• 30-day mortality in patients treated for brain metastases: extracranial causes dominate 

      Nieder, Carsten; Stanisavljevic, Luka; Aanes, Siv Gyda; Mannsåker, Bård; Haukland, Ellinor Christin (Journal article; Tidsskriftartikkel; Peer reviewed, 2022-05-12)
      Background: Established prognostic models, such as the diagnosis-specific graded prognostic assessment, were not designed to specifically address very short survival. Therefore, a brain metastases-specific 30-day mortality model may be relevant. We hypothesized that in-depth evaluation of a carefully defined cohort with short survival, arbitrarily defined as a maximum of 3 months, may provide ...
    • Contemporary radiooncological management of bone metastases from breast cancer: factors associated with prescription of different fractionation regimens (short or long course) in a rural part of North Norway with long travel distance 

      Nieder, Carsten; Dalhaug, Astrid; Haukland, Ellinor; Mannsåker, Bård; Pawinski, Adam (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-01-19)
      The aim of this study was to reduce barriers that prevent implementation of evidence-based recommendations about single-fraction palliative radiotherapy (PRT) and to demonstrate that single-fraction PRT yields similar outcomes as long-course treatment (≥10 fractions) in patients with bone metastases from breast cancer. This retrospective study (2007–2014) included 118 Norwegian female patients. All ...
    • Early death after palliative radiation treatment: 30-, 35- and 40-day mortality data and statistically robust predictors 

      Nieder, Carsten; Stanisavljevic, Luka; Mannsåker, Bård; Haukland, Ellinor Christin (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-04-03)
      Background This study analyzed mortality after radiotherapy for bone metastases (287 courses). Endpoints such as treatment in the last month of life and death within 30, 35 and 40 days from start of radiotherapy were evaluated.<p> <p>Methods Different baseline parameters including but not limited to blood test results and patterns of metastases were assessed for association with early death. After ...
    • The Glasgow prognostic score: Useful information when prescribing palliative radiotherapy 

      Nieder, Carsten; Mannsåker, Bård; Dalhaug, Astrid; Pawinski, Adam; Haukland, Ellinor Christin (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-04-26)
      The purpose of the present retrospective study was to investigate whether a score reflecting systemic inflammatory processes [the Glasgow Prognostic Score (GPS)] provides relevant information for radiation oncologists. GPS is a three‑tiered score [0: normal C-reactive protein (CRP) and albumin; 1: one abnormal result; 2: increased CRP and low albumin]. Correlations between disease type and extent, ...
    • Implementation of Locoregional Adjuvant Radiotherapy for Breast Cancer in a Rural Healthcare Region: Toxicity Outcomes in the Initial Cohort 

      Nieder, Carsten; Ressheim, Joakim Grønning; Haukland, Ellinor Christin; Mannsåker, Bård (Journal article; Tidsskriftartikkel; Peer reviewed, 2022-01-29)
      Background/Aim: The aim of this study was to analyze the toxicity of locoregional adjuvant breast cancer radiotherapy after implementation of this service in a rural healthcare region with long travel distance. Patients and Methods: This was a retrospective single-institution analysis of 87 consecutive female patients (the initial cohort), managed with conventionally fractionated 3-D conformal ...
    • Independent External Validation of the METSSS Model Predicting Survival after Palliative Radiotherapy 

      Nieder, Carsten; Mannsåker, Bård; Yobuta, Rosalba (Journal article; Tidsskriftartikkel; Peer reviewed, 2022-02-26)
      Background/Aim: A validation of the recently published METSSS model (developed from a large US database) predicting survival after palliative radiotherapy was performed. METSSS includes age, sex, cancer type, localization of distant metastases, comorbidity, and radiotherapy site. Patients and Methods: Both 1- and 5-year survival was assessed in the validation cohort. Deviations between model-predicted ...
    • Independent validation of a risk stratification model predicting survival in elderly patients irradiated for bone metastases 

