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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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| 4. |
- du Rietz, Rickard, et al.
(författare)
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Investigation of High-spin States in 53Fe
- 2005
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Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 72:1
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Tidskriftsartikel (refereegranskat)abstract
- The fusion-evaporation reactions Si-28(S-32,1 alpha 2p1n)Fe-53 at 125 MeV and Mg-24(S-32,2p1n)Fe-53 at a 95-MeV beam energy were used to investigate excited states in Fe-53. The combination of the Gammasphere Ge detector array and ancillary devices led to the construction of an extensive level scheme comprising some 90 transitions connecting 40 states. The lifetime of the yrast 25/2(-) state and upper limits for the lifetimes of a number of additional states were determined using the Cologne plunger device coupled to the GASP gamma-ray spectrometer. The experimental results are compared to large-scale shell-model calculations using different sets of two-body matrix elements. In particular, predictions on electromagnetic decay properties such as lifetimes, branching ratios, and mixing ratios are studied in detail.
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| 5. |
- Evans, AO, et al.
(författare)
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High-spin structure in Er-157 up to and above band termination
- 2006
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Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 73:6
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Tidskriftsartikel (refereegranskat)abstract
- The high-spin structure of Er-157 has been greatly expanded using the Gammasphere spectrometer to investigate the Cd-114(Ca-48,5n) reaction at 215 MeV. Many new transitions have been placed in a greatly augmented level scheme up to spin 40h with many collective rotational sequences established. With increasing angular momentum, this nucleus undergoes a Coriolis-induced shape transition from a deformed state of collective rotation to a noncollective configuration. This transition manifests itself as favored band termination near I=45h in three rotational structures. Many weakly populated states lying at high excitation energy that decay into the terminating states have been discovered. Cranked-Nilsson-Strutinsky calculations suggest that the levels that feed the terminating states arise from weakly collective configurations that break the Z=64 semimagic core.
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| 7. |
- Johansson, Emma, et al.
(författare)
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Gamma-ray Spectroscopy of the Doubly Magic Nucleus 56Ni
- 2006
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Ingår i: European Physical Journal A. Hadrons and Nuclei. - : Springer Science and Business Media LLC. - 1434-6001. ; 27:2, s. 157-165
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Tidskriftsartikel (refereegranskat)abstract
- The doubly magic N = Z nucleus Ni-56 has been investigated with two fusion-evaporation reactions; Ca-40(Si-28, 3 alpha)Ni-56 at a beam energy of 122MeV and Si-28(S-32, 2p2n)Ni-56 at 130MeV. To detect gamma-rays in coincidence with evaporated particles the Ge-detector array Gammasphere was used in conjunction with the charged-particle detector system, Microball and a 1 pi neutron detector array. Results include a significantly extended level scheme of Ni-56, which is compared to large-scale shell model calculations in the fp shell. The experimental and theoretical results agree to a large extent, with one notable exception; the theoretical model fails to predict the proper sequence of the yrast and yrare 8(+) states.
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| 9. |
- Rudolph, Dirk, et al.
(författare)
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58Ni: An Unpaired Band Crossing at New Heights of Angular Momentum for Rotating Nuclei
- 2006
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Ingår i: Physical Review Letters. - 1079-7114. ; 96:9
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Tidskriftsartikel (refereegranskat)abstract
- High-spin states in Ni-58 have been investigated by means of the fusion-evaporation reaction Si-28(S-32,2p)Ni-58 at 130 MeV beam energy. Discrete-energy levels are observed in Ni-58 at record-breaking 42 MeV excitation energy and angular momenta in excess of 30h. The states form regular rotational bands with unprecedented high rotational frequencies. A comparison with configuration dependent cranked Nilsson-Strutinsky calculations reveals an exceptional two-band crossing scenario, the interaction strength of which is strongly shape dependent.
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