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- Abe, O, et al.
(författare)
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Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials
- 2005
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Ingår i: The Lancet. - 1474-547X. ; 365:9472, s. 1687-1717
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Tidskriftsartikel (refereegranskat)abstract
- Background Quinquennial overviews (1985-2000) of the randomised trials in early breast cancer have assessed the 5-year and 10-year effects of various systemic adjuvant therapies on breast cancer recurrence and survival. Here, we report the 10-year and 15-year effects. Methods Collaborative meta-analyses were undertaken of 194 unconfounded randomised trials of adjuvant chemotherapy or hormonal therapy that began by 1995. Many trials involved CMF (cyclophosphamide, methotrexate, fluorouracil), anthracycline-based combinations such as FAC (fluorouracil, doxombicin, cyclophosphamide) or FEC (fluorouracil, epirubicin, cyclophosphamide), tamoxifen, or ovarian suppression: none involved taxanes, trastuzumab, raloxifene, or modem aromatase inhibitors. Findings Allocation to about 6 months of anthracycline-based polychemotherapy (eg, with FAC or FEC) reduces the annual breast cancer death rate by about 38% (SE 5) for women younger than 50 years of age when diagnosed and by about 20% (SE 4) for those of age 50-69 years when diagnosed, largely irrespective of the use of tamoxifen and of oestrogen receptor (ER) status, nodal status, or other tumour characteristics. Such regimens are significantly (2p=0 . 0001 for recurrence, 2p<0 . 00001 for breast cancer mortality) more effective than CMF chemotherapy. Few women of age 70 years or older entered these chemotherapy trials. For ER-positive disease only, allocation to about 5 years of adjuvant tamoxifen reduces the annual breast cancer death rate by 31% (SE 3), largely irrespective of the use of chemotherapy and of age (<50, 50-69, &GE; 70 years), progesterone receptor status, or other tumour characteristics. 5 years is significantly (2p<0 . 00001 for recurrence, 2p=0 . 01 for breast cancer mortality) more effective than just 1-2 years of tamoxifen. For ER-positive tumours, the annual breast cancer mortality rates are similar during years 0-4 and 5-14, as are the proportional reductions in them by 5 years of tamoxifen, so the cumulative reduction in mortality is more than twice as big at 15 years as at 5 years after diagnosis. These results combine six meta-analyses: anthracycline-based versus no chemotherapy (8000 women); CMF-based versus no chemotherapy (14 000); anthracycline-based versus CMF-based chemotherapy (14 000); about 5 years of tamoxifen versus none (15 000); about 1-2 years of tamoxifen versus none (33 000); and about 5 years versus 1-2 years of tamoxifen (18 000). Finally, allocation to ovarian ablation or suppression (8000 women) also significantly reduces breast cancer mortality, but appears to do so only in the absence of other systemic treatments. For middle-aged women with ER-positive disease (the commonest type of breast cancer), the breast cancer mortality rate throughout the next 15 years would be approximately halved by 6 months of anthracycline-based chemotherapy (with a combination such as FAC or FEC) followed by 5 years of adjuvant tamoxifen. For, if mortality reductions of 38% (age <50 years) and 20% (age 50-69 years) from such chemotherapy were followed by a further reduction of 31% from tamoxifen in the risks that remain, the final mortality reductions would be 57% and 45%, respectively (and, the trial results could well have been somewhat stronger if there had been full compliance with the allocated treatments). Overall survival would be comparably improved, since these treatments have relatively small effects on mortality from the aggregate of all other causes. Interpretation Some of the widely practicable adjuvant drug treatments that were being tested in the 1980s, which substantially reduced 5-year recurrence rates (but had somewhat less effect on 5-year mortality rates), also substantially reduce 15-year mortality rates. Further improvements in long-term survival could well be available from newer drugs, or better use of older drugs.
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- Adcox, K, et al.
(författare)
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PHENIX central arm tracking detectors
- 2003
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Ingår i: Nuclear Instruments & Methods in Physics Research. Section A: Accelerators, Spectrometers, Detectors, and Associated Equipment. - 0167-5087. ; 499:2-3, s. 489-507
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Tidskriftsartikel (refereegranskat)abstract
- The PHENIX tracking system consists of Drift Chambers (DC), Pad Chambers (PC) and the Time Expansion Chamber (TEC). PC1/DC and PC2/TEC/PC3 form the inner and outer tracking units, respectively. These units link the track segments that transverse the RICH and extend to the EMCal. The DC measures charged particle trajectories in the r-phi direction to determine P-T of the particles and the invariant mass of particle pairs. The PCs perform 3D spatial point measurements for pattern recognition and longitudinal momentum reconstruction and provide spatial resolution of a few mm in both r-phi and z. The TEC tracks particles passing through the region between the RICH and the EMCal. The design and operational parameters of the detectors are presented and running experience during the first year of data taking with PHENIX is discussed. The observed spatial and momentum resolution is given which imposes a limitation on the identification and characterization of charged particles in various momentum ranges. (C) 2002 Published by Elsevier Science B.V.
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- Adcox, K, et al.
(författare)
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PHENIX detector overview
- 2003
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Ingår i: Nuclear Instruments & Methods in Physics Research. Section A: Accelerators, Spectrometers, Detectors, and Associated Equipment. - 0167-5087. ; 499:2-3, s. 469-479
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Tidskriftsartikel (refereegranskat)abstract
- The PHENIX detector is designed to perform a broad study of A-A, p-A, and p-p collisions to investigate nuclear matter under extreme conditions. A wide variety of probes, sensitive to all timescales, are used to study systematic variations with species and energy as well as to measure the spin structure of the nucleon. Designing for the needs of the heavy-ion and polarized-proton programs has produced a detector with unparalleled capabilities. PHENIX measures electron and muon pairs, photons, and hadrons with excellent energy and momentum resolution. The detector consists of a large number of subsystems that are discussed in other papers in this volume. The overall design parameters of the detector are presented. (C) 2002 Elsevier Science B.V. All rights reserved.
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- Backman, L, et al.
(författare)
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Semantic Memory Functioning Across the Adult Life Span
- 1996
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Ingår i: EUROPEAN PSYCHOLOGIST. - : Hogrefe Publishing Group. - 1016-9040 .- 1878-531X. ; 1:1, s. 27-33
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Using data from the first wave of data collection in the Betula project, this research examined semantic memory performance in adulthood and old age (N = 1000). The Betula project is a 10-year longitudinal study on memory and health that involves participants from 10 age groups: 35, 40, 45, …, and 80 years of age. Results from tests of verbal fluency and vocabulary indicated no performance variation between 35 and 50 years of age, followed by a gradual deterioration with increasing age. In a test of general knowledge, only the two oldest cohorts showed deficits. When educational level was statistically controlled, a different pattern of results was seen: the middle-aged adults performed at the highest level and, with the exception of one fluency test, no age-related deficits were observed before 75 years of age. These results suggest that, although there may be age-related deficits in semantic memory in the general population, education appears to be a more important factor than adult age per se for semantic memory functioning. The data support the view that activation of preexisting memory representations is relatively unaffected by the adult aging process, and demonstrate the pivotal role of cultural factors (e.g., education, verbal experience) in proficient semantic memory functioning.
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