| 1. |
|
|
| 2. |
- Abe, O, et al.
(författare)
-
Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials
- 2005
-
Ingår i: The Lancet. - 1474-547X. ; 365:9472, s. 1687-1717
-
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.
|
|
| 3. |
|
|
| 4. |
- Clarke, M, et al.
(författare)
-
Adjuvant chemotherapy in oestrogen-receptor-poor breast cancer : patient-level meta-analysis of randomised trials
- 2008
-
Ingår i: The Lancet. - 0140-6736. ; 371:9606, s. 29-40
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The long-term effects of adjuvant polychemotherapy regimens in oestrogen-receptor-poor (ER-poor) breast cancer, and the extent to which these effects are modified by age or tamoxifen use, can be assessed by an updated meta-analysis of individual patient data from randomised trials.METHODS: Collaborative meta-analyses of individual patient data for about 6000 women with ER-poor breast cancer in 46 trials of polychemotherapy versus not (non-taxane-based polychemotherapy, typically about six cycles; trial start dates 1975-96, median 1984) and about 14 000 women with ER-poor breast cancer in 50 trials of tamoxifen versus not (some trials in the presence and some in the absence of polychemotherapy; trial start dates 1972-93, median 1982).FINDINGS: In women with ER-poor breast cancer, polychemotherapy significantly reduced recurrence, breast cancer mortality, and death from any cause, in those younger than 50 years and those aged 50-69 years at entry into trials of polychemotherapy versus not. In those aged younger than 50 years (1907 women, 15% node-positive), the 10-year risks were: recurrence 33% versus 45% (ratio of 10-year risks 0.73, 2p<0.00001), breast cancer mortality 24% versus 32% (ratio 0.73, 2p=0.0002), and death from any cause 25% versus 33% (ratio 0.75, 2p=0.0003). In women aged 50-69 years (3965 women, 58% node-positive), the 10-year risks were: recurrence 42% versus 52% (ratio 0.82, 2p<0.00001), breast cancer mortality 36% versus 42% (ratio 0.86, 2p=0.0004), and death from any cause 39% versus 45% (ratio 0.87, 2p=0.0009). Few were aged 70 years or older. Tamoxifen had little effect on recurrence or death in women who were classified in these trials as having ER-poor disease, and did not significantly modify the effects of polychemotherapy.INTERPRETATION: In women who had ER-poor breast cancer, and were either younger than 50 years or between 50 and 69 years, these older adjuvant polychemotherapy regimens were safe (ie, had little effect on mortality from causes other than breast cancer) and produced substantial and definite reductions in the 10-year risks of recurrence and death. Current and future chemotherapy regimens could well yield larger proportional reductions in breast cancer mortality.
|
|
| 5. |
- Riley, M. A., et al.
(författare)
-
Strongly Deformed Nuclear Shapes at Ultra-High Spin and Shape Coexistence in N\sim 90 Nuclei
- 2009
-
Ingår i: Acta Physica Polonica B. - 0587-4254. ; 40:3, s. 513-522
-
Tidskriftsartikel (refereegranskat)abstract
- The N similar to 90 region of the nuclear chart has featured prominently as the spectroscopy of nuclei at extreme spin has progressed. This talk will present recent discoveries from investigations of high spin behavior in the N similar to 90 Er, Tm and Yb nuclei utilizing the Gammasphere gamma-ray spectrometer. In particular it will include discussion of the beautiful shape evolution and coexistence observed in these nuclei along with the identification of a remarkable new family of band structures. The latter are very weakly populated rotational sequences with high moment of inertia that bypass the classic terminating configurations near spin 40-50 (h) over bar, marking a return to collectivity that extends discrete gamma-ray spectroscopy to well over 60 (h) over bar. Establishing the nature of the yrast states in these nuclei beyond the oblate band-termination states has been a major goal for the past two decades. Cranking calculations suggest that these new structures most likely represent stable triaxial strongly deformed bands that lie in a valley of favored shell energy in deformation and particle-number space.
|
|
| 6. |
- Grahn, T., et al.
