Camilla Hoff | Aarhus University (original) (raw)

Papers by Camilla Hoff

Journal of Clinical Oncology, May 20, 2009

6007 Background: The study aimed to evaluate if correction of low hemoglobin (Hb) levels by means... more 6007 Background: The study aimed to evaluate if correction of low hemoglobin (Hb) levels by means of the erythropoietin stimulating agent: darbepoetin alpha (Aranesp) during radiotherapy (RT) improves outcome in patients with HNSCC. Following a planned interim analysis which showed inferiority of the experimental treatment, the trial was stopped in November 2006. Methods: Pts with HNSCC eligible for primary RT alone and with Hb values below 14.0 g/dl were randomized to receive Aranesp together with accelerated fractionated RT. Pts. were stratified according to gender, T and N staging, tumor site, and institution. Aranesp was given subcutaneously in a dose of 150 micrograms weekly during RT, or stopped earlier if the Hb exceeded 15.5 g/dl. Results: In total, 522 patients (of a planned intake of 600) were included at the time of the interim analysis. Of these 514 pts were eligible for analysis (255 pts treated with Aranesp and 259 pts in the control group) with a median follow up of 49 months. Among these, 201 developed a loco-regional failure (primary endpoint). There have been 238 deaths of which 176 are due to HNSCC. The patients were evenly distributed according to the stratification parameters (gender, T and N staging, tumor site, institution).Aranesp resulted in the expected increase in Hb in more than 81% of the patients. The compliance to Aranesp was good with no significant difference in serious (cardiovascular) adverse events (3% vs. 1%). Overall, the results showed a poorer outcome in 5-year loco-regional control (59% vs. 68% (p = 0.04, RR: 1.47 [1.14–1.94]) for the Aranesp vs. control arm. This was also seen for the endpoint of disease-free survival (37% vs. 47%, p = 0.02, RR: 1.32 [1.04–1.68]), whereas there was no significant difference in overall survival (40% vs. 51%, p = 0.16, RR: 1.20 [0.93–1.55]). There were no differences in radiation related morbidity. All univariate analyses were confirmed in a multivariate setting. Conclusions: Correction of the Hb level with Aranesp in patients with HNSCC resulted in a significantly poorer tumor control after radiotherapy. The treatment principle was abandoned and the difference in outcome is being subjected to further examination. No significant financial relationships to disclose.

Ejc Supplements, Sep 1, 2007

Laryngoscope, Feb 28, 2022

ObjectivesThe management of incidental findings of FDG‐avid tonsils on PET/CT (IFT) is unclear. W... more ObjectivesThe management of incidental findings of FDG‐avid tonsils on PET/CT (IFT) is unclear. We aimed to explore the prevalence of malignancy in IFT, identify risk factors for malignancy, and calculate optimal cutoffs of maximum standardized uptake values (SUVmax) to discriminate between benign and malignant lesions.MethodsAll patients who were tonsillectomized at our institution because of IFT from October 2011 to December 2020 were included. Patients undergoing PET/CT due to suspected tonsillar disease or cancer of unknown primary were excluded.ResultsIn total, 77 patients were included, of which 11 (14%) of them had IFT malignancy. Dysphagia (p = 0.019) and alcohol abuse (p = 0.035) were associated with malignancy. Absolute SUVmax cutoff (≥9: sensitivity 100%; specificity 53%) was superior to SUVmax side‐to‐side ratio (≥1.5: sensitivity 64%; specificity 70%) to discriminate between benign and malignant lesions.ConclusionWe recommend tonsillectomy for patients with IFT displaying SUVmax ≥ 9.0, ratio ≥ 1.5, or symptoms or findings suggesting malignancy.Level of Evidence3 Laryngoscope, 132:2370–2378, 2022

Circulation, 2015

Purpose: Remote ischemic conditioning (RIC) confers protection against myocardial ischemia-reperf... more Purpose: Remote ischemic conditioning (RIC) confers protection against myocardial ischemia-reperfusion injury through cellular protective pathways but may also involve modulation of the myocardial perfusion (MP). We investigated whether RIC modulates MP and coronary vascular resistance (CVR) in ischemic and non-ischemic myocardial territories in humans. Methods: In a prospective, single blinded study, we studied 49 patients with suspected stable coronary artery disease. MP was quantified by 82 Rb-PET before and after RIC, and CVR was calculated as mean arterial pressure divided by MP. RIC was conducted as 4 cycles of 5 min upper arm ischemia followed by 5 min of reperfusion. A subsequent adenosine 82 Rb-PET stress scanning identified non-ischemic, reversibly and irreversibly ischemic myocardial segments by summed difference scores, and quantified coronary flow reserve (CFR). Results: Stress 82 Rb-PET data were available for 47 patients and identified 682 non-ischemic, 38 reversibly ...

The Laryngoscope, 2022

OBJECTIVES The management of incidental findings of FDG-avid tonsils on PET/CT (IFT) is unclear. ... more OBJECTIVES The management of incidental findings of FDG-avid tonsils on PET/CT (IFT) is unclear. We aimed to explore the prevalence of malignancy in IFT, identify risk factors for malignancy, and calculate optimal cutoffs of maximum standardized uptake values (SUVmax ) to discriminate between benign and malignant lesions. METHODS All patients who were tonsillectomized at our institution because of IFT from October 2011 to December 2020 were included. Patients undergoing PET/CT due to suspected tonsillar disease or cancer of unknown primary were excluded. RESULTS In total, 77 patients were included, of which 11 (14%) of them had IFT malignancy. Dysphagia (p = 0.019) and alcohol abuse (p = 0.035) were associated with malignancy. Absolute SUVmax cutoff (≥9: sensitivity 100%; specificity 53%) was superior to SUVmax side-to-side ratio (≥1.5: sensitivity 64%; specificity 70%) to discriminate between benign and malignant lesions. CONCLUSION We recommend tonsillectomy for patients with IFT displaying SUVmax ≥ 9.0, ratio ≥ 1.5, or symptoms or findings suggesting malignancy. LEVEL OF EVIDENCE 3 Laryngoscope, 2022.

