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M Albertsson

Publications and source records attributed to M Albertsson.

At least 19 recordsLinked to original sources
PubMed2002

A double-blind, randomised, parallel group, multinational, multicentre study comparing a single dose of ondansetron 24 mg p.o. with placebo and metoclopramide 10 mg t.d.s. p.o. in the treatment of opioid-induced nausea and emesis in cancer patients.

Nausea and emesis are common side effects of opioid drugs administered for pain relief in cancer patients. The aim of this study was to compare the anti-emetic efficacy and safety of ondansetron, placebo and metoclopramide in the treatment of opioid-induced nausea and emesis (OIE) in cancer patients. This was a multinational, multicentre, double-blind, parallel group study in which cancer patients who were receiving a full opioid agonist for cancer pain were randomised to receive one of oral ondansetron 24 mg once daily, metoclopramide 10 mg three times daily, or placebo. Study medication was started only if the patient experienced nausea and/or emesis following opioid administration. Efficacy and safety assessments were made over a study period of 24 h from the time of the first dose of anti-emetics/placebo. The study was terminated prematurely because of the difficulties in recruiting patients satisfying the stringent entry criteria. Ninety-two patients were included in the intent-to-treat population: 30 patients received placebo, 29 patients ondansetron and 33 patients metoclopramide. There was no statistically significant difference between the groups in the proportion achieving complete control of emesis (33% of patients on placebo, 48% on ondansetron and 52% on metoclopramide) or complete control of nausea (23% of patients on placebo, 17% on ondansetron and 36% on metoclopramide). Rescue anti-emetics were required in 8 of 33 patients on metoclopramide, 4 of 29 on ondansetron, and 3 of 30 on placebo. The incidence of adverse events was very low and similar in all treatment groups. Neither ondansetron 24 mg once daily nor metoclopromide 10 mg t.d.s. given orally was significantly more effective than placebo in the control of OIE in cancer patients.

Adult↗
PubMed2002

Pilocarpine treatment of xerostomia in head and neck patients.

We studied the effect of pilocarpine hydrochloride, a parasympathicomimetic agent, on major salivary gland output and subjective responses in 40 patients with salivary hypofunction. Pilocarpine increased salivary output or gave significant symptomatic relief in 21 of the 40 patients. The women fared better than the men. Side effects were uncommon, were generally mild, and caused no treatment interruption. These results indicate that pilocarpine is effective in relieving the signs and symptoms of postradiation xerostomia.

Female↗
PubMed2001

A Swedish study of chemoradiation in squamous cell carcinoma of the esophagus.

This multicenter study describes the development of a chemoradiation protocol for the treatment of non-metastatic squamous cell carcinoma of the esophagus. Eighty patients were treated with three courses of chemotherapy (cisplatinum and 5-fluorouracil) with concomitant radiotherapy (40 Gy) during the last two courses of chemotherapy. Esophagectomy was performed, when feasible. If no operation was performed, patients were planned to receive a target dose of 64 Gy. Toxicity was mainly attributable to hematological impairment and led to two adjustments of the treatment protocol (addition of filgrastim and lowering of the 5-fluorouracil dose). These changes made it possible to administer the planned treatment in a gradually higher proportion of patients (13/23 [57%] before changes of treatment compared with 30/36 [83%] after changes). Treatment-related mortality was 3.75% (3 patients, associated with leucopenic septicemia after chemotherapy). Fifty-four patients were resected. No per- or postoperative mortality was encountered. The complete response (pathological CR) rate in operated patients was 46% (27/59 patients) after chemoradiation. In the whole series the CR rate (including clinical CR for non-resected patients) was 44%. With a minimum follow-up of 37 months, the 3-year survival for the whole group was 31% compared with 57% for the CR patients. Total 5-year survival thus far (July 1999) is 26%.

Adult↗
PubMed2000

Author reply

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Journal Article↗
PubMed2000

The prognostic value of body protein in patients with lung cancer.

Lung cancer is a major cause of death in many countries. To improve the results of treatment, more individualized therapy is necessary; for this, it is necessary to identify new prognostic factors. In 21 patients with lung cancer (17 with non-small-cell lung cancer and 4 with small-cell lung cancer) that had received radiation treatment, the amount of body protein was estimated with in vivo neutron activation analysis. Patients in whom body protein decreased had recurrences of the disease earlier and a poorer survival than patients whose body protein increased. A clear relationship was seen between changes in the body's protein content and recurrence-free survival. To better evaluate the prognostic value of body protein content in patients with lung cancer, a larger number of patients and a longer follow-up period are needed.

Aged↗
PubMed1999

Megestrol acetate in advanced, progressive, hormone-insensitive cancer. Effects on the quality of life: a placebo-controlled, randomised, multicentre trial.

