Bente Brokstad Herlofson

• Süslü, Safiyye; Haugen, Håvard Jostein; Krüger, Tormod Bjartveit; Reseland, Janne Elin & Herlofson, Bente Brokstad (2026). Medication-related osteonecrosis of the jaw in cancer and osteoporosis patients: a retrospective seven-year single-center Norwegian cohort study of clinical profiles and documented soft tissue healing. Acta Odontologica Scandinavica. ISSN 0001-6357. 85, s. 713–724. doi: 10.2340/aos.v85.46983. Fulltekst i vitenarkiv Vis sammendrag

  Objective: To compare systemic profiles, oral findings, and documented soft tissue healing between cancer and osteoporosis patients with medication-related osteonecrosis of the jaw (MRONJ). Material and methods: This retrospective single-center cohort included 105 cases treated in 2013–2019 (56 cancer; 49 osteoporosis). Healing at last follow-up was analyzed using adjusted logistic regression and Firth sensitivity analysis. Results: Of 102 cases with known final status, 68 had documented healing. Osteoporosis cases were older, predominantly female, and had longer antiresorptive exposure than cancer cases (76.7 ± 11.1 vs. 70.0 ± 8.5 years; 102.5 ± 77.8 vs. 34.6 ± 28.5 months; both p < 0.001). Stage II predominated and Stage 0 was uncommon (3/105, 2.9%). Previous tooth extraction at the MRONJ lesion site was more frequent in osteoporosis (95.9% vs. 71.4%; p < 0.001). Surgical treatment was associated with higher healing odds (adjusted odds ratio [OR]: 11.12, 95% confidence interval [CI]: 4.12 to 33.35; p < 0.001), whereas cancer indication was associated with lower odds (adjusted OR: 0.23, 95% CI: 0.07 to 0.68; p = 0.011). Conclusions: Systemic profiles differed; oral patterns were similar. Non-random treatment and missing healing dates limit interpretation. Previous tooth extraction was the most frequent antecedent event; its indication and timing were unverified.

• Süslü, Safiyye; Haugen, Håvard Jostein; Krüger, Tormod Bjartveit; Herlofson, Bente Brokstad; Reseland, Janne Elin & Eriksen, Erik Fink (2026). Oral findings and antiresorptive therapy exposure duration in postmenopausal women with osteoporosis: a cross-sectional cohort study. BMC Oral Health. doi: 10.1186/s12903-026-09735-z. Fulltekst i vitenarkiv Vis sammendrag

  Background Oral findings are common among older adults, but it is unclear whether they vary with the duration of antiresorptive therapy (ART) exposure or relate to the severity of osteoporosis in postmenopausal women. Methods In this cross-sectional cohort ( n  = 129), postmenopausal women undergoing osteoporosis assessment/follow-up were stratified by ART exposure duration: no current ART control (G1, n  = 50), short ART (G2, 3–5 years; n  = 39), and long ART (G3, > 5 years; n  = 40). The prespecified primary oral endpoint was any mucosal finding ( oral_mucosal_any ), defined as ≥ 1 prespecified mucosal lesion category at oral examination. The oral_mucosal_any endpoint was analysed by component to distinguish traumatic from non-traumatic mucosal findings. Secondary oral endpoints included tooth and molar counts, periodontal findings, and the number of mucosal lesion categories. Group differences were analysed using age- and BMI-adjusted regression (G1 reference). Secondary analyses compared oral findings across fracture-burden strata and hip BMD/T-score categories and evaluated whether oral variables improved discrimination for hip osteoporosis (total hip T-score ≤ − 2.5) beyond age, BMI, and ART group. Results Mucosal findings were common and non-monotonic across ART groups (G1: 52.0%, G2: 30.8%, G3: 52.5%). Among the 59 participants with any mucosal finding, traumatic changes were present in 43 (72.9%); in a mutually exclusive classification, 38 (64.4%) had traumatic-only findings. In age- and BMI-adjusted models, short ART was associated with lower odds of oral_mucosal_any versus controls (OR 0.38, 95% CI 0.16–0.93; p  = 0.035), whereas long ART did not differ (OR 0.94, 95% CI 0.38–2.33; p  = 0.894). Tooth and molar counts, periodontal burden, and non-traumatic mucosal findings showed no robust graded pattern with ART duration. Oral findings were broadly similar across fracture-burden strata and hip BMD categories. Adding total teeth and oral_mucosal_any increased apparent Area Under the Curve (AUC) for hip osteoporosis from 0.795 to 0.820, but optimism-corrected AUC changed only from 0.736 to 0.741 (corrected ΔAUC = 0.005). Conclusions In this cross-sectional cohort, common oral findings did not show a robust graded duration–response pattern across ART exposure groups and were not consistently associated with fracture burden or hip BMD strata. The broad mucosal endpoint was largely driven by common traumatic findings and should be interpreted as a clinically pragmatic but biologically heterogeneous endpoint. Oral variables added negligible optimism-corrected discrimination beyond age, BMI, and ART group.

• Jansen, Femke; Eerenstein, Simone EJ.; Taylor, Katherine J.; Amdal, Cecilie Delphin; Bjordal, Kristin & Astrup, Guro Lindviksmoen [Vis alle 36 forfattere av denne artikkelen] (2025). Unmet supportive care needs among head and neck cancer survivors beyond 5 years after diagnosis: a multinational cohort study. The Lancet Regional Health - Europe. 59. doi: 10.1016/j.lanepe.2025.101495. Fulltekst i vitenarkiv Vis sammendrag

  Background This study investigates unmet supportive care needs (SCNs) among head and neck cancer (HNC) survivors beyond 5 years after diagnosis and examines the association with sociodemographic, clinical and lifestyle factors, and differences in European and non-European regions and healthcare systems. Methods In this cross-sectional study, 1097 HNC survivors from 11 countries completed the Short-Form Supportive Care Needs Survey (SCNS-SF34) and HNC-specific module (SCNS-HNC), encompassing physical and daily living, psychological, sexuality, HNC-specific and lifestyle domains. Scores were dichotomized per domain and across domains into moderate-high unmet SCNs (yes/no). Logistic regression analyses were used to investigate associated factors. Findings Half (50%, proportion 100/200) of HNC survivors had unmet SCNs (overall), especially unmet HNC-specific (40%, 40/100), psychological (25%, 25/100), and physical and daily living (22%, 22/100) needs. Personal (women, lower age), lifestyle (smoking, alcohol consumption) and clinical factors (advanced tumor stage, second primary tumor, multimodality treatment [versus single surgery], poor Karnofsky performance score and comorbidities) were associated with unmet SCNs. Physical and daily living, HNC-specific and overall unmet SCNs were more likely among survivors from Northern Europe compared to Southern and Western Europe. Unmet psychological, sexuality and lifestyle needs were more likely among non-European countries. All unmet SCNs (except psychological) were more likely among survivors with a national health system compared to a social and/or etatist health insurance system. Interpretation Half of HNC survivors have unmet SCNs. Insight into healthcare utilization may provide insights how to improve care.

• Westgaard, Kristine Løken; Amdal, Cecilie Delphin; Taylor, Katherine J.; Falk, Ragnhild Sørum; Bjordal, Kristin & Singer, Susanne [Vis alle 15 forfattere av denne artikkelen] (2025). Oral health-related quality of life among long-term head and neck cancer survivors: a multinational study. Supportive Care in Cancer. ISSN 0941-4355. 33(10). doi: 10.1007/s00520-025-09930-8. Fulltekst i vitenarkiv Vis sammendrag

  Purpose Our aim was to investigate oral health-related quality of life (OHRQoL) and toxicities in long-term head and neck cancer (HNC) survivors diagnosed ≥five years earlier. Methods HNC survivors treated between 2007 and 2013 participated in an international cross-sectional study. They completed the European Organization for Research and Treatment of Cancer (EORTC) core quality of life questionnaire (EORTC QLQ-C30) and the oral health module (EORTC QLQ-OH15) and attended a hospital examination. Clinicians scored toxicities using the Common Terminology Criteria for Adverse Events version 5.0. OHRQoL was analyzed based on four types of treatment: surgery, radiotherapy, chemoradiotherapy without surgery and surgery with postoperative (chemo) radiotherapy. Survivors were divided into three groups according to the EORTC QLQ-OH15 oral health-QoL scale score; the lowest (defined as poor OHRQoL), middle and highest tertile. Results Eleven sites in six countries enrolled 404 HNC survivors. The median time since diagnosis was 8.4 years, the mean age was 66 years and 67% were male. A total of 116 (29%) of the survivors reported poor OHRQoL. They were more often females and survivors with advanced disease. The survivors with poor OHRQoL also had more toxicity: dysphagia, trismus, osteonecrosis of the jaw, oral pain and dry mouth. There were no clinically significant differences in OHRQoL between the four treatment groups. Conclusion Our study showed that the survivors who reported poor OHRQoL also had a high level of late toxicity. This highlight the need for improved follow-up of the oral health of HNC survivors many years after initial treatment, especially for women and those who were treated for advanced disease.

• Singer, Susanne; Amdal, Cecilie Delphin; Bjordal, Kristin; Herlofson, Bente Brokstad; Astrup, Guro Lindviksmoen & Boehm, Andreas [Vis alle 27 forfattere av denne artikkelen] (2025). Late Toxicity and Long‐Term Quality of Life in Survivors of Cancer of the Major Salivary Glands More Than 5 Years After Diagnosis: A Multi‐National Study. Head and Neck. ISSN 1043-3074. doi: 10.1002/hed.28263. Fulltekst i vitenarkiv Vis sammendrag

  Background Because salivary gland cancers (SGC) are rare and include different tumor subtypes, data on their long‐term quality of life and late toxicities are sparse. Methods Multi‐national study including SGC survivors more than 5 years after diagnosis. They completed the European Organisation for Research and Treatment of Cancer (EORTC) quality of life core questionnaire together with its head and neck cancer module and reported problems that were most bothering for them. Toxicity was clinically assessed. Results Altogether, 60 survivors from nine countries participated and reported dry mouth (mean score 37.2), use of painkillers (35.0), problems with sexuality (30.1), insomnia (28.9), fatigue (27.8), trismus (24.9), and sticky saliva (23.3). The most frequently mentioned long‐term problem was dry mouth , mentioned by a third of all participants. The most frequent toxicities were hearing impairment , soft tissue fibrosis , dry mouth , and cranial neuropathies . Conclusions Dry mouth is a frequent and disturbing problem in SGC survivors.