European Journal of Nuclear Medicine and Molecular Imaging, 2017

The Journal of Nuclear Medicine, 2017

Radiotherapy and Oncology

Journal of Nuclear Cardiology, 2016

Remote ischemic conditioning (RIC) confers protection against myocardial ischemia-reperfusion inj... more Remote ischemic conditioning (RIC) confers protection against myocardial ischemia-reperfusion injury and may modulate coronary blood flow. We investigated whether RIC affects resting myocardial perfusion (MP) in patients with suspected ischemic coronary artery disease by quantitative MP imaging. We included 49 patients with suspected ischemic coronary artery disease. Resting MP was quantified by (82)Rubidium positron emission tomography/computed tomography ((82)Rb-PET/CT) imaging before and after RIC, performed as four cycles of 5 minutes upper arm ischemia and reperfusion. Subsequent adenosine (82)Rb-PET/CT stress-imaging identified non-ischemic and reversibly ischemic myocardial segments. MicroRNA-144 plasma levels were measured before and after RIC. Normalized for rate pressure product, RIC did not affect MP globally (P = .64) or in non-ischemic myocardial segments (P = .58) but decreased MP in reversibly ischemic myocardial segments (-0.11 mL/min/g decrease in MP following RIC; 95% CI -0.17 to -0.06, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). However, we found no effect of RIC when MP was normalized for cardiac work. MicroRNA-144 plasma levels increased following RIC (P = .006) but did not correlate with a change in global MP in response to RIC (P = .40). RIC did not substantially affect resting MP globally or in non-ischemic and reversibly ischemic myocardial territories in patients with suspected ischemic coronary artery disease.

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, Jan 18, 2016

The aim of this study was to evaluate the value of noninvasive assessment of cardiac allograft va... more The aim of this study was to evaluate the value of noninvasive assessment of cardiac allograft vasculopathy (CAV) in heart-transplanted patients by exercise stress myocardial deformation and coronary flow reserve (CFR) assessment. Fifty-eight heart-transplanted patients underwent semisupine exercise echocardiography with assessment of left ventricular (LV) longitudinal myocardial deformation. CAV was assessed by coronary angiography and noninvasive CFR by (15)O-H2O positron emission tomographic imaging and Doppler echocardiography. Patients were divided into three groups on the basis of angiographic CAV: no CAV (n = 21), mild CAV (n = 19), and severe CAV (n = 18). Patients with severe CAV had significantly lower LV global longitudinal strain (GLS) at rest (no CAV, -16 ± 2%; mild CAV, -15 ± 2%; severe CAV, -12 ± 4%; P < .001), failed to increase LV GLS during exercise (no CAV, -5.7 ± 2.0%; mild CAV, -3.3 ± 2.9%; severe CAV, -0.2 ± 2.8%; P < .0001), and had significantly lower e...

Journal of Nuclear Cardiology

Acta Oncologica, 2012

Hypoxia induced radioresistance has been acknowledged for decades. One of the indirect evidences ... more Hypoxia induced radioresistance has been acknowledged for decades. One of the indirect evidences of the influence of hypoxia on radiation response comes from the observations of a correlation between tumor control and hemoglobin level. This review examines the clinical data on the prognostic and predictive role of hemoglobin level and hemoglobin manipulation in radiotherapy of squamous cell carcinomas of the head and neck, a tumor type where hypoxic radioresistance have been previously documented. The aim is to evaluate the existing literature for information of the influence of hemoglobin concentration and hemoglobin modifications on tumor oxygenation and outcome in head and neck squamous cell cancer patients. The data from several randomized trials show that while most studies have confirmed the prognostic value of hemoglobin, increasing the hemoglobin level through transfusion or erythropoietin stimulation did not result in improved outcome for patients with low initial hemoglobin levels. Clinical studies showed that smoking reduced the oxygen carrying capacity of the blood through formation of carboxyhemoglobin, and lead to poorer response to radiotherapy in smokers compared to non-smokers. Smoking also increased the risk of the development of secondary cancers. In conclusion, low hemoglobin is a significant negative prognostic factor for radiotherapy of head and neck cancer. Correction of pre-treatment low hemoglobin by blood transfusion and/or erythropoietin stimulating agents does, however, not improve the outcome. Smoking leads to a decrease in effective hemoglobin and poorer treatment outcome. Smoking should be avoided in order to improve the therapeutic efficacy of radiotherapy and development of other smoking-related diseases and/or secondary cancers.

Head Neck J Sci Spec Head Nec, Sep 1, 2008

Background. In the context of the Danish Head and Neck Cancer Group, nationwide material from 199... more Background. In the context of the Danish Head and Neck Cancer Group, nationwide material from 1992-2001 was analyzed to study the extent and nature of the disease, evaluate treatment, compare staging systems, and examine prognosis and survival.

European Journal of Cancer Supplements, 2007