A randomised double-blind placebo-controlled multicentre trial was performed to investigate the effects of megestrol acetate (MA) on the quality of life (QoL), appetite, weight and survival of patients with advanced, incurable, hormone-insensitive cancer. QoL was assessed at the start of treatment and at 4, 8 and 12 weeks, using the EORTC-QLQ-C30 instrument. 255 patients were randomised to 320 mg of MA daily or placebo for 12 weeks. 244 patients were assessable at baseline, 190 at 4 weeks (placebo 94; MA 96), 150 at 8 weeks (placebo 69; MA 81) and 112 at 12 weeks (placebo 55; MA 57). A beneficial effect of MA on appetite loss was observed at week 4 (P < 0.0001) and possibly at week 8 (P = 0.058). Further weight loss during treatment was significant only in the placebo group. In the first 8 weeks, changes in mean global QoL were small and similar in both groups. By 12 weeks the decrease in mean global QoL was more pronounced in the MA group (P = 0.028), which was related to a deterioration in physical function, while psychosocial function was not affected. Survival was not affected by MA, and side-effects were mild. The results show that MA has a beneficial effect on appetite and that it may retard weight loss with no adverse impact on survival and with mild toxicity. However, MA does not appear to improve global QoL as measured by the EORTC QLQ-C30.

Adult↗
PubMed1999

A 252Cf-based instrument for in vivo body protein monitoring in cancer patients.

A hospital-based facility for in vivo prompt gamma neutron activation analysis of nitrogen for body protein determination is described. The patient is laid on a movable couch and is scanned with a vertically collimated neutron beam from a 252Cf neutron source (the amount of Cf varying from 120 to 40 microg due to the physical decay) positioned below the patient. Four large NaI(Tl) detectors are used to measure the 10.8 MeV gamma-rays from nitrogen. To check the long-term stability of the system, a solid phantom simulating the geometry of the adult human trunk, having similar elemental composition as tissue, was constructed. Repeated phantom measurements over 6 months gave a reproducibility in nitrogen determination of 2.9% (1 SD). Duplicate patient measurements carried out within a week showed a reproducibility of 5% (1 SD). A calibration method for absolute protein measurements in patients is presented. Patients are normally measured for 40 min; giving a mean whole-body equivalent dose of 0.25 mSv. Results from measurements on 13 cancer patients are presented.

Adult↗
PubMed1999

Effects of compression bandaging with or without manual lymph drainage treatment in patients with postoperative arm lymphedema.

We examined the effects of low stretch compression bandaging (CB) alone or in combination with manual lymph drainage (MLD) in 38 female patients with arm lymphedema after treatment for breast cancer. After CB therapy for 2 weeks (Part I), the patients were allocated to either CB or CB + MLD for 1 week (Part II). Arm volume and subjective assessments of pain, heaviness and tension were measured. The mean lymphedema volume reduction for the total group during Part I was 188 ml (p < 0.001), a mean reduction of 26% (p < 0.001). During Part II the volume reduction in the CB + MLD group was 47 ml (p < 0.001) and in CB group 20 ml. These differences were not significant (p = 0.07). A percentage reduction of 11% (p < 0.001) in the CB + MLD group and 4% in the CB group was significantly different (p = 0.04). In both the CB and the CB + MLD group, a decrease of feeling of heaviness (p < 0.006 and p < 0.001, respectively) and tension (p < 0.001 for both) in the arm was found, but only the CB + MLD group showed decreased pain (p < 0.03). Low stretch compression bandaging is an effective treatment giving volume reduction of slight or moderate arm lymphedema in women treated for breast cancer. Manual lymph drainage adds a positive effect.

Adult↗
PubMed1996

The influence of 5-fluorouracil and methotrexate on vascular endothelium. An experimental study using endothelial cells in the culture.

BACKGROUND: Cardiotoxicity still remains an unexplained toxic manifestation of 5-fluorouracil (5-FU). Clinical and experimental data suggest that endothelium of coronary arteries could be involved in the pathophysiological mechanisms of the syndrome. In order to further explain 5-FU induced cardiotoxicity, we investigated the influence of this drug on endothelial cells (EC) in a cell culture model. MATERIALS AND METHODS: The influence of 5-FU on EC, with respect to DNA synthesis, cell death and release of prostacyclin by endothelial cells (EC) was studied. For comparison, we tested methotrexate (MTX), an antimetabolite without cardiotoxic properties, in the same way. Human endothelial cell lines (HEC) and bovine endothelial cells (BEC) were incubated with increasing concentrations of 5-FU and MTX for 48 hours. (3H)thymidine incorporation, total cellular protein, loss of (3H)thymidine from prelabelled cells and 6-keto-prostaglandin F1 were measured. RESULTS: DNA synthesis decreased significantly in both HEC and BEC, and the release of prostacyclin by BEC increased significantly when incubated with 5-FU. This effect was not seen with MTX. CONCLUSION: The results indicate specific susceptibility of benign EC to 5-FU. Such susceptibility was confirmed by the release of prostacyclin by the BEC, indicating leakage secondary to EC injury.