      Nieder, Carsten; Stanisavljevic, Luka; Mannsåker, Bård; Haukland, Ellinor Christin (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-02)
      Background/Aim: Many patients with bone metastases receive palliative radiotherapy. However, treatment personalization tools are needed, due to heterogeneous survival. The aim of this study was to analyze the validity of the prognostic survival model, originally developed by Rades et al., because international variations in clinical practice and survival outcomes may impact on the performance of ...
    • Independent Validation of a Unifying Prognostic Model for Intracranial and Extracranial Metastasis-directed Radiotherapy 

      Nieder, Carsten; Stanisavljevic, Luka; Mannsåker, Bård; Haukland, Ellinor Christin (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-06-06)
      We present the first calculations of the heavy flavor diffusion coefficient using lattice QCD with light dynamical quarks corresponding to a pion mass of around 320 MeV. For temperatures 195 MeV <T< 352 MeV, the heavy quark spatial diffusion coefficient is found to be significantly smaller than previous quenched lattice QCD and recent phenomenological estimates. The result implies very fast ...
    • Initiation of systemic therapy during the last 30 days of life in patients with metastatic castration-resistant prostate cancer 

      Nieder, Carsten; Haukland, Ellinor Christin; Mannsåker, Bård; Pawinski, Adam; Yobuta, Rosalba; Norum, Jan (Journal article; Tidsskriftartikkel; Peer reviewed, 2019)
      <b>Background/Aim</b>: Compared to intravenous taxane chemotherapy, newer orally-available and/or less toxic agents for metastatic castration-resistant prostate cancer (MCRPC) may be associated with higher likelihood of starting treatment in patients with adverse prognostic features and limited life expectancy. To test this hypothesis, we analyzed the rates of treatment initiation during the last ...
    • The LabPS score: Inexpensive, Fast, and Site-agnostic Survival Prediction 

      Nieder, Carsten; Haukland, Ellinor Christin; Mannsåker, Bård; Dalhaug, Astrid (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-04)
      Objectives: To provide a widely applicable, blood-biomarker-based and performance-status-based prognostic model, which predicts the survival of patients undergoing palliative non-brain radiotherapy. This model has already been examined in a cohort of patients treated for brain metastases and performed well.<p> <p>Methods: This was a retrospective single-institution analysis of 375 patients, ...
    • Palliative appropriateness criteria: external validation of a new method to evaluate the suitability of palliative radiotherapy fractionation 

      Nieder, Carsten; Haukland, Ellinor Christin; Mannsåker, Bård; Dalhaug, Astrid (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-01-10)
      Background Recently, the palliative appropriateness criteria (PAC) score, a novel metric to aid clinical decision-making between different palliative radiotherapy fractionation regimens, has been developed. It includes baseline parameters including but not limited to performance status. The researchers behind the PAC score analyzed the percent of remaining life (PRL) on treatment. The latter was ...
    • Palliative radiotherapy during the last month of life: Have COVID-19 recommendations led to reduced utilization? 

      Nieder, Carsten; Haukland, Ellinor Christin; Mannsåker, Bård; Yobuta, Rosalba (Journal article; Tidsskriftartikkel; Peer reviewed, 2021-01)
      Background/Aim: The study aimed to evaluate practice changes in the time period of the early wave of the COVID-19 pandemic. Patients and Methods: This was a retrospective single institution study. We defined palliative radiotherapy (PRT) initiated before Saturday, March 14th as pre-COVID and PRT initiated later as during-COVID (through June 30th). Results: National COVID-19 recommendations ...
    • Palliative radiotherapy with or without additional care by a multidisciplinary palliative care team in patients with newly diagnosed cancer: A retrospective matched pairs comparison 

      Nieder, Carsten; Dalhaug, Astrid; Pawinski, Adam; Haukland, Ellinor; Mannsåker, Bård; Engljähringer, Kirsten (Journal article; Tidsskriftartikkel; Peer reviewed, 2015-03-07)
      Purpose: To analyze survival after early palliative radiotherapy (RT) in patients managed exclusively by regular oncology staff or a multidisciplinary palliative care team (MPCT) in addition. <p>Methods: Retrospective matched pairs analysis. Comparison of two groups of 29 patients each: MPCT versus none. Early RT started within three months after cancer diagnosis. <p>Results: Bone and brain ...
    • Patterns of Care and Survival in Cancer Patients with Brain Metastases Receiving Immune Checkpoint Inhibitors 

