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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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- Paul, E. S., et al.
(författare)
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Recent Results at Ultrahigh Spin: Terminating States and Beyond in Mass 160 Rare-earth Nuclei
- 2015
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Ingår i: Acta Physica Polonica. Series B: Elementary Particle Physics, Nuclear Physics, Statistical Physics, Theory of Relativity, Field Theory. - 0587-4254. ; 46:3, s. 487-496
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Tidskriftsartikel (refereegranskat)abstract
- A classic region of band termination at high spin occurs in rare-earth nuclei with around ten valence nucleons above the Gd-146 closed core. Results are presented here for such non-collective oblate (gamma = 60 degrees) terminating states in odd-Z Ho-155, odd-odd Ho-156, and even-even Er-156, where they are compared with neighbouring nuclei. In addition to these particularly favoured states, the occurrence of collective triaxial strongly deformed (TSD) bands, bypassing the terminating states and extending to over 65 (h) over bar, is reviewed.
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- Simpson, J., et al.
(författare)
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Evolution of structure and shapes in Er 158 to ultrahigh spin
- 2023
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Ingår i: Physical Review C. - 2469-9985. ; 107:5
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Tidskriftsartikel (refereegranskat)abstract
- The level structure of Er158 has been studied using the Gammasphere spectrometer via the Cd114(Ca48,4n) reaction at 215 MeV with both thin (self-supporting) and thick (backed) targets. The level scheme has been considerably extended with more than 200 new transitions and six new rotational structures, including two strongly coupled high-K bands. Configuration assignments for the new structures are based on their observed alignments, B(M1)/B(E2) ratios of reduced transition probabilities, excitation energies, and comparisons with neighboring nuclei and theoretical calculations. With increasing angular momentum, this nucleus exhibits Coriolis-induced alignments of both neutrons and protons before it then undergoes a rotation-induced transition from near-prolate collective rotation to a noncollective oblate configuration. This transition occurs via the mechanism of band termination around spin 45ħ in three rotational structures. Two distinct lifetime branches, consistent with the crossing of a collective "fast"rotational structure by an energetically favored "slow"terminating sequence, are confirmed for the positive-parity states, and similar behavior is established in the negative-parity states. Weak-intensity, high-energy transitions are observed to feed into the terminating states. At the highest spins, three collective bands with high dynamic moments of inertia and large quadrupole moments were identified. These bands are interpreted as triaxial strongly deformed structures and mark a return to collectivity at ultrahigh spin.
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| 7. |
- Hartley, D. J., et al.
(författare)
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Persistence of collective behavior at high spin in the N=88 nucleus Tb-153
- 2015
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Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 91:5
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Tidskriftsartikel (refereegranskat)abstract
- Excited states in the N = 88 nucleus Tb-153 were observed up to spin similar to 40 in an experiment utilizing the Gammasphere array. The Tb-153 states were populated in a weak alpha 4n evaporation channel of the Cl-37 + Sn-124 reaction. Two previously known sequences were extended to higher spins, and a new decoupled structure was identified. The pi h(11/2) band was observed in the spin region where other N = 88 isotopes exhibit effects of prolate to oblate shape changes leading to band termination along the yrast line, whereas Tb-153 displays a persistent collective behavior. However, minor perturbations of the very highest state in both signatures of this h(11/2) band are observed, which perhaps signal the start of the transition towards band termination.
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| 8. |
- Rees, J. M., et al.
(författare)
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High-spin terminating states in the N=88 Ho-155 and Er-156 isotones
- 2015
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Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 91:5
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Tidskriftsartikel (refereegranskat)abstract
- The Sn-124(Cl-37, 6n gamma) fusion-evaporation reaction at a bombarding energy of 180 MeV has been used to significantly extend the excitation level scheme of Ho-155(67)88. The collective rotational behavior of this nucleus breaks down above spin I similar to 30 and a fully aligned noncollective (band terminating) state has been identified at I-pi = 79/2(-). Comparison with cranked Nilsson-Strutinsky calculations also provides evidence for core-excited noncollective states at I-pi = 87/2(-) and (89/2(+)) involving particle-hole excitations across the Z = 64 shell gap. A similar core-excited state in Er-156(68)88 at I-pi = (46(+)) is also presented.
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| 9. |
- Wang, X., et al.
(författare)
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Collective structures up to spin ∼ 65h in the N 90 isotones 158Er and 157Ho
- 2012
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Ingår i: Journal of Physics: Conference Series. - : IOP Publishing. - 1742-6588 .- 1742-6596. ; 381:1
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Tidskriftsartikel (refereegranskat)abstract
- A new collective band with high dynamic moment of inertia in 158Er at spins beyond band termination has been found in addition to the two previously reported ones. The measured transition quadrupole moments (Qt) of these three bands are very similar. These three bands have been suggested to possess a triaxial strongly deformed shape, based on comparisons with calculations using the cranked Nilsson-Strutinsky model and with tilted axis cranking calculations using the Skyrme-Hartree-Fock model. In addition, three collective bands with similar high dynamic moments of inertia, tentatively assigned to 157Ho, have been observed. Thus, it is suggested that all these structures share a common underlying character and that they are most likely associated with triaxial strongly deformed minima which are predicted to be close to the yrast line at spin 50 - 70h.
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| 10. |
- Mustafa, M., et al.
(författare)
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Diverse collective excitations in Er-159 up to high spin
- 2011
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Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 84:5
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Tidskriftsartikel (refereegranskat)abstract
- A spectroscopic investigation of the gamma decays from excited states in Er-159 has been performed to study the changing structural properties exhibited as ultrahigh spins (I > 60 (h) over bar) are approached. The nucleus of Er-159 was populated by the reaction Cd-116(Ca-48, 5n gamma) at a beam energy of 215 MeV, and the resulting gamma decays were studied using the Gammasphere spectrometer. New rotational bands and extensions to existing sequences were observed, which are discussed in terms of the cranked shell model, revealing a diverse range of quasiparticle configurations. At spins around 50 (h) over bar, there is evidence for a change from dominant prolate collective motion at the yrast line to oblate non-collective structures via the mechanism of band termination. A possible strongly deformed triaxial band occurs at these high spins, which indicates collectivity beyond 50 (h) over bar. The high-spin data are interpreted within the framework of cranked Nilsson-Strutinsky calculations.
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