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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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| 6. |
- Beckers, M., et al.
(författare)
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Nucleation and growth of Ti2 AlN thin films deposited by reactive magnetron sputtering onto MgO(111)
- 2007
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Ingår i: Journal of Applied Physics. - : AIP Publishing. - 0021-8979 .- 1089-7550. ; 102:7
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Tidskriftsartikel (refereegranskat)abstract
- The nucleation and growth of Ti2 AlN thin films on MgO(111) substrates during dual direct current reactive magnetron cosputtering from Ti and Al targets in an Ar N2 atmosphere at a substrate temperature of 690 °C have been investigated. Time and thickness dependent in situ specular x-ray reflectivity and x-ray diffraction in combination with cross-sectional transmission electron microscopy and Rutherford backscattering spectroscopy reveal the formation of competing phases for slight N superstoichiometry with respect to Ti2 AlN. The stoichiometry deviations initiate the layer-by-layer growth of a ∼380 Å thick epitaxial N-substoichiometric cubic (Ti1-x Alx) Ny layer. N-vacancy driven diffusion of Ti and Al leads to decomposition of this metastable solid solution into nanosized cubic TiN y′ and AlN y″ domains as well as to a solid-state reaction with the MgO(111) by formation of a Mg2 (Al:Ti) O4 spinel, reducing the transformed (Ti1-x Alx) Ny layer thickness down to ∼60 Å. Local AlN y″ domains serve as templates for Ti2 AlN nucleation at higher thicknesses. At the same time TiN y′ and AlN y″ serve as a sink for excess gas phase N during the subsequent polycrystalline Ti2 AlN growth with random (Ti1-x Alx) Ny renucleation as a tissue phase along Ti2 AlN grain boundaries. The individual Ti2 AlN grains with vertical sizes up to the total thickness retain local epitaxy to the substrate, with basal planes nonparallel to the substrate interface. Concurrently the (Ti1-x Alx) Ny layer is further reduced by inward Ti2 AlN grain growth along the basal planes. © 2007 American Institute of Physics.
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| 7. |
- Claudio, P., et al.
(författare)
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Geochemical modelling application for a 1-d arsenic reactive transport study in alluvial aquifers, Matlab Upazila, Bangladesh
- 2009
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Ingår i: Rendiconti Online della Società Geologica Italiana. - 2035-8008. ; 6, s. 364-365
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Tidskriftsartikel (refereegranskat)abstract
- Mechanistic modelling was used to investigate the hydrochemical evolution along a vertical column, should cross-contamination occur. 1-D reactive transport was carried out to assess sorption effects on aqueous/solid arsenic distribution in Matlab Upazila, Bangladesh. Thermodynamic relationships between aqueous ions and aquifer materials have been investigated: comparison between redox couples shows electrochemical disequilibrium; sorption mainly occurs on weak and strong Hydrous Ferric-Oxides, described by the Surface Complexation Mode. The basis for reactive transport calculations is given by a static model, that evaluates the competing ions net effect: they reduce by ca. 50% arsenic bounding. Desorption process alone can give unacceptable As (aq) concentrations, starting from only a few mg/kg As (sorb). Redox zonation was the starting point for the model conception, which allowed calculating the contamination evolution in an oxidising As-low aquifer. Groundwater analysis is worked out for a 20 cells column of aquifer material, whose top represents the upper reducing aquifer, the bottom the oxidising aquifer; contamination takes place through an As-rich solution percolating into the column. Results are a function of the flow velocity, that needs to be carefully defined before further modelling.
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- Ekqvist, Susanne, et al.
(författare)
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High frequency of contact allergy to gold in patients with endovascular coronary stents
- 2007
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 1365-2133 .- 0007-0963. ; 157:4, s. 730-738
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Tidskriftsartikel (refereegranskat)abstract
- Background Stent implantation is an effective method for treatment of atherosclerotic disease. Factors predisposing to in-stent restenosis are still largely unknown. Contact allergy to metal ions eluted from the stent has been suggested to be a risk factor. Objectives To explore whether there is a possible induction of contact allergy to metals used in stents among patients with a stainless steel stent containing nickel (Ni stent) and patients with a gold-plated stent (Au stent). Methods Adults (n = 484) treated with coronary stent implantation participated in the study with patch testing. The study design was retrospective and cross-sectional with no assessment of contact allergy before stenting. Age- and sex-matched patch-tested patients with dermatitis (n = 447) served as controls. Results Of Au-stented patients, 54 of 146 (37%) were allergic to gold compared with 85 of 447 (19%) controls (P < 0.001). Within the stented population there were no statistically significant differences in contact allergy to gold or nickel between Ni-stented and Au-stented patients. In multivariate models where other risk factors for contact allergy to gold were considered, the Au stent showed a trend towards statistical significance (odds ratio 1.43, 95% confidence interval 0.95-2.16; P = 0.09). Conclusions As the frequency of contact allergy to gold is higher in stented patients independent of stent type it suggests a previous sensitization. However, several pieces of circumstantial evidence as well as statistical analysis indicate the possibility of sensitization in the coronary vessel by the Au stent. Ni stents and Au stents should not be ruled out as risk factors for induction of contact allergy to these metals.
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- Grahn, T., et al.
(författare)
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Collectivity and configuration mixing in Pb186,188 and Po194
- 2006
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Ingår i: Physical Review Letters. - 0031-9007 .- 1079-7114. ; 97:6
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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.
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