• Steybe, David; Poxleitner, Philipp; Aljohani, Suad; Herlofson, Bente Brokstad; Nicolatou-Galitis, Ourania & Patel, Vinod [Vis alle 14 forfattere av denne artikkelen] (2025). Evaluation of a context-aware chatbot using retrieval-augmented generation of answering clinical questions on medication-related osteonecrosis of the jaw. Journal of Cranio-Maxillofacial Surgery. ISSN 1010-5182. 53(4), s. 355–360. doi: 10.1016/j.jcms.2024.12.009. Fulltekst i vitenarkiv
• Taylor, Katherine J.; Amdal, Cecilie Delphin; Bjordal, Kristin; Astrup, Guro Lindviksmoen; Herlofson, Bente Brokstad & Duprez, Fréderic [Vis alle 37 forfattere av denne artikkelen] (2025). Toxicities in long-term survivors of head and neck cancer - A multi-national cross-sectional analysis. International Journal of Cancer. ISSN 0020-7136. 157(10), s. 2061–2070. doi: 10.1002/ijc.70033. Fulltekst i vitenarkiv Vis sammendrag

  Head and neck cancer (HNC) patients may experience toxicities as a result of their treatment modality. While acute toxicities have been well documented, the prevalence of toxicities at long-term follow-up of HNC survivors is less clear. As part of a multi-national, cross-sectional study, HNC survivors at least 5 years post-diagnosis were invited to undergo a toxicity examination. Using the Common Terminology Criteria for Adverse Events (version 5), 33 toxicities were assessed. From 2019 to 2021, 1094 survivors from 26 sites in 11 countries completed the assessment. Eighty-seven percent were from Europe, and most were survivors of oropharynx (35%), oral cavity (21%), or larynx cancer (19%). The majority had been diagnosed at stage III or IV (62%), and the median time since diagnosis was 8 years (range 5–36). Most had been treated with surgery and radiotherapy with or without chemotherapy (38%). Six percent had no toxicities, and 26% had only mild toxicities. 68% had at least one moderate or severe late toxicity. Overall, the most frequent late toxicities at any grade were dry mouth (67%), soft tissue fibrosis (52%), dysphagia (51%), and voice alterations (39%). Fistulae, neck and face edema, and osteonecrosis of the jaws were present in very few survivors. Our study shows that the majority of HNC survivors experience moderate or severe late toxicities, but that the problems are concentrated in a small group of specific toxicities. Understanding the problems experienced in the long term can help better inform newly diagnosed patients as well as inform survivorship follow-up initiatives.

• Legert, Karin Garming; Pedersen, Anne Marie Lynge; Gale, Gita; Tollemar, Victor; Ruokonen, Hellevi & Kantoloa, Saara [Vis alle 8 forfattere av denne artikkelen] (2024). Oral manifestations of systemic disorders - part 1. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 134, s. 104–113. doi: 10.56373/2024-2-3. Fulltekst i vitenarkiv
• Legert, Karin Garming; Wexell, Cecilia Larsson; Pedersen, Anne Marie Lynge; Gale, Gita; Tollemar, Victor & Ruokonen, Hellevi [Vis alle 8 forfattere av denne artikkelen] (2024). Oral manifestations of systemic disorders - part 2. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 134, s. 116–124. doi: 10.56373/2024-2-4. Fulltekst i vitenarkiv
• Singer, Susanne; Hammerlid, Eva; Tomaszewska, Iwona M.; Amdal, Cecilie Delphin; Herlofson, Bente Brokstad & Santos, Marcos [Vis alle 31 forfattere av denne artikkelen] (2024). The european organisation for research and treatment of cancer head and neck cancer module (EORTC QLQ-HN43): Estimates for minimal important difference and minimal important change. European Journal of Cancer. ISSN 0959-8049. 212. doi: 10.1016/j.ejca.2024.115062. Fulltekst i vitenarkiv Vis sammendrag

  Introduction Minimal important change estimates (MIC) are useful for interpreting results of clinical research with quality of life (QoL) as an endpoint. For the European Organisation for Research and Treatment of Cancer head and neck cancer module, the EORTC QLQ-HN43, no such thresholds are established. Methods Head and neck cancer patients under active treatment (n = 503) from 15 countries completed the EORTC QLQ-HN43 three times (t1: before treatment, t2: three months after t1, t3: six months after t1). A subgroup completed a Subjective Significance Questionnaire (SSQ), indicating experienced change from the previous time point in four QoL domains. QoL was assumed to deteriorate after t1 and improve again until t3. The MIC was established using the average of mean differences in SSQ groups (MICmean) and estimates based on logistic regressions (MICpredict). Additionally, minimal detectable changes (MDC) were computed using 0.5 standard deviation and standard error of the mean. Results For swallowing, speech, dry mouth, and global QoL, the MIC for deterioration were 13, 14, 26, and 10 respectively. The MIC for improvement were 8 (swallowing), 6 (dry mouth), and 5 (global QoL); no MIC for speech improvement can be presented because of insufficient correlation between change score and anchor. The MDC estimates for deterioration were 15, 14, 15, and 11. For improvement, the MDC estimates were 13, 14, 14, and 11. Conclusions Our results underline that no single MIC or MDC can be applied to all EORTC QLQ-HN43 scales, and that the MIC for deterioration seems larger than those for improvement.

• Huynh, Thuy-Tien Maria; Falk, Ragnhild Sørum; Hellebust, Taran Annette Paulsen; Dale, Einar; Astrup, Guro Lindviksmoen & Hjermstad, Marianne Jensen [Vis alle 12 forfattere av denne artikkelen] (2024). Chronic fatigue in long-term survivors of head and neck cancer treated with radiotherapy. Radiotherapy and Oncology. ISSN 0167-8140. 195. doi: 10.1016/j.radonc.2024.110231. Fulltekst i vitenarkiv Vis sammendrag

  Background There is lack of evidence on chronic fatigue (CF) following radiotherapy (RT) in survivors of head and neck cancer (HNC). We aimed to compare CF in HNC survivors > 5 years post-RT with a reference population and investigate factors associated with CF and the possible impact of CF on health-related quality of life (HRQoL). Material and methods In this cross-sectional study we included HNC survivors treated in 2007–2013. Participants filled in patient-reported outcome measures and attended a one-day examination. CF was measured with the Fatigue Questionnaire and compared with a matched reference population using t-tests and Cohen’s effect size. Associations between CF, clinical and RT-related factors were investigated using logistic regression. HRQoL was measured with the EORTC Quality of Life core questionnaire. Results The median age of the 227 HNC survivors was 65 years and median time to follow-up was 8.5 years post-RT. CF was twice more prevalent in HNC survivors compared to a reference population. In multivariable analyses, female sex (OR 3.39, 95 % CI 1.82–6.31), comorbidity (OR 2.17, 95 % CI 1.20–3.94) and treatment with intensity-modulated RT (OR 2.13, 95 % CI 1.16–3.91) were associated with CF, while RT dose parameters were not. Survivors with CF compared to those without, had significantly worse HRQoL. Conclusions CF in HNC survivors is particularly important for female patients, while specific factors associated with RT appear not to play a role. The high CF prevalence in long-term HNC survivors associated with impaired HRQoL is important information beneficial for clinicians and patients to improve patient follow-up.

• Monsen, Ragnhild Elisabeth; Lerdal, Anners; Nordgarden, Hilde; Gay, Caryl & Herlofson, Bente Brokstad (2024). A comparison of the prevalence of dry mouth and other symptoms using two different versions of the Edmonton Symptom Assessment System on an inpatient palliative care unit. BMC Palliative Care. 23(1). doi: 10.1186/s12904-024-01405-7. Fulltekst i vitenarkiv Vis sammendrag

  Background Symptom assessment is key to effective symptom management and palliative care for patients with advanced cancer. Symptom prevalence and severity estimates vary widely, possibly dependent on the assessment tool used. Are symptoms specifically asked about or must the patients add them as additional symptoms? This study compared the prevalence and severity of patient-reported symptoms in two different versions of a multi-symptom assessment tool. In one version, three symptoms dry mouth, constipation, sleep problems were among those systematically assessed, while in the other, these symptoms had to be added as an “Other problem”. Methods This retrospective cross-sectional study included adult patients with advanced cancer at an inpatient palliative care unit. Data were collected from two versions of the Edmonton Symptom Assessment System (ESAS): modified (ESAS-m) listed 11 symptoms and revised (ESAS-r) listed 9 and allowed patients to add one “Other problem”. Seven similar symptoms were listed in both versions. Results In 2013, 184 patients completed ESAS-m, and in 2017, 156 completed ESAS-r. Prevalence and severity of symptoms listed in both versions did not differ. In ESAS-m, 83% reported dry mouth, 73% constipation, and 71% sleep problems, but on ESAS-r, these symptoms were reported by only 3%, 15% and < 1%, respectively. Although ESAS-r severity scores for these three symptoms were higher than on ESAS-m, differences did not reach statistical significance. Conclusion We identified significant differences in patient symptom reporting based on whether symptoms like dry mouth, obstipation and sleep problems were specifically assessed or had to be added by patients as an “Other problem”.

