| 1. |
- Matikas, Alexios, et al.
(författare)
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Long-term safety and survival outcomes from the Scandinavian Breast Group 2004-1 randomized phase II trial of tailored dose-dense adjuvant chemotherapy for early breast cancer
- 2018
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Ingår i: Breast Cancer Research and Treatment. - : SPRINGER. - 0167-6806 .- 1573-7217. ; 168:2, s. 349-355
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Tidskriftsartikel (refereegranskat)abstract
- Although adjuvant polychemotherapy improves outcomes for early breast cancer, the significant variability in terms of pharmacokinetics results in differences in efficacy and both short and long-term toxicities. Retrospective studies support the use of dose tailoring according to the hematologic nadirs. The SBG 2004-1 trial was a randomized feasibility phase II study which assessed tailored dose-dense epirubicin and cyclophosphamide (EC) followed by docetaxel (T) (group A), the same regimen with fixed doses (group B) and the TAC regimen (group C). Women aged 18-65 years, ECOG PS 0-1 with at least one positive axillary lymph node were randomized 1:1:1. The primary endpoint of the study was the safety and feasibility of the treatment. Toxicity was graded according to CTC-AE version 3.0. The design and short-term toxicity have been previously published. Here, we report safety and efficacy data after 10 years of follow-up. A total of 124 patients were included in the study. After a median follow-up of 10.3 years, the probability for 10-year survival was 78.5, 75.1, and 63.4% and for relapse free survival 64.1, 71.0, and 59.5% for groups A, B, and C, respectively. There were no cases of clinically diagnosed cardiotoxicity or hematologic malignancies. No patient was lost to follow-up. In this randomized phase II trial, tailored dose adjuvant chemotherapy was feasible, without an increased risk for long-term adverse events after a median follow-up of 10 years.
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| 2. |
- Killander, Fredrika, et al.
(författare)
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No Increased Cardiac Mortality or Morbidity of Radiation Therapy in Breast Cancer Patients After Breast-Conserving Surgery : 20-Year Follow-up of the Randomized SweBCGRT Trial
- 2020
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Ingår i: International Journal of Radiation Oncology, Biology, Physics. - : Elsevier BV. - 0360-3016 .- 1879-355X. ; 107:4, s. 701-709
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Tidskriftsartikel (refereegranskat)abstract
- PurposeRadiation therapy (RT) after breast-conserving surgery reduces locoregional recurrences and improves survival but may cause late side effects. The main purpose of this paper was to investigate long-term side effects after whole breast RT in a randomized clinical trial initiated in 1991 and to report dose-volume data based on individual 3-dimensional treatment plans for organs at risk.Methods and MaterialsThe trial included 1187 patients with T1-2 N0 breast cancer randomized to postoperative tangential whole breast RT or no further treatment. The prescription dose to the clinical target volume was 48 to 54 Gy. We present 20-year follow-up on survival, cause of death, morbidity, and later malignancies. For a cohort of patients (n = 157) with accessible computed tomography–based 3-dimensional treatment plans in Dicom-RT format, dose-volume descriptors for organs at risk were derived. In addition, these were compared with dose-volume data for a cohort of patients treated with contemporary RT techniques.ResultsThe cumulative incidence of cardiac mortality was 12.4% in the control group and 13.0% in the RT group (P = .8). There was an increase in stroke mortality: 3.4% in the control group versus 6.7% in the RT group (P = .018). Incidences of contralateral breast cancer and lung cancer were similar between groups. The median Dmean (range) heart dose for left-sided treatments was 3.0 Gy (1.1-8.1), and the corresponding value for patients treated in 2017 was 1.5 Gy (0.4-6.0).ConclusionsIn this trial, serious late side effects of whole breast RT were limited and less than previously reported in large meta-analyses. We observed no increase in cardiac mortality in irradiated patients. Doses to the heart were a median Dmean of 3.0 Gy for left-sided RT. The observed increase in stroke mortality may partly be secondary to cardiac side effects, complications to anticoagulant treatment, or to chance, rather than a direct side effect of tangential whole breast irradiation.
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| 3. |
- Margolin, Sara, et al.
(författare)
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A randomised feasibility/phase II study (SBG 2004-1) with dose-dense/tailored epirubicin, cyclophoshamide (EC) followed by docetaxel (T) or fixed dosed dose-dense EC/T versus T, doxorubicin and C (TAC) in node-positive breast cancer.