(författare)
-
Collectivity and configuration mixing in Pb186,188 and Po194
- 2006
-
Ingår i: Physical Review Letters. - 0031-9007 .- 1079-7114. ; 97:6
-
Tidskriftsartikel (refereegranskat)abstract
- Lifetimes of prolate intruder states in Pb186 and oblate intruder states in Po194 have been determined by employing, for the first time, the recoil-decay tagging technique in recoil distance Doppler-shift lifetime measurements. In addition, lifetime measurements of prolate states in Pb188 up to the 8+ state were carried out using the recoil-gating method. The B(E2) values have been deduced from which deformation parameters |β2|=0.29(5) and |β2|=0.17(3) for the prolate and the oblate bands, respectively, have been extracted. The results also shed new light on the mixing between different shapes.
|
|
| 7. |
- Hartley, D. J., et al.
(författare)
-
Wobbling mode in Ta-167
- 2009
-
Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 80:4
-
Tidskriftsartikel (refereegranskat)abstract
- The collective wobbling mode, the strongest signature for the rotation of a triaxial nucleus, has previously been seen only in a few Lu isotopes in spite of extensive searches in nearby isotopes. A sequence of transitions in the N = 94 Ta-167 nucleus exhibiting features similar to those attributed to the wobbling bands in the Lu nuclei has now been found. This band feeds into the pi i(13/2) band at a relative energy similar to that seen in the established wobbling bands and its dynamic moment of inertia and alignment properties are nearly identical to the i(13/2) structure over a significant frequency range. Given these characteristics, it is likely that the wobbling mode has been observed for the first time in a nucleus other than Lu, making this collective motion a more general phenomenon.
|
|
| 8. |
- Herzberg, R-D, et al.
(författare)
-
Isomer spectroscopy in No-254
- 2006
-
Ingår i: Physica Scripta. - 0031-8949 .- 1402-4896. ; T125, s. 73-77
-
Tidskriftsartikel (refereegranskat)abstract
- Isomeric states in No-254 were investigated using a calorimetric method. Two different isomers were found with half-lives of T-1/2 = 266 +/- 2 ms and T-1/2 = 184 +/- 3 mu s, respectively. The dominant decay path of the 184 mu s isomer proceeds via states feeding the longer-lived 266 ms isomer. The 266 ms isomer in turn decays via a two-quasi-particle K = 3 band to the ground-state band. The full decay path was observed with the GREAT spectrometer located at the focal plane of the gas-filled separator RITU at the Accelerator Laboratory in Jyvskyl. This work sheds light on the two-quasi-particle structure in this transfermium nucleus.
|
|
| 9. |
- Ketelhut, S., et al.
(författare)
-
gamma-Ray Spectroscopy at the Limits : First Observation of Rotational Bands in Lr-255
- 2009
-
Ingår i: Physical Review Letters. - 0031-9007 .- 1079-7114. ; 102:21, s. 212501-
-
Tidskriftsartikel (refereegranskat)abstract
- The rotational band structure of Lr-255 has been investigated using advanced in-beam gamma-ray spectroscopic techniques. To date, Lr-255 is the heaviest nucleus to be studied in this manner. One rotational band has been unambiguously observed and strong evidence for a second rotational structure was found. The structures are tentatively assigned to be based on the 1/2(-)[521] and 7/2(-)[514] Nilsson states, consistent with assignments from recently obtained alpha decay data. The experimental rotational band dynamic moment of inertia is used to test self-consistent mean-field calculations using the Skyrme SLy4 interaction and a density-dependent pairing force.
|
|
| 10. |
- Ollier, J., et al.
(författare)
-
Ultrahigh-spin spectroscopy of Er-159,Er-160: Observation of triaxial strongly deformed structures
- 2009
-
Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 80:6
-
Tidskriftsartikel (refereegranskat)abstract
- Three weakly populated high-spin rotational bands associated with the gamma decay of Er-159 and Er-160 were observed in fusion-evaporation reactions involving a beam of Ca-48 at an energy of 215 MeV incident on a Cd-116 target. The gamma decays were detected using the highly efficient Gammasphere spectrometer. The discovery of these bands, which extend discrete-line spectroscopy in these nuclei to ultrahigh spin of similar to 60h, is consistent with recent observations of high-spin collective structures in isotopes of Er, Yb, and Tm around N=90. Cranked Nilsson-Strutinsky calculations suggest that these bands may arise from well-deformed triaxial configurations with either positive or negative gamma deformation.
|
|
