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Bergström, Stefan
Publications (10 of 12) Show all publications
Nilsson, J., Holgersson, G., Jaras, J., Bergström, S. & Bergqvist, M. (2018). The role of income in brain tumor patients: a descriptive register-based study. Medical Oncology, 35(4), Article ID 52.
Open this publication in new window or tab >>The role of income in brain tumor patients: a descriptive register-based study
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2018 (English)In: Medical Oncology, ISSN 1357-0560, E-ISSN 1559-131X, Vol. 35, no 4, article id 52Article in journal (Refereed) Published
Abstract [en]

Socioeconomic status (SES) and its association with cancer in general have been thoroughly studied in the last decades. Several studies have shown associations between SES and many types of cancer such as lung cancer, breast cancer, and prostate cancer. For gliomas, no clear occupational or exposure risk factors have been identified, although some possible risk factors such as use of cellular telephone are still controversial. The aim in the present study is to analyze whether there is an association between SES and development of brain cancer. Data from 1999 through 2013 were collected from the Swedish Cancer Registry and from the National Statistics of Sweden. Age-standardized incidence rates for people with different income were calculated using linear regression model. A total of 11,892 patients were included, of which 5675 were meningiomas, 1216 low-grade gliomas, and 5001 high-grade gliomas. No clear trend between increasing incidence rates and higher income was seen in neither of the investigated brain tumor histologies. In conclusion, the results should be interpreted with caution, but there does not seem to be a correlation in this material between increased income and development of brain cancer.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Brain cancer, Incidence trend, Income, Cancer Register, Socioeconomic status
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-351691 (URN)10.1007/s12032-018-1108-5 (DOI)000428784500009 ()29532282 (PubMedID)
Available from: 2018-06-04 Created: 2018-06-04 Last updated: 2018-06-04Bibliographically approved
Nilsson, J., Holgersson, G., Carlsson, T., Henriksson, R., Bergström, S. & Bergqvist, M. (2017). Incidence trends in high-grade primary brain tumors in males and females. Oncology Letters, 13(4), 2831-2837
Open this publication in new window or tab >>Incidence trends in high-grade primary brain tumors in males and females
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2017 (English)In: Oncology Letters, ISSN 1792-1074, E-ISSN 1792-1082, Vol. 13, no 4, p. 2831-2837Article in journal (Refereed) Published
Abstract [en]

The focus of the present review is to investigate whether there is a variation in the incidence rates between male and female patients with high-grade primary brain tumors and if there are altered incidence rates associated with the time at which they were diagnosed. Previous studies identified in internationally peer-reviewed journals were identified using a systematic search of the PubMed database. Due to the difficulties in data interpretation, studies that exclusively included patient data classified prior to the 2nd edition of the World Health Organization histological classification system of brain tumors were excluded. The overall incidence rates and incidence trends of male and female patients were analyzed separately. The mean age-adjusted overall incidence rate in the male population was 1.27 per 100,000 compared with 0.89 per 100,000 in the female population. The variance between the two genders differed and a Wilcoxon rank-sum test indicated that there was no significant difference in the incidence rate of high-grade primary brain tumors between males and females (P=0.3658). Furthermore, there was no significant difference in incidence rate trend between 1996-2004 and 2005-2010 for male or female populations (P=0.101 and P=0.472, respectively). The results from the present systematic review did not demonstrate a significant difference in incidence rate between the two genders. Therefore, the results from the current study are considered to be preliminary and further studies are required to elucidate this issue.

Keywords
incidence trends, high-grade brain tumors, gender
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-321444 (URN)10.3892/ol.2017.5770 (DOI)000398514200119 ()
Available from: 2017-05-05 Created: 2017-05-05 Last updated: 2017-05-05
Holgersson, G., Bergström, S., Hallqvist, A., Liv, P., Nilsson, J., Willen, L., . . . Bergqvist, M. (2017). The prognostic value of pre-treatment thrombocytosis in two cohorts of patients with non-small cell lung cancer treated with curatively intended chemoradiotherapy. Neoplasma (Bratislava), 64(6), 909-915
Open this publication in new window or tab >>The prognostic value of pre-treatment thrombocytosis in two cohorts of patients with non-small cell lung cancer treated with curatively intended chemoradiotherapy
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2017 (English)In: Neoplasma (Bratislava), ISSN 0028-2685, E-ISSN 1338-4317, Vol. 64, no 6, p. 909-915Article in journal (Refereed) Published
Abstract [en]