      Nieder, Carsten; Mannsåker, Bård; Stanisavljevic, Luka; Haukland, Ellinor Christin (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-02-15)
      Introduction: Immune checkpoint inhibitors (ICIs) have become a mainstay of treatment for different cancer types. The purpose of this study was to evaluate patterns of care and overall survival (OS) after diagnosis of brain metastases in patients managed with ICI as component of care. Methods: This was a retrospective cohort study. Fifty patients were included (34 with brain metastases at first ...
    • Patterns of treatment and outcome in patients with 20 or more brain metastases 

      Nieder, Carsten; Yobuta, Rosalba; Mannsåker, Bård (Journal article; Tidsskriftartikkel; Peer reviewed, 2019-01)
      <p><i>Background/Aim - </i>The aim of this study was to analyze the patterns of treatment and outcomes in patients with a large number of brain metastases, arbitrarily defined as 20 or more lesions. These patients are typically excluded from studies of focal brain treatment, e.g., surgery or radiosurgery, and might have a limited prognosis. <p><i>Patients and Methods - </i>This was a retrospective ...
    • Percent of remaining life on palliative radiation treatment: solely a function of fractionation? 

      Nieder, Carsten; Mannsåker, Bård; Dalhaug, Astrid (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-02-14)
      Background: This study analyzed the percent of remaining life (PRL) on treatment in patients irradiated for bone metastases. Bone metastases were treated together with other target volumes, if indicated, e.g. a 10-fraction treatment course that included brain and bone metastases. PRL was determined by calculating the time between start and finish of palliative radiotherapy (minimum 1 day in case of ...
    • Prognostic Impact of the Tumor Marker CA 15-3 in Patients With Breast Cancer and Bone Metastases Treated With Palliative Radiotherapy 

      Nieder, Carsten; Dalhaug, Astrid; Haukland, Ellinor; Mannsåker, Bård; Pawinski, Adam (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-01-25)
      <p><i>Background</i>: The aim of the study was to explore the prognostic impact of different abnormal blood tests and the tumor marker CA 15-3 as well as established parameters such as disease extent and receptor status in patients with bone metastases from breast cancer who received palliative radiotherapy in addition to contemporary systemic treatment.</p> <p><i>Methods</i>: This was a ...
    • Provider decision regret - a useful method for analysis of palliative thoracic re-irradiation for lung cancer? 

      Nieder, Carsten; Mannsåker, Bård; Yobuta, Rosalba; Haukland, Ellinor Christin (Journal article; Tidsskriftartikkel; Peer reviewed, 2020-01-30)
      Background - The overall usefulness of palliative thoracic re-irradiation depends on the balance between efficacy, survival, and toxicity, and is difficult to judge from previous studies. In the absence of patient-reported data, we developed a method for provider decision regret that addresses the question “would we re-irradiate this patient again in light of the known outcome?” Furthermore, we ...
    • Risk factors for esophagitis after hypofractionated palliative (chemo) radiotherapy for non-small cell lung cancer 

      Nieder, Carsten; Imingen, Kristian S.; Mannsåker, Bård; Yobuta, Rosalba; Haukland, Ellinor Christin (Journal article; Tidsskriftartikkel; Peer reviewed, 2020-05-01)
      <i>Introduction</i>: Esophagitis influences quality of life and might cause treatment interruption and hospitalization. Previous studies of risk factors focused on curative treatment for non-small cell lung cancer (NSCLC), which often involves concomitant chemoradiation (CRT). Given the uncertainty around extrapolation of dose constraints, we analyzed risk factors in patients treated with hypofractionated ...
    • Shortened Palliative Radiotherapy Results in a Lower Rate of Treatment During the Last Month of Life 

      Nieder, Carsten; Haukland, Ellinor Christin; Mannsåker, Bård (Journal article; Tidsskriftartikkel; Peer reviewed, 2022-01-25)
      Introduction Palliative radiotherapy (PRT) during the last month of life (PRT30) should be avoided because relevant clinical benefits are unlikely to occur. While traditional short-course fractionation regimens are suitable for most patients, a minority may derive gains from higher doses of PRT. Compared to older regimens such as 13 fractions of 3 Gy, more hypofractionated, non-ablative concepts ...