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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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- Riley, M. A., et al.
(författare)
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Strongly Deformed Nuclear Shapes at Ultra-High Spin and Shape Coexistence in N\sim 90 Nuclei
- 2009
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Ingår i: Acta Physica Polonica B. - 0587-4254. ; 40:3, s. 513-522
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Tidskriftsartikel (refereegranskat)abstract
- The N similar to 90 region of the nuclear chart has featured prominently as the spectroscopy of nuclei at extreme spin has progressed. This talk will present recent discoveries from investigations of high spin behavior in the N similar to 90 Er, Tm and Yb nuclei utilizing the Gammasphere gamma-ray spectrometer. In particular it will include discussion of the beautiful shape evolution and coexistence observed in these nuclei along with the identification of a remarkable new family of band structures. The latter are very weakly populated rotational sequences with high moment of inertia that bypass the classic terminating configurations near spin 40-50 (h) over bar, marking a return to collectivity that extends discrete gamma-ray spectroscopy to well over 60 (h) over bar. Establishing the nature of the yrast states in these nuclei beyond the oblate band-termination states has been a major goal for the past two decades. Cranking calculations suggest that these new structures most likely represent stable triaxial strongly deformed bands that lie in a valley of favored shell energy in deformation and particle-number space.
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- Gellanki, Jnaneswari, et al.
(författare)
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Characterization of Superdeformed Bands in 62Zn
- 2009
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Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 80:5
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Tidskriftsartikel (refereegranskat)abstract
- Combined data from four fusion-evaporation reaction experiments were utilized to investigate deformed and superdeformed structures in Zn-62(30)32. Combination of the Gammasphere gamma-ray spectrometer and ancillary particle detection systems allowed for the connection of rotational bands to well-known, low-lying excited states in Zn-62, as well as spectroscopy of discrete high-spin states reaching excitation energies of E-x=42.5 MeV. Four well- or superdeformed bands in Zn-62 are characterized and described by means of cranked Nilsson-Strutinsky calculations.
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- Ollier, J., et al.
(författare)
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Ultrahigh-spin spectroscopy of Er-159,Er-160: Observation of triaxial strongly deformed structures
- 2009
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Ingår i: Physical Review C (Nuclear Physics). - 0556-2813. ; 80:6
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Tidskriftsartikel (refereegranskat)abstract
- Three weakly populated high-spin rotational bands associated with the gamma decay of Er-159 and Er-160 were observed in fusion-evaporation reactions involving a beam of Ca-48 at an energy of 215 MeV incident on a Cd-116 target. The gamma decays were detected using the highly efficient Gammasphere spectrometer. The discovery of these bands, which extend discrete-line spectroscopy in these nuclei to ultrahigh spin of similar to 60h, is consistent with recent observations of high-spin collective structures in isotopes of Er, Yb, and Tm around N=90. Cranked Nilsson-Strutinsky calculations suggest that these bands may arise from well-deformed triaxial configurations with either positive or negative gamma deformation.
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- Riley, M A, et al.
(författare)
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Beyond band termination in Er-157 and the search for wobbling excitations in strongly deformed Hf-174
- 2005
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Ingår i: Journal of Physics G: Nuclear and Particle Physics. - : IOP Publishing. - 0954-3899 .- 1361-6471. ; 31:10, s. 1735-1740
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Tidskriftsartikel (refereegranskat)abstract
- High-spin terminating bands in heavy nuclei were first identified in nuclei around Er-158(90). While examples of special terminating states have been identified in a number of erbium isotopes, almost nothing is known about the states lying beyond band termination. In the present work the high-spin structure of Er-157 has been studied using the Gammasphere spectrometer. The subject of triaxial superdeformation and 'wobbling' modes in Lu nuclei has rightly attracted a great deal of attention. Very recently, four strongly or superdeformed (SD) sequences have been observed in Hf-174 and ultimate cranker calculations predict, such structures may have significant triaxial deformation. We have performed two experiments in an attempt to verify the possible triaxial nature of these bands. A lifetime measurement was performed to confirm the large (and similar) deformation of the bands. In addition, a high-statistics, thin-target experiment was run to search for linking transitions between the SD bands and possible wobbling modes.
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- Bentley, M. A., et al.
(författare)
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Isospin symmetry of odd-odd mirror nuclei: Identification of excited states in N=Z-2 Mn-48
- 2006
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Ingår i: Physical Review Letters. - 1079-7114. ; 97:13: 132501
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Tidskriftsartikel (refereegranskat)abstract
- Excited states have been observed in the N=Z-2 odd-odd nucleus Mn-48 for the first time. Through comparison with the structure of V-48, a first high-spin study of an odd-odd mirror pair has been achieved. Differences between the T=1 analogue states in this pair have been interpreted in terms of Coulomb effects, with the aid of shell-model calculations in the full pf valence space. Unlike other mirror pairs, the energy differences have been interpreted almost entirely as due to a monopole effect associated with smooth changes in radius (or deformation) as a function of angular momentum. In addition, the large energy shift between analogue negative-parity states is interpreted in terms of the electromagnetic spin-orbit interaction in nuclei.
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