• Taylor, Katherine J.; Amdal, Cecilie Delphin; Bjordal, Kristin; Astrup, Guro Lindviksmoen; Herlofson, Bente Brokstad & Duprez, Fréderic [Vis alle 36 forfattere av denne artikkelen] (2024). Long-term health-related quality of life in head and neck cancer survivors: A large multinational study. International Journal of Cancer. ISSN 0020-7136. doi: 10.1002/ijc.34861. Fulltekst i vitenarkiv Vis sammendrag

  Head and neck cancer (HNC) patients suffer from a range of health-related quality of life (HRQoL) issues, but little is known about their long-term HRQoL. This study explored associations between treatment group and HRQoL at least 5 years' post-diagnosis in HNC survivors. In an international cross-sectional study, HNC survivors completed the European Organization for Research and Treatment of Cancer (EORTC) quality of life core questionnaire (EORTC-QLQ-C30) and its HNC module (EORTC-QLQ-H&N35). Meaningful HRQoL differences were examined between five treatment groups: (a) surgery, (b) radiotherapy, (c) chemo-radiotherapy, (d) radiotherapy ± chemotherapy and neck dissection and (e) any other surgery (meaning any tumour surgery that is not a neck dissection) and radiotherapy ± chemotherapy. Twenty-six sites in 11 countries enrolled 1105 survivors. They had a median time since diagnosis of 8 years, a mean age of 66 years and 71% were male. After adjusting for age, sex, tumour site and UICC stage, there was evidence for meaningful differences (10 points or more) in HRQoL between treatment groups in seven domains (Fatigue, Mouth Pain, Swallowing, Senses, Opening Mouth, Dry Mouth and Sticky Saliva). Survivors who had single-modality treatment had better or equal HRQoL in every domain compared to survivors with multimodal treatment, with the largest differences for Dry Mouth and Sticky Saliva. For Global Quality of Life, Physical and Social Functioning, Constipation, Dyspnoea and Financial Difficulties, at least some treatment groups had better outcomes compared to a general population. Our data suggest that multimodal treatment is associated with worse HRQoL in the long-term compared to single modality.

• Huynh, Thuy-Tien Maria; Dale, Einar; Falk, Ragnhild Sørum; Hellebust, Taran Annette Paulsen; Astrup, Guro Lindviksmoen & Malinen, Eirik [Vis alle 12 forfattere av denne artikkelen] (2023). Radiation-induced long-term dysphagia in survivors of head and neck cancer and association with dose-volume parameters. Radiotherapy and Oncology. ISSN 0167-8140. 190. doi: 10.1016/j.radonc.2023.110044. Fulltekst i vitenarkiv Vis sammendrag

  Background Although dysphagia is a common side effect after radiotherapy (RT) of head and neck cancer (HNC), data on long-term dysphagia is scarce. We aimed to 1) compare radiation dose parameters in HNC survivors with and without dysphagia, 2) investigate factors associated with long-term dysphagia and its possible impact on health-related quality of life (HRQoL), and 3) investigate how our data agree with existing NTCP models. Methods This cross-sectional study conducted in 2018–2020, included HNC survivors treated in 2007–2013. Participants attended a one-day examination in hospital and filled in patient questionnaires. Dysphagia was measured with the EORTC QLQ-H&N35 swallowing scale. Toxicity was scored with CTCAE v.4. We contoured swallowing organs at risk (SWOAR) on RT plans, calculated dose-volume histograms (DVHs), performed logistic regression analyses and tested our data in established NTCP models. Results Of the 239 participants, 75 (31%) reported dysphagia. Compared to survivors without dysphagia, this group had reduced HRQoL and the DVHs for infrahyoid SWOAR were significantly shifted to the right. Long-term dysphagia was associated with age (OR 1.07, 95% CI 1.03–1.10), female sex (OR 2.75, 95% CI 1.45–5.21), and mean dose to middle pharyngeal constrictor muscle (MD-MPCM) (OR 1.06, 95% CI 1.03–1.09). NTCP models overall underestimated the risk of long-term dysphagia. Conclusions Long-term dysphagia was associated with higher age, being female, and high MD-MPCM. Doses to distally located SWOAR seemed to be risk factors. Existing NTCP models do not sufficiently predict long-term dysphagia. Further efforts are needed to reduce the prevalence and consequences of this late effect.

• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Vis alle 10 forfattere av denne artikkelen] (2023). Identification and susceptibility testing of oral candidiasis in advanced cancer patients. BMC Oral Health. 23(1). doi: 10.1186/s12903-023-02950-y. Fulltekst i vitenarkiv Vis sammendrag

  Background Patients with advanced cancer are prone to develop different opportunistic oral infection due to anti-cancer treatment or the malignancies themselves. Studies of oral fungal samples show an increased prevalence of non-Candida albicans species in mixed oral infections with Candida albicans. Non-C. albicans and C. albicans are associated with varying degrees of resistance to azoles, which may have implications for treatment. This study aimed to assess the diversity and antifungal susceptibility of Candida species detected in the oral cavity. Methods An observational study with microbiological analysis was conducted. Clinical fungal isolates were collected from patients in a hospice unit in 2014–2016. Isolates were re-grown on chromID® Candida plates in 2020. Single colony of each species was re-cultivated and prepared for biochemical identification with a VITEK2® system and verified by gene sequencing. Etest was performed on RPMI agar, and the antifungals fluconazole, amphotericin B, anidulafungin and nystatin were applied. Results Fifty-six isolates from 45 patients were identified. Seven different Candida species and one Saccharomyces species were detected. The results of biochemical identification were confirmed with sequencing analysis. Thirty-six patients had mono infection, and nine out of 45 patients had 2–3 different species detected. Of C. albicans strains, 39 out of 40 were susceptible to fluconazole. Two non-C. albicans species were resistant to fluconazole, one to amphotericin B and three to anidulafungin. Conclusion C. albicans was the predominant species, with a high susceptibility to antifungal agents. Different Candida species occur in both mono and mixed infections. Identification and susceptibility testing may therefore lead to more effective treatment and may prevent the development of resistance among patients with advanced cancer. Trail registration The study Oral Health in Advanced Cancer was registered at ClinicalTrials.gov (#NCT02067572) in 20/02/2014.

• Taylor, Katherine J.; Amdal, Cecilie Delphin; Bjordal, Kristin; Astrup, Guro Lindviksmoen; Herlofson, Bente Brokstad & Duprez, Fréderic [Vis alle 34 forfattere av denne artikkelen] (2023). Serious Long-Term Effects of Head and Neck Cancer from the Survivors’ Point of View. Healthcare. 11(6). doi: 10.3390/healthcare11060906. Fulltekst i vitenarkiv Vis sammendrag

  The long-term problems of head and neck cancer survivors (HNCS) are not well known. In a cross-sectional international study aimed at exploring the long-term quality of life in this population, 1114 HNCS were asked to state their two most serious long-term effects. A clinician recorded the responses during face-to-face appointments. A list of 15 example problems was provided, but a free text field was also available. A total of 1033 survivors responded to the question. The most frequent problems were ‘dry mouth’ (DM) (n = 476; 46%), ‘difficulty swallowing/eating’ (DSE) (n = 408; 40%), ‘hoarseness/difficulty speaking’ (HDS) (n = 169; 16%), and ‘pain in the head and neck’ (PHN) (n = 142; 14%). A total of 5% reported no problems. Logistic regression adjusted for age, gender, treatment, and tumor stage and site showed increased odds of reporting DM and DSE for chemo-radiotherapy (CRT) alone compared to surgery alone (odds ratio (OR): 4.7, 95% confidence interval (CI): 2.5–9.0; OR: 2.1, CI: 1.1–3.9), but decreased odds for HDS and PHN (OR: 0.3, CI: 0.1–0.6; OR: 0.2, CI: 0.1–0.5). Survivors with UICC stage IV at diagnosis compared to stage I had increased odds of reporting HDS (OR: 1.9, CI: 1.2–3.0). Laryngeal cancer survivors had reduced odds compared to oropharynx cancer survivors of reporting DM (OR: 0.4, CI: 0.3–0.6) but increased odds of HDS (OR: 7.2, CI: 4.3–12.3). This study provides evidence of the serious long-term problems among HNCS.

• Krüger, Tormod Bjartveit; Syversen, Unni; Herlofson, Bente Brokstad; Lian, Aina-Mari & Reseland, Janne Elin (2022). Targeting a therapeutically relevant concentration of alendronate for in vitro studies on osteoblasts. Acta Odontologica Scandinavica. ISSN 0001-6357. 80(8), s. 619–625. doi: 10.1080/00016357.2022.2072522. Fulltekst i vitenarkiv Vis sammendrag

  Objective Bisphosphonates like alendronate mainly exert their effects on osteoclasts. However, osteoblasts are also affected, but exposed to a much lower concentration in vivo than the osteoclasts. Given that the effects are dose-dependent, the intention of the study was to identify a therapeutically relevant concentration of alendronate for in vitro studies on osteoblasts. Materials and methods Primary human osteoblasts were incubated with alendronate (5, 20 and 100 µM) for 1, 3, 7 and 14 days. Proliferation and viability were assessed, and the effects on cellular growth and function were evaluated by multianalyte profiling of selected proteins in cell culture media using the Luminex 200TM. Results The viability was not affected by any of the dosages. Exposure to 5 µM alendronate had a neutral effect on osteoblast proliferation, and on secretion of osteogenic and inflammatory markers, while enhancing synthesis of a marker of angiogenesis. 20 µM alendronate induced a decline in proliferation and affected angiogenic and osteogenic biomarkers adversely. 100 µM alendronate reduced proliferation dramatically, and this dosage was excluded from further experiments. Conclusion A concentration of 5 µM alendronate exerted effects on human osteoblasts that may translate to those observed in vivo and could therefore be relevant for in vitro studies.