Chemoradiotherapy is the standard of care for inoperable stage III non-small cell lung cancer (NSCLC). This treatment, however, offers only a small chance of cure and is associated with many side effects. Little research has been made concerning which patients benefit most/least from the treatment. The present study evaluates the prognostic value of anemia, leukocytosis and thrombocytosis at diagnosis in this treatment setting. In the present study, data were collected retrospectively for 222 patients from two different phase II studies conducted between 2002-2007 in Sweden with patients treated with chemoradiotherapy for stage IIIA-IIIB NSCLC. Clinical data and the serum values of hemoglobin (Hgb), White blood cells (WBC) and Platelets (Plt) at enrollment were collected for all patients and studied in relation to overall survival using Kaplan-Meier product-limit estimates and a multivariate Cox proportional hazards regression model.

The results showed that patients with thrombocytosis (Plt > 350 x 109/L) had a shorter median overall survival (14.5 months) than patients with normal Plt at baseline (23.7 months). Patients with leukocytosis (WBC > 9 x 109/L) had a shorter median survival (14.9 months) than patients with a normal WBC at baseline (22.5 months). However, in a multivariate model including all lab parameters and clinical factors, only thrombocytosis and performance status displayed a prognostic significance.

In Conclusion, thrombocytosis showed to be an independent prognostic marker associated with shorter overall survival in stage III NSCLC treated with curatively intended chemoradiotherapy. This knowledge can potentially be used together with established prognostic factors, such as performance status when choosing the optimal therapy for the individual patient in this clinical setting.

Keywords
NSCLC, anemia, leukocytosis, thrombocytosis, prognostic, survival
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-339512 (URN)10.4149/neo_2017_614 (DOI)000418756500013 ()28895417 (PubMedID)
Available from: 2018-01-19 Created: 2018-01-19 Last updated: 2018-01-19Bibliographically approved
Nilsson, J., Berglund, A., Bergström, S., Bergqvist, M. & Lambe, M. (2017). The role of comorbidity in the management and prognosis in nonsmall cell lung cancer: a population-based study. Acta Oncologica, 56(7), 949-956
Open this publication in new window or tab >>The role of comorbidity in the management and prognosis in nonsmall cell lung cancer: a population-based study
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2017 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 56, no 7, p. 949-956Article in journal (Refereed) Published
Abstract [en]

Background: Coexisting disease constitutes a challenge for the provision of optimal cancer care. The influence of comorbidity on lung cancer management and prognosis remains incompletely understood. We assessed the influence of comorbidity on treatment intensity and prognosis in a population-based setting in patients with nonsmall cell lung cancer.Material and methods: Our study was based on information available in Lung Cancer Data Base Sweden (LcBaSe), a database generated by record linkage between the National Lung Cancer Register (NLCR) and several other population-based registers in Sweden. The NLCR includes data on clinical characteristics on 95% of all patients with lung cancer in Sweden since 2002. Comorbidity was assessed using the Charlson Comorbidity Index. Logistic regression and time to event analysis was used to address the association between comorbidity and treatment and prognosis.Results: In adjusted analyses encompassing 19,587 patients with a NSCLC diagnosis and WHO Performance Status 0-2 between 2002 and 2011, those with stage-IA-IIB disease and severe comorbidity were less likely to be offered surgery (OR: 0.45; 95% CI: 0.36-0.57). In late-stage disease (IIIB-IV), severe comorbidity was also associated with lower chemotherapy treatment intensity (OR: 0.76; 95% CI: 0.65-0.89). In patients with early, but not late-stage disease, severe comorbidity in adjusted analyses was associated with an increased all-cause mortality, while lung cancer-specific mortality was largely unaffected by comorbidity burden.Conclusions: Comorbidity contributes to the poor prognosis in NSCLC patients. Routinely published lung cancer survival statistics not considering coexisting disease conveys a too pessimistic picture of prognosis. Optimized management of comorbid conditions pre- and post-NSCLC-specific treatment is likely to improve outcomes.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2017
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-323491 (URN)10.1080/0284186X.2017.1324213 (DOI)000401721200008 ()28486004 (PubMedID)
Funder
Swedish Cancer Society
Available from: 2017-06-22 Created: 2017-06-22 Last updated: 2017-06-22Bibliographically approved
Nilsson, J., Kallman, M., Ostlund, U., Holgersson, G., Bergqvist, M. & Bergström, S. (2016). The Use of Complementary and Alternative Medicine in Scandinavia. Anticancer Research, 36(7), 3243-3251
Open this publication in new window or tab >>The Use of Complementary and Alternative Medicine in Scandinavia
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2016 (English)In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 36, no 7, p. 3243-3251Article, review/survey (Refereed) Published
Abstract [en]

