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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. |
- Slama, J, et al.
(författare)
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Plešovice zircon – A new natural standard for U-Pb and Hf isotopic microanalysis
- 2007
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Ingår i: Goldschmidt Conference Abstracts.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Increasing number of geological applications requires theuse of well-characterized and widely available referencematerials for in situ analysis. We have established a newnatural zircon standard (“Plešovice”) for U-Pb dating and Hfisotopic analysis by laser ablation ICP-MS.The ID-TIMS U-Pb age of the Plešovice zircon has beendetermined to 336.9±0.2 Ma (95% confidence limits; mean206Pb/238U age). The U-Pb ages obtained by LA ICP-MS (3labs) and SIMS techniques show larger spread but within theiranalytical uncertainties they are consistent with the TIMS age.Hafnium isotopic composition of the Plešovice zircon appearsto be homogenous within and between grains. Combined laserablation and solution MC ICP-MS analyses gave a mean176Hf/177Hf value of 0.282481±0.000013 (95% confidencelimits, 87 analyses). Cathodoluminescence and BSE imagingand chemical analyses revealed that discrete zones in thePlešovice zircon are enriched in trace elements and especiallyin U and Th. Raman spectroscopy suggests that these highlyradiation-damaged areas have not undergone any annealing.Our LA ICP-MS analyses did not indicate any Pb-loss but thehigh intensities of measured U signal require that these areasare avoided during routine U-Pb isotopic analysis.
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- Chew, D M, et al.
(författare)
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The tectonothermal evolution and provenance of the Tyrone Central Inlier, Ireland: Grampian imbrication of an outboard Laurentian microcontinent?
- 2008
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Ingår i: Journal of the Geological Society. - : Geological Society of London. - 2041-479X .- 0016-7649. ; 165:3, s. 675-685
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Tidskriftsartikel (refereegranskat)abstract
- The Tyrone Central Inlier is a metamorphic terrane of uncertain affinity situated outboard of the main Dalradian outcrop (south of the Fair Head-Clew Bay Line) and could represent sub-arc basement to part of the enigmatic Midland Valley Terrane. Using a combination of isotopic, structural and petrographic evidence, the tectonothermal evolution of the Tyrone Central Inlier was investigated. Sillimanite-bearing 14 metamorphic assemblages (c. 670 degrees C, 6.8 kbar) and leucosomes in paragneisses are cut by granite pegmatites, which post-date two deformation fabrics. The leucosomes yield a weighted average Pb-207/Ph-206 zircon age of 467 +/- 12 Ma whereas the main fabric yields a Ar-40-Ar-39 biotite cooling age of 468 +/- 1.4 Ma. The pegmatites yield 457 +/- 7 Ma and 458 +/- 7 Ma Rb-Sr muscovite-feldspar ages and Ar-40-Ar-39 step-heating plateaux of 466 +/- 1 Ma and 468 +/- 1 Ma, respectively. The metasedimentary rocks yield Palaeoproterozoic Sm-Nd model ages and laser ablation inductively coupled plasma mass spectrometry detrital zircon U-Pb analyses from a psammitic gneiss yield age populations at 1.05-1.2, 1.5, 1.8, 2.7 and 3.1 Ga. Combined, these data permit correlation of the Tyrone Central Inlier with either the Argyll or the Southern Highland Group of the Dalradian Supergroup. The inlier was thus part of Laurentia onto which the Tyrone ophiolite was obducted.
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| 10. |
- Slama, Jiri, et al.
(författare)
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Plesovice zircon : A new natural reference material for U-Pb and Hf isotopic microanalysis
- 2008
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Ingår i: Chemical Geology. - : Elsevier BV. - 0009-2541 .- 1872-6836. ; 249:02-jan, s. 1-35
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Tidskriftsartikel (refereegranskat)abstract
- Matrix-matched calibration by natural zircon standards and analysis of natural materials as a reference are the principle methods for achieving accurate results in inicrobeam U-Pb dating and Hf isotopic analysis. We describe a new potential zircon reference material for laser ablation ICP-MS that was extracted from a potassic granulite facies rock collected in the southern part of the Bohemian Massif (Plesovice, Czech Republic). Data from different techniques (ID-TIMS, SIMS and LA ICP-MS) and several laboratories suggest that this zircon has a concordant U-Pb age with a weighted mean Pb-206/U-238 date of 337.13 +/- 0.37 Ma (ID-TIMS, 95% confidence limits, including tracer calibration uncertainty) and U-Pb age homogeneity on the scale used in LA ICP-MS dating. Inhomogeneities in trace element composition due to primary growth zoning prevent its use as a calibration standard for trace element analysis. The content of U varies from 465 ppm in pristine parts of the grains to similar to 3000 ppm in actinide-rich sectors that correspond to pyramidal faces with a high degree of metamictization (present in ca. 30% of the grains). These domains are easily recognized from high intensities on BSE images and should be avoided during the analysis. Hf isotopic composition of the Plesovice zircon (>0.9 wt.% Hf) is homogenous within and between the grains with a mean Hf-176/Hf-177 value of 0.282492 +/- 0.000013 (2SD). The age and Hf isotopic homogeneity of the Plesovice zircon together with its relatively high U and Pb contents make it an ideal calibration and reference material for laser ablation ICP-MS measurements, especially when using low laser energies and/or small diameters of laser beam required for improved spatial resolution.
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