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Falkmer, Ursula
Alternative names
Publications (4 of 4) Show all publications
Thoresen, L., Frykholm, G., Lydersen, S., Ulveland, H., Baracos, V., Prado, C. M. M., . . . Falkmer, U. (2013). Nutritional status, cachexia and survival in patients with advanced colorectal carcinoma. Different assessment criteria for nutritional status provide unequal results. Clinical Nutrition, 32(1), 65-72
Open this publication in new window or tab >>Nutritional status, cachexia and survival in patients with advanced colorectal carcinoma. Different assessment criteria for nutritional status provide unequal results
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2013 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 32, no 1, p. 65-72Article in journal (Refereed) Published
Abstract [en]

Background and aims: Different nutrition assessment tools and definitions are proposed for cancer-associated malnutrition and wasting (cachexia). We studied the associations between these assessments and overall survival in stage IV colorectal carcinoma patients. Methods: Anthropometric measures, energy intake, biochemical variables, nutritional risk screening, assessment of malnutrition, cachexia and body composition from computed tomography images were analysed, in 77 patients from Norway and Canada. Results were dichotomized into presence or absence of nutritional risk, malnutrition, cachexia and sarcopenia (low muscle mass) and associated with survival. Results: Overall, 22% up to 55% of the patients had cachexia according to different cachexia criteria: 34% were malnourished, 42% were at nutritional risk, and 39% were sarcopenic. Forty-four percent of the patients did not meet criteria for any of these conditions. Patients with cachexia defined by Cancer Cachexia Study Group (CCSG) had shorter survival in an unadjusted analysis, [Hazard ratio (HR) = 2.43; 95% confidence interval (CI) 1.32-4.47; P = 0.005]. After adjusting for nation, age and gender, cachexia (HR = 2.26; CI 1.18-432; P = 0.014) and malnutrition (HR = 1.83; CI 1.06-3.13; P = 0.029) remained significant predictors of survival. Conclusions: Nutritional depletion in up to 55% of the patients was found. The lack of concordance between the results obtained by different assessment criteria was obvious. CCSGs cachexia score was the best prognostic factor for overall survival.

Place, publisher, year, edition, pages
Elsevier, 2013
Keywords
Advanced colorectal carcinoma; Nutritional risk; Cachexia; Sarcopenia; Malnutrition; Survival
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-96493 (URN)10.1016/j.clnu.2012.05.009 (DOI)000315251600009 ()
Available from: 2013-08-23 Created: 2013-08-20 Last updated: 2017-12-06
Karlsson, J. O., Adolfsson, K., Thelin, B., Jynge, P., Andersson, R. & Falkmer, U. G. (2012). First Clinical Experience with the Magnetic Resonance Imaging Contrast Agent and Superoxide Dismutase Mimetic Mangafodipir as an Adjunct in Cancer Chemotherapy-A Translational Study. Translational Oncology, 5(1), 32-38
Open this publication in new window or tab >>First Clinical Experience with the Magnetic Resonance Imaging Contrast Agent and Superoxide Dismutase Mimetic Mangafodipir as an Adjunct in Cancer Chemotherapy-A Translational Study
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2012 (English)In: Translational Oncology, ISSN 1944-7124, E-ISSN 1936-5233, Vol. 5, no 1, p. 32-38Article in journal (Refereed) Published
Abstract [en]

Preclinical research suggests that the clinically approved magnetic resonance imaging contrast agent mangafodipir may protect against adverse events (AEs) caused by chemotherapy, without interfering negatively with the anticancer efficacy. The present translational study tested if pretreatment with mangafodipir lowers AEs during curative (adjuvant) FOLFOX6 chemotherapy in stage III colon cancer (Dukes C). The study was originally scheduled to include 20 patients, but because of the unforeseen withdrawal of mangafodipir from the market, the study had to be closed after 14 patients had been included. The withdrawal of mangafodipir was purely based on commercial considerations from the producer and not on any safety concerns. The patients were treated throughout the first 3 of 12 scheduled cycles. Patients were randomized to a 5-minute infusion of either mangafodipir or placebo (7 in each group). AEs were evaluated according to the National Cancer Institutes (NCI) Common Terminology Criteria for Adverse Events and the Sanofi-NCI criteria. The primary end points were neutropenia and neurosensory toxicity. There were four AEs of grade 3 (severe) and one AE of grade 4 (life threatening) in four patients in the placebo group, whereas there were none in the mangafodipir group (P andlt; .05). Of the grade 3 and 4 events, two were neutropenia and one was neurosensory toxicity. Furthermore, white blood cell count was statistically, significantly higher in the mangafodipir group than in the placebo group (P andlt; .01) after treatment with FOLFOX. This small feasibility study seems to confirm what has been demonstrated preclinically, namely, that pretreatment with mangafodipir lowers AEs during adjuvant 5-fluorouracil plus oxaliplatin-based chemotherapy in colon cancer patients.