• Tanem, Kristine Eidal; Stensvold, Einar; Wilberg, Petter; Skaare, Anne B; Brandal, Petter & Herlofson, Bente Brokstad (2022). Oral and dental late effects in long-term survivors of childhood embryonal brain tumors. Supportive Care in Cancer. ISSN 0941-4355. 30, s. 10233–10241. doi: 10.1007/s00520-022-07405-8. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Purpose To investigate oral and dental late effects in survivors of childhood brain tumors medulloblastoma (MB) and central nervous system supratentorial primitive neuroectodermal tumor (CNS-PNET). Methods This cross-sectional study assessed oral and dental late effects in MB/CNS-PNET survivors treated before 20 years of age, and with a minimum of 2 years since treatment. Participants went through an oral and radiographic examination. We assessed oral status using the decayed-missing-filled index (DMFT), oral dryness, maximum mouth opening (MMO), fungal infection, and registration of dental developmental disturbances (DDD) in the form of hypodontia, microdontia, and enamel hypoplasia. Results The 46 participants’ mean age at enrolment was 27 ± 12.8 years and at treatment 8.5 ± 5.2 years, and the mean time since treatment was 18.9 ± 12 years. Over a third (35%) of survivors had reduced mouth opening (mean 29.3 ± 5.6 mm (range 16–35)). A significantly lower MMO was found in individuals treated ≤ 5 years compared to survivors treated &gt; 5 years ( p  = 0.021). One or more DDD were registered in 30.4% of the survivors, with a significantly higher prevalence in individuals treated ≤ 5 years ( p  &lt; 0.001). Hypodontia was the most prevalent type of DDD. There was no difference in DMFT score in relation to age at treatment. Oral dryness was not frequently reported or observed in these survivors. Conclusion Survivors of childhood MB/CNS-PNET are at risk of oral and dental late effects including reduced mouth opening and DDD. The risk is highest in survivors treated before the age of 5.

• Hynne, Håvard; Aqrawi, Lara A.; Jensen, Janicke Liaaen; Thiede, Bernd; Palm, Øyvind & Amdal, Cecilie Delphin [Vis alle 10 forfattere av denne artikkelen] (2022). Proteomic Profiling of Saliva and Tears in Radiated Head and Neck Cancer Patients as Compared to Primary Sjögren’s Syndrome Patients. International Journal of Molecular Sciences. ISSN 1661-6596. 23(7). doi: 10.3390/ijms23073714. Fulltekst i vitenarkiv Vis sammendrag

  Patients with head and neck cancer (HNC) and patients with primary Sjögren’s syndrome (pSS) may exhibit similar symptoms of dry mouth and dry eyes, as a result of radiotherapy (RT) or a consequence of disease progression. To identify the proteins that may serve as promising disease biomarkers, we analysed saliva and tears from 29 radiated HNC patients and 21 healthy controls, and saliva from 14 pSS patients by mass spectrometry-based proteomics. The study revealed several upregulated, and in some instances overlapping, proteins in the two patient groups. Histone H1.4 and neutrophil collagenase were upregulated in whole saliva of both patient groups, while caspase-14, histone H4, and protein S100-A9 were upregulated in HNC saliva only. In HCN tear fluid, the most highly upregulated protein was mucin-like protein 1. These overexpressed proteins in saliva and tears play central roles in inflammation, host cell injury, activation of reactive oxygen species, and tissue repair. In conclusion, the similarities and differences in overexpressed proteins detected in saliva from HNC and pSS patients may contribute to the overall understanding of the different pathophysiological mechanisms inducing dry mouth. Thus, the recurring proteins identified could possibly serve as future promising biomarkers

• Tanem, Kristine Eidal; Wilberg, Petter; Diep, Phoi Phoi; Ruud, Ellen; Skaare, Anne B & Brinch, Lorentz [Vis alle 7 forfattere av denne artikkelen] (2022). Oral chronic GVHD after allogeneic stem cell transplantation without total body irradiation performed at a young age. Supportive Care in Cancer. ISSN 0941-4355. 30(5), s. 4121–4128. doi: 10.1007/s00520-022-06836-7. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Purpose Long-term survivors (LTSs) of allogeneic hematopoietic stem cell transplantation (allo-HCT) may experience oral long-term effects like chronic graft-versus-host disease (oral cGVHD). The aim of this study was to investigate oral cGVHD in patients treated at a young age (&lt; 30 years) more than 5 years after allo-HCT without total body irradiation (TBI). Methods All 94 participants went through a semi-structured interview, and an oral examination. Diagnosis of oral cGVHD was based on the “National Institutes of Health (NIH) cGVHD diagnosis and staging consensus criteria” from 2014. Results Mean age at transplantation was 17.5 years (range 0.4–29.9 years), and mean time since transplantation was 16.7 years (range 6–26 years). Oral cGVHD was diagnosed in 26 (28%) of 94 LTSs. Of which 20 (21.5%) showed lichen planus-like (LPL) changes, and additionally six (6.5%) also fulfilled the diagnostic criteria of oral cGVHD since they had one or more distinctive signs and symptoms of oral cGVHD combined with definite cGVHD in another organ. No LTSs reported oral cGVHD (NIH) grade 3. There was a significant association between cGVHD in the oral cavity and cGVHD in another organ (77% vs 29%, p  &lt; 0.001). Out of 72 LTSs, who answered the questions regarding taste disturbances, 16 (22%) reported dysgeusia. No LTSs developed secondary malignancies in the oral cavity during follow-up time. Conclusion Oral long-term effects, such as oral cGVHD, may persist for many years after allo-HCT without TBI-conditioning in patients treated at a young age.

• Tanem, Kristine Eidal; Stensvold, Einar; Wilberg, Petter; Skaare, Anne B; Singh, Preet Bano & Brandal, Petter [Vis alle 7 forfattere av denne artikkelen] (2022). Taste and smell function in long-term survivors after childhood medulloblastoma/CNS-PNET. Supportive Care in Cancer. ISSN 0941-4355. 30, s. 6155–6162. doi: 10.1007/s00520-022-07048-9. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Purpose To investigate taste and smell function in survivors, with a minimum of 2 years since treatment of childhood medulloblastoma (MB)/central nervous system supratentorial primitive neuroectodermal tumor (CNS-PNET). Methods This cross-sectional study included 40 survivors treated ≤ 20 years of age. Taste strips with four concentrations of sweet, sour, salt, and bitter were used to assess taste function in all participants. Score from 0 to 16; ≥ 9 normogeusia, &lt; 9 hypogeusia, and complete ageusia which equals no sensation. No sensation of a specific taste quality equals ageusia of that quality. Thirty-two participants conducted smell testing using three subtests of Sniffin’ sticks: threshold, discrimination, and identification. Together they yield a TDI-score from 1 to 48; functional anosmia ≤ 16.00, hyposmia &gt; 16.00– &lt; 30.75, normosmia ≥ 30.75– &lt; 41.50, and ≥ 41.50 hyperosmia. Results were compared with normative data. Survivors rated their taste and smell function using a numerical rating scale (NRS) score 0–10. Results Forty survivors with a mean time since treatment of 20.5 years, 13 (32.5%) were diagnosed with hypogeusia, nine (22.5%) of these being ageusic to one or more taste qualities. Seventeen (53%) of 32 participants were diagnosed with hyposmia. The mean scores of the olfactory subtests, and TDI score were significantly lower than normative data ( P  &lt; 0.0001). The mean NRS scores of smell and taste function were 7.9 ± 1.5 and 8 ± 1.3, respectively. Conclusion Our study showed impaired taste and smell function in survivors of childhood MB/CNS-PNET using objective measurements. However, subjective ratings did not reflect objective findings.

• Huynh, Thuy-Tien Maria; Aass, Hans Christian Dalsbotten; Falk, Ragnhild Sørum; Astrup, Guro Lindviksmoen; Helland, Åslaug & Bjøro, Trine [Vis alle 14 forfattere av denne artikkelen] (2022). Associations between patient-reported late effects and systemic cytokines in long-term survivors of head and neck cancer treated with radiotherapy. Journal of cancer survivorship. ISSN 1932-2259. doi: 10.1007/s11764-022-01273-1. Fulltekst i vitenarkiv Vis sammendrag

  Purpose Head and neck cancer (HNC) treatment may lead to late effects and impaired health-related quality of life of survivors. Knowledge on long-term late effects after radiotherapy (RT) and potential underlying biological mechanisms is lacking. We assessed the prevalence of xerostomia, dysphagia, and chronic fatigue (CF) in HNC survivors ≥ 5 years post-RT, and examined associations between pro-inflammatory cytokines and late effects. Methods In a cross-sectional study, 263 HNC survivors treated between 2007 and 2013 were enrolled. They completed validated questionnaires assessing xerostomia and dysphagia (the EORTC QLQ-H&N35), and CF (the Fatigue Questionnaire), and underwent blood sampling and clinical examination. Pro-inflammatory cytokines were analyzed in 262 survivors and 100 healthy age- and gender-matched controls. Results Median time since treatment was 8.5 years. The proportions of survivors reporting xerostomia, dysphagia, and CF were 58%, 31%, and 33%, respectively, with a preponderance of females. We found no significant associations between IL-6, IL-8, IP-10, TARC, TNF, or ENA-78 and the three late effects. The odds of having elevated levels of IL-6 and IP-10 were significantly higher in the survivors compared to the controls. Conclusions More than one-third of long-term HNC survivors experienced xerostomia, dysphagia, and CF. Persistent inflammation, with elevated systemic cytokines, was not associated with these late effects, although HNC survivors had higher levels of some cytokines than the controls. Implications for Cancer Survivors This study provides new knowledge on late effects that can serve as grounds for informing patients with HNC about risk of late effects more than 5 years after RT.

