| 1. |
- Joensuu, Heikki, et al.
(författare)
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Adjuvant Capecitabine, Docetaxel, Cyclophosphamide, and Epirubicin for Early Breast Cancer : Final Analysis of the Randomized FinXX Trial
- 2012
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Ingår i: Journal of Clinical Oncology. - : American Society of Clinical Oncology. - 0732-183X .- 1527-7755. ; 30:1, s. 11-18
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Capecitabine is an active agent in the treatment of breast cancer. It is not known whether integration of capecitabine into an adjuvant regimen that contains a taxane, an anthracycline, and cyclophosphamide improves outcome in early breast cancer.Patients and Methods: Women with axillary node-positive or high-risk node-negative breast cancer were randomly assigned to receive either three cycles of docetaxel and capecitabine (TX) followed by three cycles of cyclophosphamide, epirubicin, and capecitabine (CEX; n = 753) or three cycles of docetaxel (T) followed by three cycles of cyclophosphamide, epirubicin, and fluorouracil (CEF; n = 747). The primary end point was recurrence-free survival (RFS).Results: During a median follow-up time of 59 months, 214 RFS events occurred (local or distant recurrences or deaths; TX/CEX, n = 96; T/CEF, n = 118). RFS was not significantly different between the groups (hazard ratio [HR], 0.79; 95% CI, 0.60 to 1.04; P = .087; 5-year RFS, 86.6% for TX/CEX v 84.1% for T/CEF). Fifty-six patients assigned to TX/CEX died during the follow-up compared with 75 of patients assigned to T/CEF (HR, 0.73; 95% CI, 0.52 to 1.04; P = .080). In exploratory analyses, TX/CEX improved breast cancer-specific survival (HR, 0.64; 95% CI, 0.44 to 0.95; P = .027) and RFS in women with triple-negative disease and in women who had more than three metastatic axillary lymph nodes at the time of diagnosis. We detected little severe late toxicity. Conclusion: Integration of capecitabine into a regimen that contains docetaxel, epirubicin, and cyclophosphamide did not improve RFS significantly compared with a similar regimen without capecitabine. J Clin Oncol 30:11-18. (c) 2011 by American Society of Clinical Oncology
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| 2. |
- Joensuu, Heikki, et al.
(författare)
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Outcome of patients with HER2-positive breast cancer treated with or without adjuvant trastuzumab in the Finland Capecitabine Trial (FinXX)
- 2014
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Ingår i: Acta Oncologica. - : Informa Healthcare. - 0284-186X .- 1651-226X. ; 53:2, s. 186-194
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundLittle information is available about survival outcomes of patients with HER2-positive early breast cancer treated with adjuvant capecitabine-containing chemotherapy with or without trastuzumab.Patients and methodsOne thousand and five hundred patients with early breast cancer were entered to the Finland Capecitabine trial (FinXX) between January 2004 and May 2007, and were randomly assigned to receive either three cycles of adjuvant TX (docetaxel, capecitabine) followed by three cycles of CEX (cyclophosphamide, epirubicin, capecitabine; TX-CEX) or three cycles of docetaxel followed by three cycles of CEF (cyclophosphamide, epirubicin, fluorouracil; T-CEF). The primary endpoint was recurrence-free survival (RFS). The study protocol was amended in May 2005 while study accrual was ongoing to allow adjuvant trastuzumab for patients with HER2-positive cancer. Of the 284 patients with HER2-positive cancer accrued to FinXX, 176 (62.0%) received trastuzumab after amending the study protocol, 131 for 12 months and 45 for nine weeks. The median follow-up time was 6.7 years.ResultsPatients with HER2-positive cancer who received trastuzumab had better RFS than those who did not (five-year RFS 89.2% vs. 75.9%; HR 0.41, 95% CI 0.23 -0.72; p = 0.001). Patients treated with trastuzumab for 12 months or nine weeks had similar RFS. There was no significant interaction between trastuzumab administration and the type of chemotherapy. Four (2.3%) patients treated with trastuzumab had heart failure or left ventricular dysfunction, three of these received capecitabine.ConclusionAdjuvant trastuzumab improves RFS of patients treated with TX-CEX or T-CEF. Few patients had cardiac failure.
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| 3. |
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| 4. |
- Lönn, David, et al.