Background: Complementary alternative medicine (CAM) is widely used among patients with cancer. This usage may have potentially harmful effects, especially when combined with anticancer drugs. However, some complementary methods may benefit patients. This review investigated the prevalence of CAM use among patients with cancer in Scandinavia and secondly studied the educational levels of CAM users compared to non-users. Materials and Methods: A systematic search of the PubMed library was carried out to locate articles published between January 2000 and October 2015 that investigated prevalence of CAM use among Scandinavian patients with cancer. Results: Twenty-two articles were found, of which nine were included in the review. The prevalence of CAM use was 7.9% to 53%, with an average of 36.0% across all studies. Conclusion: Use of CAM is widespread among patients with cancer. Knowledge about CAM should be disseminated to both patients and staff in order to optimise discussions about CAM in clinical practice.

Keywords
Complementary alternative medicine, CAM, Scandinavia, review
National Category
Other Health Sciences
Identifiers
urn:nbn:se:uu:diva-300621 (URN)000378867600002 ()27354580 (PubMedID)
Available from: 2016-08-10 Created: 2016-08-10 Last updated: 2018-02-26Bibliographically approved
Holgersson, G., Bergström, S., Harmenberg, J., Ringbom, M., Klockare, M., Jerling, M., . . . Bergqvist, M. (2015). A phase I pilot study of the insulin-like growth factor 1 receptor pathway modulator AXL1717 in combination with gemcitabine HCl and carboplatin in previously untreated, locally advanced, or metastatic non-small cell lung cancer. Medical Oncology, 32(4), Article ID 129.
Open this publication in new window or tab >>A phase I pilot study of the insulin-like growth factor 1 receptor pathway modulator AXL1717 in combination with gemcitabine HCl and carboplatin in previously untreated, locally advanced, or metastatic non-small cell lung cancer
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2015 (English)In: Medical Oncology, ISSN 1357-0560, E-ISSN 1559-131X, Vol. 32, no 4, article id 129Article in journal (Refereed) Published
Abstract [en]

AXL1717 is an orally bioavailable IGF-1R pathway modulator that has been shown to have anti-tumoral effects. The objectives of the present study were to define maximum tolerated dose and the recommended phase II dose (RPTD) of AXL1717 in combination with gemcitabine HCl and carboplatin in non-small cell lung cancer (NSCLC). Patients with previously untreated, locally advanced, or metastatic NSCLC (squamous cell cancer or adenocarcinoma) in good performance status and with preserved major organ functions were enrolled in the study. The study was an open-label phase I study with planned cohorts of three patients per dose level of AXL1717 (215, 290, and 390 mg BID). In total, 12 patients were enrolled in the study, and of these, two were prematurely excluded. AXL1717 was administered at one dose level, 215 mg BID. A total number of 81 unique adverse events were reported. Bone marrow toxicity was reported in 10 out of 12 patients, and this organ class showed the largest number of related events. AXL1717 in combination with gemcitabine HCl and carboplatin is a possible treatment approach in previously untreated, locally advanced, or metastatic non-small cell lung cancer. However, due to the bone marrow toxicity profile shown in the present study, further dose increases of AXL1717 above 215 mg BID will probably not be feasible. Therefore, 215 mg BID constitutes maximum tolerated dose and RPTD.

