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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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- Mason, P, et al.
(författare)
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Octupole signatures in Ba-124,Ba-125
- 2005
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Ingår i: Journal of Physics G. - : IOP Publishing. - 0954-3899 .- 1361-6471. ; 31:10, s. S1729-S1733
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Tidskriftsartikel (refereegranskat)abstract
- The gamma decay of the nuclei Ba-121,Ba-125 has been investigated with the EUROBALL array, using the reaction Ni-64+Ni-64 at E-beam = 255 and 261 MeV. Six new E1 transitions have been found in the nucleus Ba-125, suggesting a significant role of octupole correlations in the origin of its parity doublets. The J(pi) = 3(-) level of the nucleus Ba-124 has been identified for the first time. Its excitation energy is in very good agreement with a prediction based on a microscopic model including octupole interactions.
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- Valiente-Dobon, J. J., et al.
(författare)
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Lifetime Measurements of the Neutron-Rich N=30 Isotones Ca-50 and Sc-51: Orbital Dependence of Effective Charges in the fp Shell
- 2009
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Ingår i: Physical Review Letters. - 1079-7114. ; 102:24
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Tidskriftsartikel (refereegranskat)abstract
- The lifetimes of the first excited states of the N=30 isotones Ca-50 and Sc-51 have been determined using the Recoil Distance Doppler Shift method in combination with the CLARA-PRISMA spectrometers. This is the first time such a method is applied to measure lifetimes of neutron-rich nuclei populated via a multinucleon transfer reaction. This extends the lifetime knowledge beyond the f(7/2) shell closure and allows us to derive the effective proton and neutron charges in the fp shell near the doubly magic nucleus Ca-48, using large-scale, shell-model calculations. These results indicate an orbital dependence of the core polarization along the fp shell.
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- Mason, P.R.D., et al.
(författare)
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In situ determination of sulfur isotopes in sulfur-rich materials by laser ablation multiple-collector inductively coupled plasma mass spectrometry (LA-MC-ICP-MS)
- 2006
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Ingår i: JOURNAL OF ANALYTICAL ATOMIC SPECTROMETRY. - : Royal Society of Chemistry (RSC). - 0267-9477. ; 21:2, s. 177-186
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Tidskriftsartikel (refereegranskat)abstract
- A new method has been developed for the accurate and precise measurement of sulfur isotopes (S-32, S-33, S-34) in solids on a scale down to 80-100 pin by laser ablation multiple collector inductively coupled plasma mass spectrometry (LA-MC-ICP-MS). The method was developed independently on two different sets of instrumentation, both of which give equivalent results with comparable accuracy and precision. The first instrumental set-up utilizes Xe gas in a hexapole collision and reaction cell for interference attenuation coupled with a mass discrimination correction by external normalization using a nebulised vapour of Cl-37/Cl-35 standard solution. The second employs high mass resolution by sector field mass spectrometry to avoid the interfering O2+ isobars with a Si-30/Si-29 standard aerosol for external normalization. The external isotope mass discrimination correction was applied using the exponential law and was further calibrated for both sets of instrumentation by linear interpolation in a sample-standard bracketing method. Mean delta(34)S(V-CDT) and delta(33)S(V-CDT) show excellent agreement (within analytical error, typically 0.6 and 1.5%, respectively) with compiled data for IAEA-S series AgS standard reference materials. Results for NIST SRM 127 (sulfate) were less accurate when calibrated against the IAEA-S series sulfides, whilst significant and consistent deviations in accuracy of up to 3%. were observed in both sets of instrumentation for Soufre de Lacq SRM sulfur. Such generic matrix effects may be widespread in LA-ICP-MS due to differential ablation rates, particle formation, particle transport efficiency and ionization efficiency in an argon plasma.
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