(författare)
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Experimental and finite element robustness studies of a bumper system subjected to an offset impact loading
- 2011
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Ingår i: International Journal of Crashworthiness. - Abingdon, Oxford, UK : Taylor & Francis Group. - 1358-8265 .- 1754-2111. ; 16:2, s. 155-168
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Tidskriftsartikel (refereegranskat)abstract
- A product of high quality is a product that performs well, not only in exactly the situations it was designed to handle but also in slightly different situations that arise in the usage of the product. As a specific example, the performance of a bumper system should not depend on small fluctuations in the manufacturing process or on small variations in the impact event. In this work, the robustness of an existing vehicle bumper system subjected to a crash load has been evaluated both experimentally and numerically. In the latter case, different widely used approaches to numerically assess the robustness have been utilised. A reliable numerical robustness study provides the designer with a valuable tool for improving a design, and an evaluation of these methods in this context is therefore of interest. It is concluded that for the example under study, both the Monte Carlo method and the metamodel-based Monte Carlo methods work well. Furthermore, for moderate dispersions levels, i.e. a small design space with no bifurcation in the deformation pattern, a linear response approximation is shown to have a sufficient accuracy to be used in the metamodel-based robustness analysis. The performed numerical robustness studies also point out that the performance of a nominal simulation, i.e. a simulation conducted with mean values for all variables, does not in general predict the mean performance of the finite element model. Finally, some possible design improvements for the bumper system under study are also identified
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| 5. |
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| 6. |
- Lönngren, Johanna, 1985-, et al.
(författare)
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Sustainable Development in Nano-Perspectives : An Innovative Student Initiative
- 2010
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Ingår i: Engineering Education in Sustainable Development, conference proceedings. - : Engineering Education in Sustainable Development, Gothenburg, Sweden.
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Konferensbidrag (refereegranskat)abstract
- This paper describes and discusses a novel class for sustainable development at the faculty of engineering at Lund University, Sweden. Based on personal experience and student questionnaires, the study discusses applied pedagogical approaches (case study, role play, matrix approach) and suggests improvements to the structure of the class. The project is a student initiative, making student involvement and its effects on learning for sustainable development central topics of this paper, thereby challenging the notion of engineering students as passive receivers of education for sustainable development.
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| 7. |
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| 8. |
- Malmodin, Jens, et al.
(författare)
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Life Cycle Assessment of ICT : Carbon Footprint and Operational Electricity Use from the Operator, National, and Subscriber Perspective in Sweden
- 2014
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Ingår i: Journal of Industrial Ecology. - : Wiley. - 1088-1980 .- 1530-9290. ; 18:6, s. 829-845
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Tidskriftsartikel (refereegranskat)abstract
- The use of information and communication technology (ICT) is growing throughout society, and new products and solutions are developed at an increasing rate. To enable environmental assessment of specific ICT products and other products that rely on ICT in some way, a more complete, detailed, and up-to-date study based on real measurements is needed. To date, similar studies have not been readily available or fully comprehensive. This study assessed the overall operational electricity use and life-cycle-based carbon footprint (CF) relating to ICT in Sweden, including activities not commonly addressed previously, such as shared data transport networks and data centers and manufacturing of network infrastructure. Specific, detailed inventory data are presented and used for assessment of the Internet Protocol core network, data transmission, operator activities, and access network. These specific data, in combination with secondary, more generic data for end-user equipment, allow a comprehensive overall assessment. The majority of the ICT network CF is the result of end-user equipment, mainly personal computers, followed by third-party enterprise networks and data centers and then access networks. The parts closest to the user proved to be clearly responsible for the majority of the impact. The results are presented for Swedish ICT networks and for ICT networks in general based on a global average electricity mix.