• Kruger, Tormod Bjartveit; Herlofson, Bente Brokstad; Lian, Aina-Mari; Syversen, Unni & Reseland, Janne Elin (2021). Alendronate and omeprazole in combination reduce angiogenic and growth signals from osteoblasts. Bone Reports. 14:100750, s. 1–7. doi: 10.1016/j.bonr.2021.100750. Fulltekst i vitenarkiv Vis sammendrag

  Objective: Due to gastrointestinal side effects of oral bisphosphonates (BPs), proton pump inhibitors (PPIs) are often prescribed. PPIs may enhance the risk of osteonecrosis of the jaw, a rare side effect of BPs. Therefore, the objective of this study was to evaluate the effects of the oral BP alendronate (ALN) and the PPI omeprazole (OME) alone and in combination on primary human osteoblasts and gingival fibroblasts in vitro. Methods: Human gingival fibroblasts and normal human osteoblasts were incubated with either 5 μM of ALN or 1 μM of OME, or ALN + OME for 1, 3, 7 or 14 days. Effect on viability was evaluated by the lactate dehydrogenase activity in the medium and on proliferation by quantifying 3H-thymidin incorporation. Multianalyte profiling of proteins in cell culture media was performed using the Luminex 200TM system to assess the effect on selected bone markers and cytokines. Results: The proliferation of osteoblasts and fibroblasts was reduced upon exposure to ALN + OME. ALN induced an early, temporary rise in markers of inflammation, and OME and ALN + OME promoted a transient decline. An initial increase in IL-13 occurred after exposure to all three options, whereas ALN + OME promoted IL-8 release after 7 days. OME and ALN + OME promoted a transient reduction in vascular endothelial growth factor (VEGF) from osteoblasts, whereas ALN and ALN + OME induced a late rise in VEGF from fibroblasts. Osteoprotegerin release was enhanced by ALN and suppressed by OME and ALN + OME. Conclusions: ALN + OME seemed to exaggerate the negative effects of each drug alone on human osteoblasts and gingival fibroblasts. The anti-proliferative effects, modulation of inflammation and impairment of angiogenesis, may induce unfavorable conditions in periodontal tissue facilitating development of osteonecrosis.

• Herlofson, Bente Brokstad; Lund, Bodil Kristina; Pinholt, Else Marie & Seppänen-Kaijansinkko, Riitta (2021). The Nordic Success Story - Four women in Oral and maxillofacial Surgery from four Nordic countries. Face to Face, Magazine, IAOMS. Fulltekst i vitenarkiv
• Singer, Susanne; Hammerlid, Eva; Tomaszewska, Iwona M; Amdal, Cecilie Delphin; Bjordal, Kristin & Herlofson, Bente Brokstad [Vis alle 31 forfattere av denne artikkelen] (2021). Methodological approach for determining the Minimal Important Difference and Minimal Important Change scores for the European Organisation for Research and Treatment of Cancer Head and Neck Cancer Module (EORTC QLQ-HN43) exemplified by the Swallowing scale. Quality of Life Research. ISSN 0962-9343. doi: 10.1007/s11136-021-02939-6. Fulltekst i vitenarkiv
• Westgaard, Kristine Løken; Hynne, Håvard; Amdal, Cecilie Delphin; Young, Alix; Singh, Preet Bano & Chen, Xiangjun [Vis alle 12 forfattere av denne artikkelen] (2021). Oral and ocular late effects in head and neck cancer patients treated with radiotherapy. Scientific Reports. 11:4026, s. 1–11. doi: 10.1038/s41598-021-83635-w. Fulltekst i vitenarkiv Vis sammendrag

  A broader understanding of oral and ocular late effects in head and neck cancer (HNC) patients who underwent intensity-modulated radiotherapy (IMRT) may provide valuable information in follow-up and improve quality of life. Twenty-nine HNC patients treated at least 6 months earlier and 30 age-matched controls were recruited. After completing several questionnaires: Oral Health Impact Profile-14 (OHIP-14), Shortened Xerostomia Inventory (SXI), Ocular Surface Disease Index (OSDI) and McMonnies Dry Eye questionnaire (MDEQ), participants underwent oral and ocular examinations. Oral examination included clinical oral dryness score (CODS) and secretion rates of unstimulated and stimulated saliva (UWS, SWS). Ocular examination included tear film break-up time, Schirmer test and ocular surface staining. The patients had more problems related to dry mouth than controls based on CODS and SXI, and more complaints of dry eye disease based on OSDI and MDEQ. UWS and SWS rates and oral health related quality of life were significantly lower in the patient group. Subjective oral dryness (SXI) correlated significantly with subjective ocular dryness (OSDI and MDEQ). Our study demonstrates that HNC patients treated with IMRT experience late effects in terms of xerostomia and ocular dryness underlining the importance of interdisciplinary approach in the evaluation and follow-up of HNC patients.

• Chen, Xiangjun; Badian, Reza; Hynne, Håvard; Amdal, Cecilie Delphin; Herlofson, Bente Brokstad & Utheim, Øygunn Aass [Vis alle 10 forfattere av denne artikkelen] (2021). Alterations in meibomian glands in patients treated with intensity-modulated radiotherapy for head and neck cancer. Scientific Reports. 11:22419, s. 1–7. doi: 10.1038/s41598-021-01844-9. Fulltekst i vitenarkiv Vis sammendrag

  Patients undergoing intensity-modulated radiotherapy (IMRT) for head and neck cancer may have increased incidence of dry eye disease and the exact mechanism is unclear. The present study aims to assess tear film and meibomian gland (MG) features in patients who received IMRT for head and neck cancer not involving the orbital area. Twenty-seven patients (64.7 ± 9.8 years) and 30 age-matched controls (61.4 ± 11.0 years) underwent a comprehensive dry eye work-up. Compared to the control group, the patients had more lid margin abnormalities, and worse meibum quality. The MG loss, calculated as (tarsal area-MG area)/tarsal area, was higher in the patient group in both the upper (53.0 ± 12.0% vs. 35.1 ± 10.3%, p < 0.001) and lower lids (69.5 ± 12.6% vs. 48.5 ± 12.5%, p < 0.001). In the patient group, more MG loss in the lower lids correlated with worse meibum quality (r = 0.445, p = 0.029). In contrast, there was no significant difference in aqueous tear production level, measured with Schirmer test. Patients treated with IMRT for head and neck cancer seemed to have comparable lacrimal gland function to the controls despite more dry eye symptoms. However, the patients had MG functional and morphological changes, which may present a higher risk for developing dry eye disease.

• Monsen, Ragnhild Elisabeth; Herlofson, Bente Brokstad; Gay, Caryl; Fjeld, Katrine Gahre; Hove, Lene Hystad & Malterud, Karl Egil [Vis alle 11 forfattere av denne artikkelen] (2021). A mouth rinse based on a tea solution of Salvia officinalis for oral discomfort in palliative cancer care: A randomized controlled trial. Supportive Care in Cancer. ISSN 0941-4355. doi: 10.1007/s00520-021-06021-2. Fulltekst i vitenarkiv Vis sammendrag

  Background: Few clinical studies evaluate interventions to reduce oral discomfort among patients in palliative care. Aim: This study examines the efficacy of a Salvia officinalis (SO) based herbal mouth rinse compared to conventional normal saline (NS) in order to improve oral health. Design: A block-randomized controlled trial. Data were collected before and after a 4-day intervention with either SO (n=44) or NS (n=44). Numerical rating scales (NRS, 0-10) and 12 items from the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Oral Health 17 (EORTC QLQ-OH17) measured patient-reported oral symptoms. An oral examination was performed before and after the intervention. Setting/participants: This study included adult patients with late-stage cancer in an inpatient hospice unit. Results: Of the 88 patients included (mean age=63.9 years, SD=10.6), 73 (83%) completed the study. At baseline, 78% reported dry mouth on the EORTC QLQ-OH17, and 80% rated dry mouth ≥4 on the NRS. Total oral health scores based on the 12 EORTC QLQ-OH17 items improved similarly in both groups (p

• Ehrenstein, Vera; Heide-Jørgensen, Uffe; Schiødt, Morten; Akre, Olof; Herlofson, Bente Brokstad & Hansen, Svein [Vis alle 13 forfattere av denne artikkelen] (2021). Osteonecrosis of the jaw among patients with cancer treated with denosumab or zoledronic acid: Results of a regulator-mandated cohort postauthorization safety study in Denmark, Norway, and Sweden. Cancer. ISSN 0008-543X. doi: 10.1002/cncr.33802. Fulltekst i vitenarkiv Vis sammendrag

  BACKGROUND Osteonecrosis of the jaw (ONJ) is an adverse effect of antiresorptive treatment. This study estimated incidence proportions and incidence rates of ONJ in cancer patients with bone metastases from solid tumors treated for the prevention of skeletal-related events in routine clinical practice. METHODS This cohort study in Denmark, Norway, and Sweden in 2011-2018 included 3 treatment cohorts: a denosumab inception cohort (DEIC), a zoledronic acid inception cohort (ZAIC), and a denosumab-switch cohort (DESC). The authors estimated 1- to 5-year incidence proportions and incidence rates of ONJ overall, by cancer site (breast, prostate, or other solid tumor), and by country. ONJ diagnoses were confirmed by adjudication. RESULTS There were 1340 patients in the DEIC, 1352 in the ZAIC, and 408 in the DESC. The median ages of the 3 cohorts were 70, 69, and 70 years, respectively; the proportions of men were 72.6%, 53.8%, and 48.3%, respectively; and the median follow-up was 19.8, 12.9, and 13.3 months, respectively. The 5-year incidence proportions of ONJ were 5.7% (95% confidence interval [CI], 4.4%-7.3%) in the DEIC, 1.4% (95% CI, 0.8%-2.3%) in the ZAIC, and 6.6% (95% CI, 4.2%-10.0%) in the DESC. The corresponding ONJ incidence rates per 100 person-years were 3.0 (95% CI, 2.3-3.7), 1.0 (95% CI, 0.6-1.5), and 4.3 (95% CI, 2.8-6.3). Incidence proportions and incidence rates were highest in patients with prostate cancer and in Denmark. CONCLUSIONS This study provides estimates of the risk of medically confirmed ONJ among patients initiating denosumab or zoledronic acid in routine clinical practice in 3 Scandinavian countries. The results varied by cancer site and by country.