- 2011
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Ingår i: Acta Oncologica. - : Informa Healthcare. - 0284-186X .- 1651-226X. ; 50:1, s. 35-41
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to evaluate the feasibility of tailored and dose-dense epirubicin and cyclophosphamide followed by docetaxel as adjuvant breast cancer therapy. Material and methods. Patients with node-positive breast cancer received either four cycles of biweekly and tailored EC (epirubicin 38-60-75-90-105-120 mg/m(2), cyclophosphamide 450-600-900-1200 mg/m(2)) followed by four cycles of docetaxel (60-75-85-100 mg/m(2)) (arm A) or the same regimen with fixed doses (E(90)C(600) + 4 → T(75) + 4) (arm B) or docetaxel, doxorubicin and cyclophosphamide (T(75)A(50)C(500)) every three weeks for six cycles (arm C). All patients received G-CSF support and prophylactic ciprofloxacin. Results. One-hundred and twenty-four patients were randomised in the study. In the A, B and C arm, 17% 19% and 3% of the patients had one or more cycles delayed due to side-effects whereas 24%, 5% and 15% experienced a grade 3 infection or febrile neutropenia. After the introduction of an extra week between the EC and T parts in the A and B arms, grade 3 hand-foot-skin reactions were reduced from 5 to 0.2%. Twenty-nine percent (A and B) and 20% (C) of the patients were hospitalised due to side-effects. Discussion. Dose-dense and tailored EC/T can be given with manageable toxicity and is after adjustment presently studied in the phase III Panther trial.
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| 4. |
- Akselsson, Cecilia, et al.
(författare)
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A Combined Measurement and Modelling Approach to Assess the Sustainability of Whole-Tree Harvesting—A Swedish Case Study
- 2021
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Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 13:4
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Tidskriftsartikel (refereegranskat)abstract
- The demand of renewable energy has increased the interest in whole-tree harvesting. The sustainability of whole-tree harvesting after clear-cutting, from an acidification point of view, depends on two factors: the present acidification status and the further loss of buffering capacity at harvesting. The aims of this study were to investigate the relationship between these two factors at 26 sites along an acidification gradient in Sweden, to divide the sites into risk classes, and to examine the geographical distribution of them in order to provide policy-relevant insights. The present status was represented by the acid neutralizing capacity (ANC) in soil solution, and the loss of buffering capacity was represented by the estimated exceedance of critical biomass harvesting (CBH). The sites were divided into three risk classes combining ANC and exceedance of CBH. ANC and exceedance of CBH were negatively correlated, and most sites had either ANC < 0 and exceedance (high risk) or ANC > 0 and no exceedance (low risk). There was a geographical pattern, with the high risk class concentrated to southern Sweden, which was mainly explained by higher historical sulfur deposition and site productivity in the south. The risk classes can be used in the formulation of policies on whole-tree harvesting and wood ash recycling.
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| 5. |
- Akselsson, Cecilia, et al.
(författare)
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Acidification trends in south Swedish forest soils 1986-2008 : Slow recovery and high sensitivity to sea-salt episodes.
- 2013
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Ingår i: Science of the Total Environment. - : Elsevier BV. - 1879-1026 .- 0048-9697. ; 444, s. 271-287
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Tidskriftsartikel (refereegranskat)abstract
- Soil water chemistry in forest soils over 20years was studied at nine sites in southern Sweden. The aim was to investigate the recovery from acidification and the influence of strong sea salt episodes that occur in the region. All sites but one showed signs of recovery from acidification along with the reduced sulphur deposition, but the recovery progress was slow and the soil water was in most cases still highly acidic at the end of the period. In several cases the recovery was delayed by episodes of sea salt deposition, leading to transient acidification. The less marked decrease of sulphur concentrations in soil water than of sulphur deposition, highlighted the importance of sulphur adsorption/desorption in the acidification and recovery process. Nitrogen retention capacity was exceeded on one site, leading to nitrate leaching and extremely low pH. Storm fellings on two sites in the end of the period led to effects similar to those of regeneration fellings. It was concluded that the soils in the region are in an early stage of recovery. The future progress of recovery strongly depends on future nitrogen retention of forest soils and the frequency of sea salt episodes.
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| 6. |
- Akselsson, Cecilia, et al.
(författare)
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Assessing the risk of N leaching from forest soils across a steep N deposition gradient in Sweden.