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| 9. |
- Nilsson, Greger
(författare)
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Cardiovascular Side Effects of Radiotherapy in Breast Cancer
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the thesis was to study cardiovascular side effects of radiotherapy (RT) in breast cancer (BC).In a study base of 25,171 women with BC diagnosed 1970-2000, we found a statistically significant 12% increase of stroke, compared to the stroke incidence in the background population.A case-control study of 282 cases with BC followed by a stroke and 1:1 matched controls with BC but not stroke was performed. In women irradiated to internal mammary chain (IMC) and supraclavicular lymph nodes (SCL) vs. a pooled group of women not irradiated or irradiated to targets other than IMC and SCL, a statistically significant increase of stroke with an odds ratio of 1.8 was observed. There were no associations between BC laterality, targets of RT, and hemisphere location of stroke. The radiation targets IMC and SCL, showed a statistically significant trend for an increased risk of stroke with daily fraction dose.A study of 199 patients with BC, examined by coronary angiography, detected a four- to seven-fold increase of high grade coronary artery stenosis in mid and distal left anterior descending artery (LAD), including distal diagonal branch, when comparing women with irradiated left-sided BC to those with right-sided. An increase of clinically significant coronary artery stenosis was found in pre-specified hotspot areas for radiation among women irradiated to the left breast/chest wall or to the IMC. Thus, the coronary arteries should be regarded as organs at risk in RT of BC.In a study of 15 BC patients treated with 3D conformal RT, a marked difference in dose distribution in mid and distal LAD between left- and right-sided BC was demonstrated. Irradiated right-sided BC mainly received low doses of scattered and transmitted radiation to the coronary arteries. On the contrary, tangential RT to the left breast without regional lymph node irradiation yielded coronary artery max doses of approximately 50 Gray to distal LAD, probably not safe concerning late radiation vascular effects.To conclude, we found cardiovascular side effects in women irradiated for BC, resulting in stroke and coronary artery disease, and showed an association between the targets for RT and the anatomical location of these vascular events.
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| 10. |
- Nilsson, Greger, et al.
(författare)
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Distribution of Coronary Artery Stenosis After Radiation for Breast Cancer
- 2012
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Ingår i: Journal of Clinical Oncology. - 0732-183X .- 1527-7755. ; 30:4, s. 380-386
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE To study distribution of coronary artery stenosis among patients with breast cancer (BC) and to assess correlation between radiotherapy (RT) and location of stenosis. PATIENTS AND METHODS A Swedish BC cohort diagnosed from 1970 to 2003 was linked to registers of coronary angiography from 1990 to 2004, which yielded 199 patients. Stenoses of the coronary arteries were graded from 0 to 5, where 0 indicated a normal vessel and 5 indicated occlusion. Two hotspot areas for radiation were defined: proximal right coronary artery (prox RCA), mid and distal left anterior descending artery and distal diagonal (mdLAD + dD). RT regimens were categorized as high or low risk of irradiating the hotspot areas. Left breast/chest wall was considered high risk for mdLAD + dD; left internal mammary chain (IMC), high risk for prox RCA and mdLAD + dD from 1970 to 1995 and thereafter solely for mdLAD + dD; and right IMC, high risk for prox RCA. Other RT targets and no RT were considered low risk. Results were expressed in odds ratios (ORs) and 95% CIs. RESULTS For irradiated left- versus right-sided BC, the OR for grade 3 to 5 stenosis in mdLAD + dD was 4.38 (95% CI, 1.64 to 11.7), and for grade 4 to 5 stenosis, the OR was 7.22 (95% CI, 1.64 to 31.8). For high-risk RT versus low-risk or no RT, the OR for grade 3 to 5 stenosis in hotspot areas was 1.90 (95% CI, 1.11 to 3.24). CONCLUSION An increase of stenosis in mdLAD + dD in irradiated left-sided BC and an association between high-risk RT and stenosis in hotspot areas for radiation indicate a direct link between radiation and location of coronary stenoses.
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| 11. |
- Olofsson, Kurt, et al.
(författare)
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New TailCast manufacturing process
- 2012
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Konferensbidrag (refereegranskat)abstract
- A new material- and manufacturing concept has been developed in the ongoing EU research project COMETA. The concept is called Tailored Reinforcement for Epoxy Casting (TailCast). TailCast uses a pre-consolidated grid structure made of continuous fibers, which is loaded as an insert into a conventional casting process. The resulting material- and product structure can hence be designed to incorporate a tailored reinforcement package of continuous fibers, short fibers and particles. This paper deals with material- and process developments towards a low Coefficient of Thermal Expansion (CTE) as well as the manufacture of a flange demonstrator for COMETA. The gained low composite CTE will furthermore reduce the sensitivity to humidity, which is important for this application.
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| 12. |
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