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- Ejlertsen, Bent, et al.
(författare)
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Similar efficacy for ovarian ablation compared with cyclophosphamide, methotrexate, and fluorouracil: from a randomized comparison of premenopausal patients with node-positive, hormone receptor-positive breast cancer
- 2006
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Ingår i: J Clin Oncol. - : American Society of Clinical Oncology (ASCO). - 1527-7755. ; 24:31, s. 4956-4962
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Tidskriftsartikel (refereegranskat)abstract
- To compare the efficacy of ovarian ablation versus chemotherapy in early breast cancer patients with hormone receptor–positive disease. Patients and Methods We conducted an open, randomized, multicenter trial including premenopausal breast cancer patients with hormone receptor–positive tumors and either axillary lymph node metastases or tumors with a size of 5 cm or more. Patients were randomly assigned to ovarian ablation by irradiation or to nine courses of chemotherapy with intravenous cyclophosphamide, methotrexate, and fluorouracil (CMF) administered every 3 weeks. Results Between 1990 and May 1998, 762 patients were randomly assigned, and the present analysis is based on 358 first events. After a median follow-up time of 8.5 years, the unadjusted hazard ratio for disease-free survival in the ovarian ablation group compared with the CMF group was 0.99 (95% CI, 0.81 to 1.22). After a median follow-up time of 10.5 years, overall survival (OS) was similar in the two groups, with a hazard ratio of 1.11 (95% CI, 0.88 to 1.42) for the ovarian ablation group compared with the CMF group. Conclusion In this study, ablation of ovarian function in premenopausal women with hormone receptor–positive breast cancer had a similar effect to CMF on disease-free and OS. No significant interactions were demonstrated between treatment modality and hormone receptor content, age, or any of the well-known prognostic factors.
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- Gabrielsson, Åke, 1942-, et al.
(författare)
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Individ och agentskap i strategiska processer : En syntetisk och handlingslogisk ansats
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Even if strategy research often assumes that strategies are the result of intentional and purposeful behaviour the individual and human agency have tended to be neglected. Few empirical studies focus on how the individuals, their conceptions and actions interact with strategy formation. Based on ideas from process research and critical realism we made a review of the research and we maintain that the bulk of the research is based on simplified assumptions. We therefore propose a supplementary socio-cognitive approach based on more realistic assumptions, a synthesis and action logic approach, emphasising the individuals, the leading team and their embeddedness. In a process study with a comparative case study design we followed, in real time for about a decade, strategy formation processes in intermediate organisation in local economic development. Various methods of data collection and analysis were combined. By laying bare some of the mechanisms that explain the outcome in four processes we demonstrate the use of the proposed approach. A theoretical construction, the agent´s strategic concepts of action (SCA), aims at capturing the conceptions as an expression of the individual frame of reference providing reasons for action. The SCA carries explanatory power and is significant for both the process and content of the strategies. A typology of the SCAs is developed. The composition, the interaction and the structure of the team are other central aspects. We conclude that a strong group well suited to lead a formation process include a proactive strategist with a strategic idea and social capability; the role constellation is differentiated, and supplementary and other strategic actors relate to the strategy and the contextual roots in a way that will support the strategy. We also demonstrate in which circumstances some cognitive, social and political mechanisms discussed in earlier research are activated.
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- Grimvall, Anders, et al.
(författare)
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Phytotoxic Substances in Runoff from Forested Catchment Areas
- 1991
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Ingår i: Humic substances in the aquatic and terrestrial environment : proceedings of an international symposium, Linköping, Sweden, August 21-23, 1989. - Berlin Heidelberg New York : Springer. - 3540537023 ; , s. 397-406
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Bokkapitel (refereegranskat)abstract
- Runoff from different catchment areas in southem Sweden was tested in a root bioassay based on solution cultures of cucumber seedlings. Water samples from agricultural catchment areas produced no signs at all or only weak signs of inhibited root growth, whereas several water samples from catchmcnt areas dominated by mires or coniferous forests produced visible root injuries. The most severe root injuries (very short roots, discolouration, swelling of root tips and lack of root hairs) were caused by samples from a catchment area without local emissions and dominated by old stands of spruce. Fractionation by ultrafiltration showed that the phytotoxic effect of these samples could be attributed to organic matter with a nominal molecular-weight exceeding 1000 or to substances associated with organic macromolecules. Experiments aimed at concentrating phytotoxic compounds from surface water indicated that the observed growth inhibition was caused by strongly hydrophilic substances. Previous reports on phytotoxic, organic substances of natura! origin have emphasized interaction between plants growing close together. The presence of phytotoxic substances in runoff indicates that there is also a large-scale dispersion of such compounds.
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- McGale, Paul, et al.
(författare)
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Incidence of heart disease in 35,000 women treated with radiotherapy for breast cancer in Denmark and Sweden
- 2011
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Ingår i: Radiotherapy and Oncology. - Amsterdam : Elsevier. - 0167-8140 .- 1879-0887. ; 100:2, s. 167-175
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To study incidence of radiation-related heart disease in a large population of breast cancer patients followed for up to 30 years. Material and methods: 72,134 women diagnosed with breast cancer in Denmark or Sweden during 1976-2006 and followed prospectively. Radiation-related risk was studied by comparing women with left-sided and right-sided tumours. Results: 34,825 women (48%) received radiotherapy. Among unirradiated women tumour laterality had little relevance to heart disease. Among irradiated women mean dose to the whole heart was 6.3 Gy for left-sided tumours and 2.7 Gy for right-sided tumours. Mortality was similar in irradiated women with left-sided and right-sided tumours, but incidence ratios, left-sided versus right-sided, were raised: acute myocardial infarction 1.22 (95% CI 1.06-1.42), angina 1.25 (1.05-1.49), pericarditis 1.61 (1.06-2.43), valvular heart disease 1.54 (1.11-2.13). Incidence ratios for all heart disease were as high for women irradiated since 1990 (1.09 [1.00-1.19]) as for women irradiated during 1976-1989 (1.08 [0.99-1.17]), and were higher for women diagnosed with ischaemic heart disease prior to breast cancer than for other women (1.58 [1.19-2.10] versus 1.08 [1.01-1.15], p for difference = 0.01). Conclusions: Breast cancer radiotherapy has, at least until recently, increased the risk of developing ischaemic heart disease, pericarditis and valvular disease. Women with ischaemic heart disease before breast cancer diagnosis may have incurred higher risks than others. (C) 2011 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 100 (2011) 167-175
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