- 2010
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Ingår i: Environmental Pollution. - : Elsevier BV. - 0269-7491 .- 1873-6424. ; 158:12, s. 3588-3595
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Tidskriftsartikel (refereegranskat)abstract
- Nitrogen leaching from boreal and temporal forests, where normally most of the nitrogen is retained, has the potential to increase acidification of soil and water and eutrophication of the Baltic Sea. In parts of Sweden, where the nitrogen deposition has been intermediate to high during recent decades, there are indications that the soils are close to nitrogen saturation. In this study, four different approaches were used to assess the risk of nitrogen leaching from forest soils in different parts of Sweden. Nitrate concentrations in soil water and C:N ratios in the humus layer where interpreted, together with model results from mass balance calculations and detailed dynamic modelling. All four approaches pointed at a risk of nitrogen leaching from forest soils in southern Sweden. However, there was a substantial variation on a local scale. Basing the assessment on four different approaches makes the assessment robust.
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| 7. |
- Alvez, Maria Bueno, et al.
(författare)
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Next generation pan-cancer blood proteome profiling using proximity extension assay
- 2023
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Ingår i: Nature Communications. - : Springer Nature. - 2041-1723. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- A comprehensive characterization of blood proteome profiles in cancer patients can contribute to a better understanding of the disease etiology, resulting in earlier diagnosis, risk stratification and better monitoring of the different cancer subtypes. Here, we describe the use of next generation protein profiling to explore the proteome signature in blood across patients representing many of the major cancer types. Plasma profiles of 1463 proteins from more than 1400 cancer patients are measured in minute amounts of blood collected at the time of diagnosis and before treatment. An open access Disease Blood Atlas resource allows the exploration of the individual protein profiles in blood collected from the individual cancer patients. We also present studies in which classification models based on machine learning have been used for the identification of a set of proteins associated with each of the analyzed cancers. The implication for cancer precision medicine of next generation plasma profiling is discussed.
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| 8. |
- Amloy, Supaluck, et al.
(författare)
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Excitons and biexcitons in InGaN quantum dot like localization centers
- 2014
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Ingår i: Nanotechnology. - : IOP Publishing. - 0957-4484 .- 1361-6528. ; 25:49, s. 495702-
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Tidskriftsartikel (refereegranskat)abstract
- Indium segregation in a narrow InGaN single quantum well creates quantum dot (QD) like exciton localization centers. Cross-section transmission electron microscopy reveals varying shapes and lateral sizes in the range ∼1–5 nm of the QD-like features, while scanning near field optical microscopy demonstrates a highly inhomogeneous spatial distribution of optically active individual localization centers. Microphotoluminescence spectroscopy confirms the spectrally inhomogeneous distribution of localization centers, in which the exciton and the biexciton related emissions from single centers of varying geometry could be identified by means of excitation power dependencies. Interestingly, the biexciton binding energy (Ebxx) was found to vary from center to center, between 3 to −22 meV, in correlation with the exciton emission energy. Negative binding energies are only justified by a three-dimensional quantum confinement, which confirms QD-like properties of the localization centers. The observed energy correlation is proposed to be understood as variations of the lateral extension of the confinement potential, which would yield smaller values of Ebxx for reduced lateral extension and higher exciton emission energy. The proposed relation between lateral extension and Ebxx is further supported by the exciton and the biexciton recombination lifetimes of a single QD, which suggest a lateral extension of merely ∼3 nm for a QD with strongly negative Ebxx = −15.5 meV.
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| 9. |
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| 10. |
- Braun, Sabine, et al.
(författare)
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Nitrogen deposition in forests: Statistical modeling of total deposition from throughfall loads
- 2022
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Ingår i: Frontiers in Forests and Global Change. - : IVL Svenska Miljöinstitutet. - 2624-893X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Nitrogen (N) gradient studies in some cases use N deposition inthroughfall as measure of N deposition to forests.For evaluating critical loadsof N, however, information on total N deposition is required, i.e., the sum ofestimates of dry, wet and occult deposition.Methods: The present paper collects a number of studies in Europe wherethroughfall and total N deposition were compared in different forest types.From this dataset a function was derived which allows to estimate total Ndeposition from throughfall N deposition.Results: At low throughfall N deposition values, the proportion of canopyuptake is high and thus the underestimation of total deposition by throughfallN needs to be corrected.At throughfall N deposition values > 20 kg Nha?1 yr?1 canopy uptake is getting less important.Conclusion: This work shows that throughfall clearly underestimates totaldeposition of nitrogen. With the present data set covering large parts of Europe it is possible to derive a critical load estimate from gradient studiesusing throughfall data.
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