• Aqrawi, Lara A.; Chen, Xiangjun; Hynne, Håvard; Amdal, Cecilie Delphin; Reppe, Sjur & Aass, Hans Christian Dalsbotten [Vis alle 14 forfattere av denne artikkelen] (2020). Cytokines Explored in Saliva and Tears from Radiated Cancer Patients Correlate with Clinical Manifestations, Influencing Important Immunoregulatory Cellular Pathways. Cells. 9(9). doi: 10.3390/cells9092050. Fulltekst i vitenarkiv Vis sammendrag

  Although radiotherapy is a common form of treatment for head and neck cancer, it may lead to tissue damage in the salivary and lacrimal glands, possibly affecting cytokine expression in the gland fluid of treated individuals. Cytokine profiles in saliva and tear fluid of 29 radiated head and neck cancer patients and 20 controls were screened using a multiplex assay. Correlations between cytokine expression and clinical oral and ocular manifestations were examined, and cellular pathways influenced by these cytokines were assessed using the Functional Enrichment Analysis Tool. Significantly elevated cytokines identified in patient saliva were CCL21, IL-4, CX3CL1, CCL2, CXCL1 and CCL15. Many of these cytokines correlated positively with objective signs of oral dryness, and reduced saliva production in the patients. Although CCL21 and IL-4 levels were significantly lower in patient tear fluid, they correlated with subjective ocular symptoms. These increased salivary cytokines affected pro-inflammatory and apoptotic cellular pathways, including T cell signalling, several interleukin signalling pathways, TNF and TGF-β receptor signalling, and the apoptotic p53 pathway. In conclusion, the upregulated salivary cytokines identified suggest an interplay between innate and adaptive immunity, affecting immunoregulatory cellular pathways. Whether this is due to late effects of radiotherapy or tissue repair remains to be investigated.

• Tashbayev, Behzod; Garen, Torhild Oddveig; Palm, Øyvind; Chen, Xiangjun; Herlofson, Bente Brokstad & Vik, Alix Rosslyn Young [Vis alle 13 forfattere av denne artikkelen] (2020). Patients with non-Sjögren's sicca report poorer general and oral health-related quality of life than patients with Sjögren's syndrome: a cross-sectional study. Scientific Reports. 10(2063). doi: 10.1038/s41598-020-59078-0. Fulltekst i vitenarkiv Vis sammendrag

  Understanding the impact of the disease on quality of life is crucial in patient management. In this cross-sectional study, general and oral health-related quality of life questionnaires, and thorough examinations of oral and ocular dryness were performed in age- and sex-matched patients with primary Sjögren’s syndrome (pSS group), non-Sjögren’s syndrome sicca (non-SS group) and healthy controls. General and oral health-related quality of life were investigated with the 36-Item Short Form Health Survey and the 14-Item Oral Health Impact Profle questionnaires, respectively. Subjective symptoms of xerostomia and ocular dryness were recorded using the Summated Xerostomia Inventory and Ocular Surface Disease Index, respectively. Clinical examinations included evaluation of clinical oral dryness scores, candida counts, unstimulated and stimulated saliva secretory rates, tear osmolarity, tear flm break-up time, Schirmer I test and ocular surface staining. Both patient groups had pronounced signs and symptoms of xerostomia and ocular dryness. Even though the non-SS patients had less severe clinical signs than the pSS patients, they demonstrated much poorer general and oral health-related quality of life. In conclusion, non-SS patients require more attention in order to improve their quality of life.

• Skaare, Anne B; Szyszko, Ewa Alicja; Herlofson, Bente Brokstad & Søland, Tine Merete (2020). Orofacial granulomatosis: a questionnaire study among Norwegian dental clinicians. European Archives of Paediatric Dentistry. ISSN 1818-6300. 21(5), s. 557–564. doi: 10.1007/s40368-020-00511-3. Fulltekst i vitenarkiv
• Skjerven, Henrik; Riis, Ulf Harald; Herlofson, Bente Brokstad & Ellingsen, Jan Eirik (2019). In Vivo Accuracy of Implant Placement Using a Full Digital Planning Modality and Stereolithographic Guides. International Journal of Oral & Maxillofacial Implants. ISSN 0882-2786. 34(1), s. 124–132. doi: 10.11607/JOMI.6939. Fulltekst i vitenarkiv
• Schiodt, Morten; Otto, Sven; Fedele, Stefano; Bedogni, Alberto; Nicolatou-Galitis, Ourania & Guggenberger, Robert [Vis alle 9 forfattere av denne artikkelen] (2019). Workshop of European task force on medication‐related osteonecrosis of the jaw—Current challenges. Oral Diseases. ISSN 1354-523X. s. 1–7. doi: 10.1111/odi.13160. Fulltekst i vitenarkiv Vis sammendrag

  MRONJ is a potentially serious complication of anti‐resorptive (AR) treatment in patients with skeletal metastases due to various cancers as well as osteoporosis (Campisi et al., 2014). MRONJ may also develop in anti‐resorptive‐naive individuals exposed to a variety of anti‐angiogenic agents (Mohamed, Nielsen, & Schiodt, 2018; Nicolatou‐Galitis, Kouri, et al., 2019; Pimolbutr, Porter, & Fedele, 2018). MRONJ may lead to a reduced quality of life due to jaw bone infections, chronic pain, tooth loss, impaired function, and disfigurement. Since the first report by Marx, 2003 (Marx, 2003), the number of cases and relevant publications has increased significantly (M. Schiodt, PubMed Search 26.6.2019, unpublished). Despite significant progress in our knowledge of the disease, there remain a number of controversial aspects that are of high relevance to researchers, clinicians, and not least patients. The European Task Force on MRONJ comprises of a multidisciplinary group of European clinical investigators with a special interest in the diagnosis and management of MRONJ and a track record of relevant research and publications, who considered the current controversies on MRONJ a reason for academic concern, a potential threat to patients, and a limitation for better research. The group met up in two separate workshops in order to (a) highlight some of the most controversial aspects of current knowledge on MRONJ and (b) provide an expert opinion‐based consensus on these topics with a view to help clinicians making informed decisions on patient's care and inspire future investigators to design better clinical studies. The Group agreed to focus upon three highly controversial aspects of MRONJ: (a) definition and classification, (b) risk factors, and (c) management/treatment of MRONJ.

• Singh, Preet Bano; Young, Alix; Homayouni, Amin; Hove, Lene Hystad; Petrovski, Beata & Herlofson, Bente Brokstad [Vis alle 9 forfattere av denne artikkelen] (2019). Distorted Taste and Impaired Oral Health May Affect Nutritional Status in Patients with Sicca Complaints. Nutrients. 11(2). doi: 10.3390/nu11020264. Fulltekst i vitenarkiv Vis sammendrag

  Senses of smell and taste, saliva flow, and dental status are considered as important factors for the maintenance of a good nutritional status. Salivary secretory rates, chemosensory function, burning mouth sensation, halitosis and dental status were investigated in 58 patients with primary Sjögren’s syndrome (pSS), 22 non-Sjögren’s syndrome sicca (non-SS) patients, and 57 age-matched healthy controls. A significantly greater proportion of patients with pSS and non-SS had ageusia, dysgeusia, burning mouth sensation, and halitosis compared to controls. Patients with pSS had significantly lower olfactory and gustatory scores, and significantly higher caries experience compared to controls. Patients with pSS and non-SS patients had significantly lower unstimulated and stimulated whole saliva secretory rates compared to controls. The findings indicated that several different aspects of oral health were compromised in both, patients with pSS and non-SS, and this may affect their food intake and, hence, their nutritional status. Although non-SS patients do not fulfill Sjögren’s syndrome classification criteria, they have similar or, in some cases, even worse oral complaints than the patients with pSS. Further studies are needed to investigate food preferences, dietary intake, and nutritional status in these two patient groups in relation to their health condition.

• Chen, Xiangjun; Aqrawi, Lara Adnan; Utheim, Tor Paaske; Tashbayev, Behzod; Utheim, Øygunn Aass & Reppe, Sjur [Vis alle 12 forfattere av denne artikkelen] (2019). Elevated cytokine levels in tears and saliva of patients with primary Sjögren's syndrome correlate with clinical ocular and oral manifestations. Scientific Reports. 9(1). doi: 10.1038/s41598-019-43714-5. Fulltekst i vitenarkiv Vis sammendrag

  Investigating cytokines in tear fluid and saliva may offer valuable information for understanding the pathogenesis of primary Sjögren’s syndrome (pSS). Cytokine profiles in both tear fluid and saliva of pSS patients, non-Sjögren’s syndrome (non-SS) subjects with sicca symptoms, and healthy controls without sicca complaints were analysed. Furthermore, relationships associating the severity of clinical ocular and oral manifestations with the upregulated cytokines were assessed. In tear fluid, pSS patients showed elevated levels of IL-1ra, IL-2, IL-4, IL-8, IL-12p70, IL-17A, IFN-γ, IP-10, MIP-1b, and Rantes compared to non-SS subjects and healthy controls. The increased cytokine levels (except IP-10) correlated significantly with reduced tear production, less stable tear film, and greater ocular surface damage. In saliva, pSS patients had a higher IP-10 level, which correlated with higher candida score; and an elevated MIP-1a level, which correlated significantly with lower unstimulated and stimulated whole saliva secretion rates. The upregulated cytokines identified in tear fluid and saliva of pSS patients show a clear interplay between innate and adaptive immune responses that may contribute to disease pathogenesis. The increase of IP-10 and MIP in both tears and saliva further emphasises the essential role of macrophages and innate immunity in pSS.

