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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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- Kröll, T., et al.
(författare)
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Transfer Reactions on Neutron-rich Nuclei at REX-ISOLDE
- 2009
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Ingår i: AIP Conference Proceedings. - 1551-7616 .- 0094-243X. ; 1165, s. 363-368 461
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Konferensbidrag (refereegranskat)abstract
- We report on one- and two-neutron transfer reactions to study the single-particle properties of nuclei at the border of the "island of inversion". The (d,p)- and (t,p)-reactions in inverse kinematics on the neutron-rich isotope Mg-30, delivered as radioactive beam by the REX-ISOLDE facility, have been investigated. The outgoing protons have been detected and identified by a newly built array of Si detectors. The gamma-decay of excited states has been detected in coincidence by the MINIBALL array. First results for Mg-31 and from the search for the second, spherical, 0(+) state in Mg-32 are presented.
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- Andreyev, A. N., et al.
(författare)
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alpha decay of the new isotopes Rn-193,Rn-194
- 2006
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Ingår i: Physical Review C. Nuclear Physics. - 0556-2813 .- 1089-490X. ; 74:6, s. 064303-
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Tidskriftsartikel (refereegranskat)abstract
- The new neutron-deficient isotopes Rn-193,Rn-194 have been identified in the complete fusion reaction Cr-52+Sm-144 -> Rn-196(*) at the velocity filter SHIP. The alpha-decay energy and half-life value of Rn-194 were determined to be E-alpha=7700(10) keV and T-1/2=0.78(16) ms, respectively. For Rn-193 the half-life of T-1/2=1.15(27) ms and two alpha lines at E-alpha 1=7685(15) keV, I-alpha 1=74(20)% and E-alpha 2=7875(20) keV, I-alpha 2=26(12)% were found. The decay pattern of Rn-193, which is substantially different from that of the heavier odd-A Rn isotopes, provides first experimental evidence for the long-predicted deformation in the very neutron-deficient Rn nuclei.
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- Antalic, S., et al.
(författare)
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The new isotopes in Po-Rn region
- 2007
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Ingår i: Acta Physica Polonica B. - 0587-4254 .- 1509-5770. ; 38:4, s. 1557-1560
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Tidskriftsartikel (refereegranskat)abstract
- This contribution reviews the results of the recent experiments at the velocity filter SHIP in GSI Darmstadt obtained in the region of neutron deficient isotopes from lead to radon. The data for new very neutron-deficient isotopes Po-187, Rn-193,Rn-194 and their decay properties are presented. The isotopes were produced and identified in the complete fusion reactions Ti-46+Sm-144 -> Po-187+3n and Cr-52+Sm-144 -> Rn-194,Rn-193+2,3n.
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- Hoots, W. K., et al.
(författare)
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Secondary prophylaxis with recombinant activated factor VII improves health-related quality of life of haemophilia patients with inhibitors
- 2008
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Ingår i: Haemophilia. - : Wiley. - 1351-8216 .- 1365-2516. ; 14:3, s. 466-466
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Tidskriftsartikel (refereegranskat)abstract
- Haemophilia patients with inhibitors characteristically have impaired joint function and reduced health-related quality of life (HRQoL). This analysis examined whether secondary prophylaxis with recombinant activated factor VII (rFVIIa) improves HRQoL vs. conventional on-demand therapy in patients with haemophilia with inhibitors and frequent bleeds. After a 3-month preprophylaxis period, 22 patients received daily rFVIIa prophylaxis (90 or 270 mu g kg(-1)) for 3 months, followed by 3 months' postprophylaxis. Days of hospitalization, absence from school/work and mobility aids requirements were recorded. HRQoL was assessed by EuroQoL (EQ-5D) questionnaire, visual analogue scale (VAS), derived Time to Trade-Off (TTO) scores and Quality Adjusted Life Years (QALYs). rFVIIa prophylaxis significantly (P < 0.0001) reduced bleeding frequency vs. prior on-demand therapy. Hospitalization (5.9% vs. 13.5%; P = 0.0026) and absenteeism from school/work (16.7% vs. 38.7%; P = 0.0127) decreased during prophylaxis; these effects tended to be maintained during postprophylaxis. HRQoL (evaluated by EQ-5D) tended to improve during and after rFVIIa prophylaxis. Notably, pain decreased and mobility increased in 40.9% and 27.3% of patients, respectively, at the end of the postprophylaxis period vs. preprophylaxis. Median VAS score increased from 66 to 73 (P = 0.048), and TTO scores suggested better HRQoL (0.62 vs. 0.76; P = 0.054) during postprophylaxis than preprophylaxis. Small to moderate changes in effect sizes were reported for VAS and TTO scores. Median QALYs were 0.68 (VAS) and 0.73 (TTO). Reductions in bleeding frequency with secondary rFVIIa prophylaxis were associated with improved HRQoL vs. on-demand therapy.
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| 9. |
- Stefanescu, I., et al.
(författare)
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Coulomb Excitation of 68,70Cu: First Use of Postaccelerated Isomeric Beams
- 2007
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Ingår i: Physical Review Letters. ; 98
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Tidskriftsartikel (refereegranskat)abstract
- We report on the first low-energy Coulomb excitation measurements with radioactive Ipi=6- beams of odd-odd nuclei 68,70Cu. The beams were produced at ISOLDE, CERN and were post-accelerated by REX-ISOLDE to 2.83 MeV/nucleon. gamma rays were detected with the MINIBALL spectrometer. The 6- beam was used to study the multiplet of states (3-, 4-, 5-, 6-) arising from the pi2p3/2nu1g9/2 configuration. The 4- state of the multiplet was populated via Coulomb excitation and the B(E2;6--->4-) value was determined in both nuclei. The results obtained illustrate the fragile stability of the Z=28 shell and N=40 subshell closures. A comparison with large-scale shell-model calculations using the 56Ni core shows the importance of the proton excitations across the Z=28 shell gap to the understanding of the nuclear structure in the neutron-rich nuclei with N[approximate]40.
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| 10. |
- Stefanescu, I, et al.
(författare)
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Interplay between single-particle and collective effects in the odd-A Cu isotopes beyond N=40
- 2008
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Ingår i: Physical Review Letters. - 1079-7114. ; 100:11
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Tidskriftsartikel (refereegranskat)abstract
- Collective properties of the low-lying levels in the odd-A Cu67-73 were investigated by Coulomb excitation with radioactive beams. The beams were produced at ISOLDE and postaccelerated by REX-ISOLDE up to 2.99 MeV/u. In Cu-67,Cu-69, low-lying 1/2(-), 5/2(-), and 7/2(-) states were populated. In Cu-71,Cu-73, besides the known transitions deexciting the single-particle-like 5/2(-) and core-coupled 7/2(-) levels, gamma rays of 454 and 135 keV, respectively, were observed for the first time. Based on a reanalysis of beta-decay work and comparison with the systematics, a spin 1/2(-) is suggested for these excited states. Three B(E2) values were determined in each of the four isotopes. The results indicate a significant change in the structure of the odd-A Cu isotopes beyond N=40 where single-particle-like and collective levels are suggested to coexist at very low excitation energies.
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