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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. |
- Shin, J. H., et al.
(författare)
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IA-2 autoantibodies in incident type I diabetes patients are associated with a polyadenylation signal polymorphism in GIMAP5
- 2007
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Ingår i: Genes Immun. - : Springer Science and Business Media LLC. - 1466-4879 .- 1476-5470. ; 8:6, s. 503-12
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Tidskriftsartikel (refereegranskat)abstract
- In a large case-control study of Swedish incident type I diabetes patients and controls, 0-34 years of age, we tested the hypothesis that the GIMAP5 gene, a key genetic factor for lymphopenia in spontaneous BioBreeding rat diabetes, is associated with type I diabetes; with islet autoantibodies in incident type I diabetes patients or with age at clinical onset in incident type I diabetes patients. Initial scans of allelic association were followed by more detailed logistic regression modeling that adjusted for known type I diabetes risk factors and potential confounding variables. The single nucleotide polymorphism (SNP) rs6598, located in a polyadenylation signal of GIMAP5, was associated with the presence of significant levels of IA-2 autoantibodies in the type I diabetes patients. Patients with the minor allele A of rs6598 had an increased prevalence of IA-2 autoantibody levels compared to patients without the minor allele (OR=2.2; Bonferroni-corrected P=0.003), after adjusting for age at clinical onset (P=8.0 x 10(-13)) and the numbers of HLA-DQ A1*0501-B1*0201 haplotypes (P=2.4 x 10(-5)) and DQ A1*0301-B1*0302 haplotypes (P=0.002). GIMAP5 polymorphism was not associated with type I diabetes or with GAD65 or insulin autoantibodies, ICA, or age at clinical onset in patients. These data suggest that the GIMAP5 gene is associated with islet autoimmunity in type I diabetes and add to recent findings implicating the same SNP in another autoimmune disease.
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| 6. |
- Bret, Antoine, et al.
(författare)
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Magnetic field effects on instabilities driven by a field-aligned relativistic warm electron beam and warm bulk electrons
- 2007
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Ingår i: 34th European Physical Society Conference on Plasma Physics,2007. - Warsaw : European Physical Society. ; , s. P2.079-
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Konferensbidrag (refereegranskat)abstract
- Instabilities driven by relativistic electron beams are being investigated due to their importance for plasma heating and electromagnetic field generation in astrophysical and laboratory plasmas. Particle-in-cell (PIC) simulations of initially unmagnetized colliding plasmas have demonstrated the generation of strong magnetic fields and a moderate electron acceleration. The inclusion of a flow-aligned magnetic field suppresses the electromagnetic filamentation instability and PIC simulations have shown that the plasma dynamics turns quasi-electrostatic. To quantify the impact of the magnetic field, we have analyzed numerically a magnetized multi-fluid model that includes a kinetic pressure term. This fluid model allows us to examine the beam-driven instability at all angles between the wavevector and the magnetic field vector. More accurate kinetic models typically focus only on the filamentation instability, due to the increased analytical complexity. We present here the fluid model and a growth rate map of the entire k-space for a beam Lorentz factor 4. We verify that the two-stream, mixed mode and filamentation instability belong to the same wave branch and that the magnetic field selects the fastest-growing mode. We estimate the magnetic fields required to suppress the filamentation and the mixed mode instabilities.
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| 7. |
- Bret, Antoine, et al.
(författare)
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Oblique electromagnetic instabilities for a hot relativistic beam interacting with a hot and magnetized plasma
- 2006
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Ingår i: Physics of Plasmas. - : AIP Publishing. - 1070-664X .- 1089-7674. ; 13:8, s. 082109-1-082109-8
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Tidskriftsartikel (refereegranskat)abstract
- The temperature-dependent fluid model from Phys. Plasmas 13, 042106 (2006) is expanded in order to explore the oblique electromagnetic instabilities, which are driven by a hot relativistic electron beam that is interpenetrating a hot and magnetized plasma. The beam velocity vector is parallel to the magnetic-field direction. The results are restricted to nonrelativistic temperatures. The growth rates of all instabilities but the two-stream instability can be reduced by a strong magnetic field so that the distribution of unstable waves becomes almost one dimensional. For high beam densities, highly unstable oblique modes dominate the spectrum of unstable waves as long as omega(c)/omega(p)less than or similar to 2 gamma(3/2)(b), where omega(c) is the electron gyrofrequency, omega(p) is the electron plasma frequency, and gamma(b) is the relativistic factor of the beam. A uniform stabilization over the entire k space cannot be achieved.
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- Zoller, P, et al.
(författare)
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Quantum information processing and communication - Strategic report on current status, visions and goals for research in Europe
- 2005
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Ingår i: European Physical Journal D. Atomic, Molecular, Optical and Plasma Physics. - : Springer Science and Business Media LLC. - 1434-6060 .- 1434-6079. ; 36:2, s. 203-228
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Tidskriftsartikel (refereegranskat)abstract
- We present an excerpt of the document "Quantum Information Processing and Communication: Strategic report on current status, visions and goals for research in Europe", which has been recently published in electronic form at the website of FET (the Future and Emerging Technologies Unit of the Directorate General Information Society of the European Commission, http://www.cordis.lu/ist/fet/qipc-sr.htm). This document has been elaborated, following a former suggestion by FET, by a committee of QIPC scientists to provide input towards the European Commission for the preparation of the Seventh Framework Program. Besides being a document addressed to policy makers and funding agencies (both at the European and national level), the document contains a detailed scientific assessment of the state-of-the-art, main research goals, challenges, strengths, weaknesses, visions and perspectives of all the most relevant QIPC sub-fields, that we report here.
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