Animals↗
PubMed1996

Palliation of dysphagia in patients with malignant esophageal strictures. Comparison of results of radiotherapy, chemotherapy and esophageal stent treatment.

Dysphagia is the earliest and the most common symptom of malignant disease in the esophagus. The palliative effects on dysphagia of radiotherapy (RT) and chemotherapy (CT) were evaluated retrospectively and compared with the effect of the self-expanding stent, evaluated in the prospective study. After completion of treatment, 78 (56%) of 140 patients treated with RT; 31 (49%) of 63 patients treated with CT; and 53 (81%) of 66 patients treated with stent insertion were free from dysphagia. Stent treatment has a good and prompt effect on dysphagia and can be recommended for palliation of patients with malignant esophageal strictures.

Adenocarcinoma↗
PubMed1996

The appearance of endothelium in small arteries after treatment with 5-fluorouracil. An electron microscopic study of late effects in rabbits.

Cardiotoxicity is an unexplained toxic manifestation of 5-fluorouracil (5-FU). Its possible mechanism could be a direct cytotoxic effect on the vascular endothelium. We have tested this hypothesis in an experimental study in rabbits, using scanning and transmission electron microscopic evaluation of endothelium in small arteries (the central artery of the ear). The perfusion fixation method at physiological pressure and temperature was used. Both local and systemic effects of 5-FU on endothelium were studied 1, 3, 7, 14 and 30 days after in vivo treatment with 5-FU. Fifteen rabbits were used and five additional animals served as controls. The following parameters were evaluated: vessel wall and endothelial cell contraction, cell oedema, cytolysis, occurrence of denuded areas, platelet adhesion/aggregation and fibrin formation. For the description of each parameter, a scale of negative points (0.0-3.0) was used. We found severe cell damage with accompanying thrombus formation. The findings support the hypothesis that the thrombogenic effect of 5-FU, secondary to its direct cytotoxic effect on endothelium, is the pathophysiological mechanism behind 5-FU cardiotoxicity.

Animals↗
PubMed1995

Changes of blood viscosity in patients treated with 5-fluorouracil--a link to cardiotoxicity?

Cardiotoxicity is a serious but relatively unknown side-effect of treatment with 5-fluorouracil (5-FU). The underlying mechanism of 5-FU cardiotoxicity has not been defined. The aim of the present study was to determine whether hemorheological factors might in part explain 5-FU cardiotoxicity. Changes of blood and plasma viscosity, fibrinogen and hematocrit were studied in 11 patients treated by 5-FU. The study showed a decrease in blood and plasma viscosity during treatment with 5-FU, probably caused by a decrease of plasma fibrinogen. Reversible cardiotoxic effects were demonstrated in four patients.

Adult↗
PubMed1995

The influence of 5-fluorouracil on the endothelium in small arteries. An electron microscopic study in rabbits.

5-Fluorouracil (5-FU) is a widely used antineoplastic agent. 5-FU induced cardiotoxicity is a still relatively unknown side-effect of this drug. This phenomenon could be due to a direct cytotoxic effect on the endothelial cells. We tested this hypothesis in an experimental study in rabbits, by scanning or transmission electron microscopic evaluation of endothelium in small arteries (the central artery of the ear) after in vivo treatment with 5-FU. Both local and systemic effects of 5-FU on endothelium were studied 15, 30, 60 and 120 minutes after intra-arterial or intraperitoneal treatment. Perfusion fixation at physiological pressure and temperature was used in order to minimize damage to the endothelium during the preparation procedure. Eighteen rabbits weighing 2.5-3.0 kg were used, and 6 animals served as controls. The following parameters were evaluated: vessel wall and endothelial cell contraction, cell edema, cytolysis, occurrence of denuded areas, platelet adhesion/aggregation and fibrin formation. For the description of each parameter a scale of negative points was used. Irreversible cell damage was observed in 5-FU treated animals: disruption of the endothelial sheet and patchy exposure of the subendothelium, sometimes as a focus for thrombus formation. Our findings support the hypothesis that the thrombogenic effect of 5-FU secondary to its direct cytotoxic effect on endothelium might be one of the pathophysiological mechanisms behind 5-FU induced cardiotoxicity.

Animals↗
PubMed1994

Acute and delayed effects of radiotherapy in patients with oesophageal squamous cell carcinoma treated with chemotherapy, surgery and pre- and postoperative radiotherapy.

Among 73 patients with oesophageal squamous cell carcinoma treated with chemotherapy (cisplatin + 5-fluorouracil), surgery and pre- and postoperative radiotherapy, the 1-year survival rate was 68% and the 5-year rate 26%. The treatment was well tolerated, though there were 11 cases of pericardial or pleural effusion, in all of which the effusion was benign and could be successfully treated with pleural aspiration and/or pleurodesis, pericardiocentesis, or in one case pericardectomy.

Antineoplastic Combined Chemotherapy Protocols↗