Keywords
Phase I, IGF-1, AXL1717, Chemotherapy, NSCLC
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-258837 (URN)10.1007/s12032-015-0578-y (DOI)000351474100043 ()25794491 (PubMedID)
Available from: 2015-07-23 Created: 2015-07-20 Last updated: 2018-02-26Bibliographically approved
Holgersson, G., Bergström, S., Liv, P., Nilsson, J., Edlund, P., Blomberg, C., . . . Bergqvist, M. (2015). Effect of Increased Radiotoxicity on Survival of Patients with Non-small Cell Lung Cancer Treated with Curatively Intended Radiotherapy. Anticancer Research, 35(10), 5491-5497
Open this publication in new window or tab >>Effect of Increased Radiotoxicity on Survival of Patients with Non-small Cell Lung Cancer Treated with Curatively Intended Radiotherapy
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2015 (English)In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 35, no 10, p. 5491-5497Article in journal (Refereed) Published
Abstract [en]

Aim: To elucidate the impact of different forms of radiation toxicities (esophagitis, radiation pneumonitis, mucositis and hoarseness), on the survival of patients treated with curatively intended radiotherapy for non-small cell lung cancer (NSCLC). Patients and Methods: Data were individually collected retrospectively for all patients diagnosed with NSCLC subjected to curatively intended radiotherapy (>= 50 Gy) in Sweden during the time period 1990 to 2000. Results: Esophagitis was the only radiation-induced toxicity with an impact on survival (hazard ratio=0.83, p=0.016). However, in a multivariate model, with clinical-and treatment-related factors taken into consideration, the impact of esophagitis on survival was no longer statistically significant (hazard ratio=0.88, p=0.17). Conclusion: The effect on survival seen in univariate analysis may be related to higher radiation dose and to the higher prevalence of chemotherapy in this group. The results do not suggest that the toxicities examined have any detrimental effect on overall survival.

Keywords
NSCLC, radiotherapy, toxicity, esophagitis, survival
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-265679 (URN)000361823200042 ()26408714 (PubMedID)
Available from: 2015-11-04 Created: 2015-11-02 Last updated: 2017-12-01Bibliographically approved
Blomberg, C., Nilsson, J., Holgersson, G., Edlund, P., Bergqvist, M., Adwall, L., . . . Bergström, S. (2015). Randomized Trials of Systemic Medically-treated Malignant Mesothelioma: A Systematic Review. Anticancer Research, 35(5), 2493-2501
Open this publication in new window or tab >>Randomized Trials of Systemic Medically-treated Malignant Mesothelioma: A Systematic Review
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2015 (English)In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 35, no 5, p. 2493-2501Article, review/survey (Refereed) Published
Abstract [en]

Malignant pleural mesothelioma (MPM) is a rare but aggressive malignancy mainly localized to the pleura. Malignant mesothelioma grows highly invasive into surrounding tissue and has a low tendency to metastasize. The median overall survival (OS) of locally advanced or metastatic disease without treatment is 4-13 months but, during recent years, improvement in survival has been achieved since treatment for patients with mesothelioma has improved with better palliative care, systemic medical treatment, surgery and improved diagnostics methods. The present review aims at describing available data from randomized trials considering systemic medical treatment for this patient category.

Keywords
Malignant mesothelioma, randomized trials, review
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-257356 (URN)000354267200003 ()
Available from: 2015-07-03 Created: 2015-07-01 Last updated: 2017-12-04Bibliographically approved
Sooman, L., Ekman, S., Tsakonas, G., Jaiswal, A., Navani, S., Edqvist, P.-H., . . . Lennartsson, J. (2014). PTPN6 expression is epigenetically regulated and influences survival and response to chemotherapy in high-grade gliomas. Tumor Biology, 35(5), 4479-4488
Open this publication in new window or tab >>PTPN6 expression is epigenetically regulated and influences survival and response to chemotherapy in high-grade gliomas
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2014 (English)In: Tumor Biology, ISSN 1010-4283, E-ISSN 1423-0380, Vol. 35, no 5, p. 4479-4488Article in journal (Refereed) Published
Abstract [en]

Background: The prognosis of high-grade glioma patients is poor and the tumors are characterized by resistance to therapy. The aims of this study were to analyze the prognostic value of the expression of the protein tyrosine phosphatase, non-receptor type 6 (PTPN6, also referred to as SHP1) in high-grade glioma patients and the epigenetic regulation of the expression of PTPN6 and the role of its expression in chemotherapy resistance in glioma-derived cells.

