (DOI)000307041000018 ()
Tilgjengelig fra: 2012-10-02 Laget: 2012-10-02 Sist oppdatert: 2017-12-07bibliografisk kontrollert
Krause, J., Bergman, A., Graf, W., Nilsson, A. & Mahteme, H. (2012). Ultrasonography findings and tumour quantification in patients with pseudomyxoma peritonei. European Journal of Radiology, 81(4), 648-651
Åpne denne publikasjonen i ny fane eller vindu >>Ultrasonography findings and tumour quantification in patients with pseudomyxoma peritonei
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2012 (engelsk)Inngår i: European Journal of Radiology, ISSN 0720-048X, E-ISSN 1872-7727, Vol. 81, nr 4, s. 648-651Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Pseudomyxoma peritonei (PMP) is a disease with various clinical presentations and the diagnostic value of ultrasonography (US) is under investigated. The purpose of this study was to identify the most common US finding in PMP and to investigate US sensitivity, specificity, positive and negative predictive value in quantifying tumour burden in different abdomino-pelvic regions in PMP patients. Between February 2006 and December 2008, 54 patients were treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) due to PMP. The results from preoperative US examination with and without intravenously administrated contrast (SonoVue) were compared to surgical findings. The mean US peritoneal cancer index (PCI) was 6 (range 0-25) and the surgical PCI was 18 (range 3-27) p<0.0001. The histo-pathological subtypes did not influence the US findings. Ascites, bowel loops adhesions and omental cake were mostly visualised correctly by US. The sensitivity of US in quantification of tumour nodules was 91.5% (range 74-100%) and specificity was 33.8% (range 18-55%). The positive predictive value of US examination in PMP was 22% (range 11-44%) and the negative predictive value was 93% (range 77-100%). US can detect the most common PMP findings (ascites and omental cake). The sensitivity of US to quantify PMP tumour burden in different abdominio-pelvic region was relatively high, however, this imaging tool had low specificity.

Emneord
Peritoneal carcinomatosis, Hyperthermia, Prophylactic strategy, Sugarbaker Protocol/techniques, Mainland China
HSV kategori
Identifikatorer
urn:nbn:se:uu:diva-165400 (URN)10.1016/j.ejrad.2011.01.033 (DOI)000301372300051 ()21349674 (PubMedID)
Tilgjengelig fra: 2012-01-05 Laget: 2012-01-05 Sist oppdatert: 2017-12-08bibliografisk kontrollert
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