• Singer, Susanne; Amdal, Cecilie Delphin; Hammerlid, Eva; Tomaszewska, Iwona M.; Silva, Joaquim Castro & Mehanna, Hisham [Vis alle 33 forfattere av denne artikkelen] (2019). International validation of the revised European Organisation for Research and Treatment of Cancer Head and Neck Cancer Module, the EORTC QLQ-HN43: Phase IV. Head and Neck. ISSN 1043-3074. s. 1–13. doi: 10.1002/hed.25609. Fulltekst i vitenarkiv

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• Herlofson, Bente Brokstad (2025). "Tenner og kjever råtner på norske sykehjem". Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2025). Når behandlingen utfordrer munnhelsen - Bisfosfonater og kjevekomplikasjoner ved myelomatose - Hva bør man passe på? Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2025). Hvordan forholde seg til pasienter på antiresorptiv behandling? Fokus på MRONJ. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2025). Kjevene - Fokus på osteonekrose og osteoartritt. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad & Tanem, Kristine Eidal (2025). Fokus på munnhelse og kreft. 2. Fulltekst i vitenarkiv
• Westgaard, Kristine Løken; Amdal, Cecilie Delphin; Taylor, Katherine J.; Falk, Ragnhild Sørum; Bjordal, Kristin & Singer, Susanne [Vis alle 15 forfattere av denne artikkelen] (2025). Correction to: Oral health‑related quality of life among long‑term head and neck cancer survivors: a multinational study. Supportive Care in Cancer. ISSN 0941-4355. 33(10), s. 894–894. doi: 10.1007/s00520-025-09991-9. Fulltekst i vitenarkiv
• Taylor, Katherine J.; Amdal, Cecilie Delphin; Bjordal, Kristin; Astrup, Guro Lindviksmoen; Herlofson, Bente Brokstad & Duprez, Fréderic [Vis alle 37 forfattere av denne artikkelen] (2025). Reply to ‘Comment on “Toxicities in long‐term survivors of head and neck cancer—A multi‐national cross‐sectional analysis”’. International Journal of Cancer. ISSN 0020-7136. doi: 10.1002/ijc.70292. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad & Stang, Sølve (2024). Livet etter kreften - en læringsserie av Munn- og Halskreftforeningen - deltagelse i episode 1 og 2 av 10stk. [Internet]. Munn- og Halskreftforeningens nettside. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2024). MRONJ in Norway and Scandinavia - The dilemma: surgical or conservative treatment. Fulltekst i vitenarkiv
• Giltvedt, Karen Marie; Tingvoll, Dag Petter Nilsen & Herlofson, Bente Brokstad (2024). Skandinavisk ONJ kohort studie - et skandinavisk samarbeid Fokus på de norske resultatene. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2024). Introduction and background of the European MRONJ Expert Group. Fulltekst i vitenarkiv
• Bankvall, Maria; Legert, Karin Garming; Hasséus, Bengt; Rautava, Jaana; Richter, Svend & Pedersen, Anne Marie Lynge [Vis alle 9 forfattere av denne artikkelen] (2024). Past and future perspectives of oral medicine in the Nordic countries as a reflection of the global community. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 134, s. 10–20. doi: 10.56373/2024-1-4. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2023). Kjevebenspatologi og benmodulerende behandling - Betydning for pasienter med myelomatose? Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2023). Munnhelse og kreft - Fokus på pasienter med myelomatose. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad & Langeland, Øystein (2023). Autotransplantasjon av tenner - Nytt fra kirurgens ståsted? Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad; Vang, Kjersti & Berstad, Johanna Elisabeth Rykke (2023). Oral fokussanering i forbindelse med strålebehandling for hode-/halskreft. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad; Tingvoll, Dag Petter Nilsen & Giltvedt, Karen Marie (2023). The Scandinavian ONJ Cohort Study, an 8-years research collaboration - Focus on the Norwegian study results. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2023). Kjevebenspatologi - Antiresorptiv behandling og MRONJ med fokus på pasienter med osteoporose. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2022). Oral helse og kreft - Tverrfaglige utfordringer. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2022). MRONJ - collaboration projects - International, national and single center ONJ studies. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad & Westgaard, Kristine Løken (2022). The Oral Health Subproject - part of the Late toxicity and long-term quality of life study in head and neck cancer survivors. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2022). Oral helse og kreft - Dagens er fremtidens utfordringer. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2022). The Scandinavian ONJ Cohort Study - ONJ collaboration projects. Fulltekst i vitenarkiv
• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Vis alle 10 forfattere av denne artikkelen] (2022). Orale soppinfeksjoner - mer enn Candida albicans: mikrobiologiske analyser av prøver fra alvorlig syke pasienter med kreft. Fulltekst i vitenarkiv Vis sammendrag

  Bakgrunn Pasienter med alvorlig kreftsykdom er utsatte for orale soppinfeksjoner, grunnet sykdommen, kreftbehandling og/eller svekket immunforsvar. Orale soppinfeksjon påvirker pasienters matlyst, ernæringstilstand og livskvalitet. Candida albicans er en vanlig soppart i munnhulen, men forekomst av non-albicans Candida-arter, og i kombinasjon med C. albicans, er økende. Artene har varierende toleranse for antimykotiske midler, det kan gi behandlingsutfordringer. Hensikten med studien var å identifisere og resistensteste Candida sopparter i munnhulen til alvorlig syke pasienter med kreft. Metode Sopprøver tatt under studien Oral Health in Advanced Cancer i perioden 2014 – 2016, ble analysert høsten 2020. Pasientprøvene ble re-dyrket ved Institutt for oral biologi, Universitetet i Oslo. Soppartene ble identifisert biokjemisk og ved DNA sekvensering, og resistenstestet for antimykotiske legemidler: fluconazole, amphotericin B, anidulafungin og nystatin. Resultat Vi analyserte totalt 56 isolater fra 45 pasienter og identifiserte syv Candida arter og en Saccharomyces. Til sammen hadde 36 pasienter oppvekst av én soppart, og 9 pasienter hadde 2 til 3 ulike sopparter i munnhulen. Av C. albicans artene var 39 av 40 følsomme for fluconazole. To Candida parapsilosis og en Candida tropicalis var resistent mot anidulafungin. En C. tropicalis var resistent mot anidulafungin. En Candida glabrata var resistent mot fluconazole. Konklusjon Studien viste at forskjellige Candida arter forekommer både i monoinfeksjoner og blandingsinfeksjoner. C. albicans var dominerende med høy følsomhet for antimykotiske midler. Blandingsinfeksjoner kan komplisere behandlingen og forårsake gjentagende infeksjoner. Mikrobiologiske prøver og analyser med identifisering og resistenstesting, bør være en del av utredningen hos pasienter med alvorlig og tilbakevendende orale soppinfeksjoner.

• Herlofson, Bente Brokstad (2022). Tann-og munnhelseutfordringer - ansvar og økonomi. Fulltekst i vitenarkiv
• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Vis alle 10 forfattere av denne artikkelen] (2022). Identification and susceptibility testing of oral candidiasis in advanced cancer patients – an important diagnostic tool. Fulltekst i vitenarkiv Vis sammendrag

  Background: Candida albicans is the most common fungal species detected in the oral cavity. Studies of oral fungal samples have shown an increased prevalence of non-C. albicans species in mixed infection with C. albicans. Non-C. albicans and C. albicans are associated with varying degrees of resistance to azole. This may have implications for treatment, due to acquired antifungal resistance. Aims: To assess the diversity and susceptibility of detected Candida species in the oral cavity in patients with advanced cancer. Methods: Clinical fungal isolates sampled in 2014-2016 from 45 patients in a hospice unit were analyzed. A total of 56 isolates were grown on chromID Candida plates. After phenotypic identification by colour of the colonies, one single colony of each species was re-cultivated and prepared for identification on a VITEK2® system. Susceptibility testing with E-test was performed on RPMI agar, and the antifungal agents fluconazole, amphotericin B, anidulafungin and nystatin were tested. Results: A total of 56 Candida isolates were identified. The diversity of Candida species was dominated by C. albicans at 89%, followed by C. glabrata 11%, C. parapsilosis 7%, C. tropicalis 4%, C. krusei 2%, C. guilliermondii 2% and C. dubliniesis 2%. Thirty-six patients had monoculture, and nine patients had 2-3 different species detected. Almost all C. albicans strains (97.5%) were susceptible to fluconazole. One C. parapsilosis and one C. tropicalis strain were resistant to anidulafungin. One C. glabrata was resistant to fluconazole and another was just below the threshold for resistance. Conclusion: C. albicans was the most prevalent Candida species in our sample. Variation in susceptibility was observed in patients with both C. albicans and C. glabrata. Combinations of Candida species and the lack of identification and susceptibility testing may lead to inadequate treatment and accelerate the development of resistance.

• Monsen, Ragnhild Elisabeth; Kristoffersen, Anne Karin; Gay, Caryl; Herlofson, Bente Brokstad; Fjeld, Katrine Gahre & Hove, Lene Hystad [Vis alle 10 forfattere av denne artikkelen] (2022). Oral candidiasis in advanced cancer – identification and susceptibility testing of detected Candida species. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: Candida albicans is the most common fungal species in the oral cavity. Increased prevalence of non-C. albicans are detected, and co-infection with C. albicans may have implications for treatment, due to antifungal resistance. The aim of the study was to assess the diversity and susceptibility of oral yeasts in patients with advanced cancer. Methods: Clinical fungal isolates were sampled in 2014-2016 from 45 patients in a hospice unit. Totally 56 isolates were grown on chromID Candida plates, prepared for biochemical identification, and controlled with DNA sequencing. E-test was performed with the antifungal agents fluconazole, amphotericin B, anidulafungin and nystatin were tested. Results: A total of 56 isolates were identified. Candida species was dominated by C. albicans at 71%, followed by C. glabrata 9%, C. parapsilosis 5%, C. tropicalis 4%, C. krusei 2%, C. guilliermondii 2% and C. dubliniesis 2%. Nine patients had 2-3 different species. C. albicans strains were susceptible to fluconazole in 97.5%. One C. parapsilosis and one C. tropicalis strain were resistant to anidulafungin. One C. glabrata was resistant to fluconazole and another was just below the threshold for resistance. The sequencing confirmed the biochemical identification. Conclusion: C. albicans was the most prevalent species. Variation in susceptibility was observed in patients with mixed colonies. Combinations of Candida species and the lack of identification and susceptibility testing may lead to inadequate treatment.