Material and methods: PTPN6 expression was analyzed with immunohistochemistry in 89 high-grade glioma patients. Correlation between PTPN6 expression and overall survival was analyzed with Kaplan-Meier univariate analysis and Cox regression multivariate analysis. Differences in drug sensitivity to a panel of 16 chemotherapeutic drugs between PTPN6 overexpressing clones and control clones were analyzed in vitro with the fluorometric microculture cytotoxicity assay. Cell cycle analysis was done with Krishan staining and flow cytometry. Apoptosis was analyzed with a cell death detection ELISA kit as well as cleaved caspase-3 and caspase-9 Western blotting. Autophagy was analyzed with LC3B Western blotting. Methylation of the PTPN6 promoter was analyzed with bisulfite-Pyrosequencing and demethylation of PTPN6 was done with decitabine treatment.

Results: PTPN6 expression correlated in univariate analysis to poor survival for anaplastic glioma patients (p=0.026). In glioma-derived cell lines, overexpression of PTPN6 caused increased resistance (p<0.05) to the chemotherapeutic drugs bortezomib, cisplatin and melphalan. PTPN6 expression did not affect bortezomib-induced cell cycle arrest, apoptosis or autophagy. Low PTPN6 promoter methylation correlated to protein expression and the protein expression was increased upon demethylation in glioma-derived cells.

Conclusion: PTPN6 expression may be a factor contributing to poor survival for anaplastic glioma patients and in glioma-derived cells its expression is epigenetically regulated and influences the response to chemotherapy.

Keywords
high-grade glioma, PTPN6, SHP1, survival, chemotherapy, methylation
National Category
Cell and Molecular Biology
Identifiers
urn:nbn:se:uu:diva-214761 (URN)10.1007/s13277-013-1590-5 (DOI)000335759800063 ()
Available from: 2014-01-09 Created: 2014-01-09 Last updated: 2018-01-11Bibliographically approved
Johansson, F., Ekman, S., Blomquist, E., Henriksson, R., Bergström, S. & Bergqvist, M. (2012). A Review of Dose-dense Temozolomide Alone and in Combination with Bevacizumab in Patients with First Relapse of Glioblastoma. Anticancer Research, 32(9), 4001-4006
Open this publication in new window or tab >>A Review of Dose-dense Temozolomide Alone and in Combination with Bevacizumab in Patients with First Relapse of Glioblastoma
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2012 (English)In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 32, no 9, p. 4001-4006Article, review/survey (Refereed) Published
Abstract [en]

Treatment of patients with glioblastoma improved dramatically when concomitant and adjuvant temozolomide was added to external radiation therapy. The addition of this new treatment schedule as well as the improvements in individually-tailored radiation treatment, has resulted in a larger proportion of patients being fit for further treatment after first relapse. One of the most interesting combinations that have started to become part of the therapeutic arsenal in the daily clinic is dose-dense temozolomide in combination with bevacizumab. We reviewed and compiled the literature concerning the present topic based on a search of the PubMed database (http://www.ncbi.nlm.nih.gov/pubmed/) for the years between 1995 and 2011. The clinical studies that have been performed are small and divergent, making it difficult to grade the scientific evidence for the combinatorial treatment of dose-dense temozolomide and bevacizumab. However, the available studies and the experience we have at our departments suggest that this combination is of interest for glioblastoma patients experiencing first relapse. More randomized clinical trials are needed in order to establish the standard of treatment at first relapse in patients with glioblastoma.

Keywords
Dose-dense, temozolomide, bevacizumab, glioblastoma, relapse, review
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-184594 (URN)000309243200054 ()22993350 (PubMedID)
Available from: 2012-11-09 Created: 2012-11-09 Last updated: 2017-12-07Bibliographically approved
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