Place, publisher, year, edition, pages
NEOPLASIA PRESS, 1150 W MEDICAL CENTER DR, MSRB III, RM 9303, ANN ARBOR, MI 48109-0648 USA, 2012
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-79112 (URN)10.1593/tlo.11277 (DOI)000304817600005 ()
Note

Funding Agencies|Medical Research Council of Southeast Sweden|FORSS-85191|PledPharma AB||

Available from: 2012-06-29 Created: 2012-06-29 Last updated: 2017-12-07Bibliographically approved
Thoresen, L., Frykholm, G., Lydersen, S., Ulveland, H., Baracos, V., Birdsell, L. & Falkmer, U. (2012). The association of nutritional assessment criteria with health-related quality of life in patients with advanced colorectal carcinoma. European Journal of Cancer Care, 21(4), 505-516
Open this publication in new window or tab >>The association of nutritional assessment criteria with health-related quality of life in patients with advanced colorectal carcinoma
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2012 (English)In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 21, no 4, p. 505-516Article in journal (Refereed) Published
Abstract [en]

Health-related quality of life (QoL) is a goal in nutritional oncology but the association between nutritional status and QoL is rarely explored. The aim of the study was to investigate the association of nutritional assessment criteria with QoL in 50 patients with advanced colorectal carcinoma. A second aim was to investigate changes in body weight and QoL during a 3-month follow-up. Muscle mass, nutritional risk, malnutrition and cachexia according to three different criteria were assessed, as well as health-related QoL. At inclusion, 36 patients experienced weight loss, 10 patients sarcopenia, 25 were at nutritional risk, 16 were malnourished and 11, 14 and 31 patients had cachexia according to different criteria. All nutritional assessment criteria discriminated between groups of patients with worse or better QoL to varying degrees. Malnutrition and cachexia defined by the European Palliative Care Research Collaborative and adjusted for recent gain or stabilisation of body weight discriminated on most QoL scores. Weight loss at follow-up was associated with a decrease in several QoL scores. Recognition of weight loss as well as diagnosing malnutrition and cachexia should be the first steps in an interventional pathway to enhance nutritional status and QoL in patients with advanced colorectal carcinoma.

Place, publisher, year, edition, pages
Blackwell Publishing, 2012
Keywords
quality of life; cachexia; nutrition; bowel cancer; symptoms; colon cancer
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-79786 (URN)10.1111/j.1365-2354.2012.01327.x (DOI)000305134700011 ()
Available from: 2012-08-17 Created: 2012-08-14 Last updated: 2017-12-07
Fors, E. A., Bertheussen, G. F., Thune, I., Juvet, L. K., Elvsaas, I.-K. O., Oldervoll, L., . . . Leivseth, G. (2011). Psychosocial interventions as part of breast cancer rehabilitation programs? Results from a systematic review. Psycho-Oncology, 20(9), 909-918
Open this publication in new window or tab >>Psychosocial interventions as part of breast cancer rehabilitation programs? Results from a systematic review
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2011 (English)In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 20, no 9, p. 909-918Article, review/survey (Refereed) Published
Abstract [en]

Objective: This systematic review aimed to determine the effectiveness of psychoeducation, cognitive behavioural therapy (CBT) and social support interventions used in the rehabilitation of breast cancer (BC) patients. less thanbrgreater than less thanbrgreater thanMethods: We conducted a systematic literature search to identify randomised controlled trials of female BC patients who underwent different psychosocial interventions during or after primary cancer treatment. The methodological quality of all studies was independently assessed by two reviewers. Studies with low quality, less than 20 participants in each group, patients with metastatic cancer, data not presented separately for BC and studies that included other cancer types were excluded. less thanbrgreater than less thanbrgreater thanResults: Among 9617 identified studies, only 18 RCTs published between 1999 and 2008, including 3272 patients were finally included in this systematic evaluation. Outcome measures were categorised into quality of life (QoL), fatigue, mood, health behaviour and social function. Six trials examined psychoeducation had inconsistent results, both during and after the primary treatment. Seven trials examined the effect of CBT, four of which given after primary treatment (range 6-12 weeks) demonstrated improvements in QoL; the other three CBT studies given during primary treatment (range 9-20 weeks) had inconsistencies. Five studies addressed social support and showed no conclusive impacts of this intervention. less thanbrgreater than less thanbrgreater thanConclusions: Limited documentation exists on the efficacy of psychosocial rehabilitation interventions among BC patients. However, we found that patients might have QoL benefits from CBT given after primary BC treatment. More documentation is needed regarding the effects of CBT during primary treatment and the effects of psychoeducation and social support.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2011
Keywords
breast cancer, oncology, rehabilitation, psychosocial, systematic review
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-71388 (URN)10.1002/pon.1844 (DOI)000295122700001 ()
Available from: 2011-10-14 Created: 2011-10-14 Last updated: 2017-12-08
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