• Monsen, Ragnhild Elisabeth; Nordgarden, Hilde; Gay, Caryl; Lerdal, Anners & Herlofson, Bente Brokstad (2022). Munntørrhet - et manglende symptom i Edmonton Symptom Assessment System? Fulltekst i vitenarkiv
• Hynne, Håvard; Aqrawi, Lara A.; Chen, Xiangjun; Amdal, Cecilie Delphin; Reppe, Sjur & Aass, Hans Christian Dalsbotten [Vis alle 14 forfattere av denne artikkelen] (2021). Cytokine profiling, clinical oral and ocular manifestations post radiotherapy. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2021). Munnhulekreft - Orale potensielt maligne tilstander, orale alarmsymptomer Pasienter på benmodulerende behandling. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2021). Munnhelse ved kreft og kreftbehandling. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2021). Hvordan forholde seg til pasienter på benmodulerende behandling - Når kan tenner ekstraheres? Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2021). Pasienter på antiresorptiv behandling og kjeveosteonekrose. Fulltekst i vitenarkiv
• Bjørkeng, Astrid Skiftesvik; Herlofson, Bente Brokstad & Myhre, Sigrun (2021). Podkast: Hvordan virker kreftbehandling på kroppen? [Internet]. Universitetet i Oslo, Universitetsplassen podkast. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad; Schiødt, Morten & Wexell, Cecilia Larsson (2021). Acute and chronic inflammation, osteomyelitis, medication-related ostoenecrosis of the jaw and osteoradionecrosis. I Bjørnland, Tore (Red.), Nordic Textbook of Oral and Maxillofacial Surgery. Munksgaard Forlag. ISSN 9788762820128. s. 151–182. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2020). Pasienter på benmodulerende behandling og osteonekrose - med fokus på myelomatose. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2020). Kreftpasienter på antiresorptiv behandling med risiko for utvikling av osteonekrose i kjevene. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2020). Pasienter på benmodulerende behandling og osteonekrose. Fulltekst i vitenarkiv
• Steffensen, Inger-Lise; Alexander, Jan; Binderud, Mona-Lise; Bruzell, Ellen Merete; Dahl, Knut Helkås & Granum, Berit [Vis alle 13 forfattere av denne artikkelen] (2020). Risk assessments of aspartame, acesulfame K, sucralose and benzoic acid from soft drinks, "saft", nectar and flavoured water. European Journal of Nutrition and Food Safety. 12(8), s. 66–68. doi: 10.9734/EJNFS72020/v12i830265. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2020). Jaw osteomyelitis/osteonecrosis - clinical presentation, diagnosis, therapy. Fulltekst i vitenarkiv
• Skaare, Anne B; Herlofson, Bente Brokstad & Søland, Tine Merete (2020). Orofacial granulomatose og Crohns sykdom – et klinisk kasus og en litteraturgjennomgang. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 130(11), s. 914–920. Fulltekst i vitenarkiv
• Monsen, Ragnhild Elisabeth; Herlofson, Bente Brokstad; Gay, Caryl; Fjeld, Katrine Gahre; Hove, Lene Hystad & Saghaug, Elisabeth [Vis alle 10 forfattere av denne artikkelen] (2019). A comparison of normal saline mouth rinse and mouth rinse based on Salvia officinalis in palliative care: A randomized controlled trial. Fulltekst i vitenarkiv
• Young, Alix; Singh, Preet Bano; Hynne, Håvard; Westergaard, Kristine Løken; Hove, Lene Hystad & Rykke, Morten [Vis alle 10 forfattere av denne artikkelen] (2019). Oral Investigations in Head and Neck Cancer Patients after Radiotherapy. Fulltekst i vitenarkiv Vis sammendrag

  Objectives: To investigate oral complaints and findings in head and neck cancer (HNC) patients who had received radiotherapy and compare them with controls. Methods: As part of a larger study, 30 HNC patients (14 female, age 64.2±9.6y) and 26 age- and sex-matched controls (13 female, 62.9±12.9y, p=0.850) were examined at the Dry Mouth Clinic, Faculty of Dentistry, Oslo. Oral health-related quality of life (OHRQoL) was assessed using the short form Oral Health Impact Profile (OHIP-14: high score-low OHRQoL). Self-reported dysgeusia (yes/no) and sense of taste (10-point VAS: high score-good smell sense) were recorded. Taste scores were recorded using taste strips (high score-good taste function). Oral candida counts were determined from cheek and tongue swabs (0=no growth, 1=minimal, 2=moderate, 3=severe). Volatile sulphur compounds (VSC) in mouth air samples were determined by gas chromatography and related to perceptive threshold-levels (H2S≤112ppb, CH3SH≤26ppb). Between-group comparisons were performed using Mann-Whitney U test and Chi-square test. Results: The HNC patients reported significantly poorer OHRQoL than controls (OHIP sum-score: 18.4±12.4 vs 1.2±2.0, p<0.001). They reported significantly poorer sense of taste compared to controls (6.4±2.4 vs 7.8±1.9, p=0.018), and more often dysgeusia (26.7% vs 7.7%, p=0.087). The measured gustatory scores (20.4±6.4 vs 22.3±4.6, p=0.315) were similar for both groups. Candida scores were significantly higher in the patient group (1.6±1.3 vs 0.7±0.9, p=0.024). The percentage of HNC patients who had oral H2S above the threshold level was significantly lower than for the controls (0% vs 27%, p<0.05). This was not the case for CH3SH (5.5% vs 27%, p=0.105). Conclusion: After radiotherapy, these HNC patients experienced negative oral consequences of the treatment. They reported poorer OHRQoL, and had reduced taste sensation and higher oral candida counts. However, the underlying reason for less problems with halitosis in HNC patients than in controls is worth further exploration.

• Jensen, Janicke Liaaen; Chen, Xiangjun; Hynne, Håvard; Westgaard, Kristine Løken; Hove, Lene Hystad & Young, Alix [Vis alle 14 forfattere av denne artikkelen] (2019). Sjögren’s versus irradiated head-neck cancer patients: oral and ocular investigations. Fulltekst i vitenarkiv
• Hynne, Håvard; Westgaard, Kristine Løken; Herlofson, Bente Brokstad; Amdal, Cecilie Delphin; Hove, Lene Hystad & Young, Alix [Vis alle 10 forfattere av denne artikkelen] (2019). Oral and Ocular Findings in Radiated Head-and Neck Cancer Patients. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2019). Pasienter som skal ha eller som står på på benmodulerende behandling - samarbeid mellom lege og tannlege. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2019). The Scandinavian ONJ Cohort Study - 8 year research collaboration on ONJ in Norway, Sweden and Denmark. Fulltekst i vitenarkiv
• Lossius, Sara Ekern & Herlofson, Bente Brokstad (2019). Sunn munn, god helse. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2019). Oppdatering vedrørende pasienter på benmodulerende behandling. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2019). Oral health issues in the society, with a focus on cancer and cancer treatment. A research project. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2019). Pasienter på benmodulerende behandling. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad & Ingstad, Hanne Kleven (2019). Oral cancer og oral medisin. Fulltekst i vitenarkiv
• Monsen, Ragnhild Elisabeth; Herlofson, Bente Brokstad; Gay, Caryl; Dahl, Marianne; Saghaug, Elisabeth & Slaaen, Joran [Vis alle 7 forfattere av denne artikkelen] (2019). Dry mouth - a missing symptom in multiple assessment tools? Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2019). Jaw bone pathology - a challenge for the wave of new medical treatments in cancer and osteoporosis. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2019). Oral cancer awareness week. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2019). Rettigheter og oppfølging av oral helse ved kreftsykdom. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad (2019). Oral medisin. Fulltekst i vitenarkiv
• Herlofson, Bente Brokstad; Kjølle, Gry Karina; Westgaard, Kristine Løken; Løndalen, Ayca & Bruland, Øyvind (2018). Osteonecrosis of the jaw in a patient with bone metastatic prostate cancer after long-term bisphosphonate treatment with severe deterioration following radium-223. Clinical Genitourinary Cancer. ISSN 1558-7673. s. 1–4. doi: 10.1016/j.clgc.2018.05.003. Fulltekst i vitenarkiv
• Monsen, Ragnhild Elisabeth; Lerdal, Anners; Herlofson, Bente Brokstad & Nordgarden, Hilde (2024). Oral Health in Advanced Cancer. Assessment and management of oral symptoms and fungal infection in adult patients with advanced cancer. Universitetet i Oslo. ISSN 9788234804137. Fulltekst i vitenarkiv Vis sammendrag

  Oral symptom and problems are highly prevalent in patient with advanced cancer, and xerostomia is reported in 84% of the cases. Between 30% - 50% of the patients develop oral infections, which most common infection is oral candidiasis. Despite the symptoms negative impact on quality of life, oral symptoms and problems are not systematically assessed or treated in palliative care. The evidence supporting the effectiveness of mouth rinses in alleviating oral discomfort is limited. Additionally, knowledge of oral fungal species and their susceptibility to antifungal agents are spares. The overall aim of this thesis was to investigate oral symptoms and problems in patients with limited life expectancy receiving inpatient palliative care due to advanced cancer. In study 1 we performed an interventions study where we investigated the effect of a mouth rinse based on the herb Salvia Officinalis (SO) compared to standard care using normal saline in 88 patients with advanced cancer. Both groups showed statistically significant improvement in their overall oral symptoms and SO was as effective as standard care. In study 2 we conducted a microbiological analysis of oral swab tests from 45 patients taken during study 1. Seven different Candida species were detected, and nine patients had mixed infection. The susceptibility to antifungal agents was high. In Study 3, we observed the symptom dry mouth in two different versions of a symptom assessment questionnaire. The symptom dry mouth was included in one version, while in a revised version, patients were required to report dry mouth as an “Other problem”. Dry mouth was the third most reported symptom when prompted in a symptom list, whereas the symptom was significantly less reported in the revised version. This thesis highlights the presence of oral symptoms and problems in patients with advanced cancer and has shown that SO mouth rinse was as good as normal saline in an oral care procedure. Furthermore, there is a diversity of Candida species and mixed oral infections occurs. Finally, systematic assessment is crucial to identify the present of different oral symptoms.

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