206 research outputs found

    Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

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    Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

    Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

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    Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

    Inclusive heavy-flavour production at central and forward rapidity in Xe–Xe collisions at sNN\sqrt{s_{\rm NN}} = 5.44 TeV

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    The first measurements of the production of muons and electrons from heavy-flavour hadron decays in Xe–Xe collisions at sNN\sqrt{s_{\rm NN}} = 5.44 TeV, using the ALICE detector at the LHC, are reported. The measurement of the nuclear modification factor RAAR_{AA} is performed as a function of transverse momentum pTp_T in several centrality classes at forward rapidity (2.5 < y < 4) and midrapidity (|y| < 0.8) for muons and electrons from heavy-flavour hadron decays, respectively. A suppression by a factor up to about 2.5 compared to the binary-scaled pp reference is observed in central collisions at both central and forward rapidities. The RAAR_{AA} of muons from heavy-flavour hadron decays is compared to previous measurements in Pb–Pb collisions at sNN\sqrt{s_{\rm NN}} = 5.02 TeV. When the nuclear modification factors are compared in the centrality classes 0–10% for Xe–Xe collisions and 10–20% for Pb–Pb collisions, which have similar charged-particle multiplicity density, a similar suppression, with RAAR_{AA} ∌ 0.4 in the pTp_T interval 4 < pTp_T < 8 GeV/c, is observed. The comparison of the measured RAAR_{AA} values in the two collision systems brings new insights on the properties of the quark-gluon plasma by investigating the system-size and geometry dependence of medium-induced parton energy loss. The results of muons and electrons from heavy-flavour hadron decays provide new constraints to model calculations

    Inclusive heavy-flavour production at central and forward rapidity in Xe-Xe collisions at , root sNN=5.44 TeV

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    The first measurements of the production of muons and electrons from heavy-flavour hadron decays in Xe–Xe collisions at sNN=5.44 TeV, using the ALICE detector at the LHC, are reported. The measurement of the nuclear modification factor RAA is performed as a function of transverse momentum pT in several centrality classes at forward rapidity (2.5<y<4) and midrapidity (|y|<0.8) for muons and electrons from heavy-flavour hadron decays, respectively. A suppression by a factor up to about 2.5 compared to the binary-scaled pp reference is observed in central collisions at both central and forward rapidities. The RAA of muons from heavy-flavour hadron decays is compared to previous measurements in Pb–Pb collisions at sNN=5.02 TeV. When the nuclear modification factors are compared in the centrality classes 0–10% for Xe–Xe collisions and 10–20% for Pb–Pb collisions, which have similar charged-particle multiplicity density, a similar suppression, with RAA∌0.4 in the pT interval 4<pT<8 GeV/c, is observed. The comparison of the measured RAA values in the two collision systems brings new insights on the properties of the quark-gluon plasma by investigating the system-size and geometry dependence of medium-induced parton energy loss. The results of muons and electrons from heavy-flavour hadron decays provide new constraints to model calculations

    Publisher Correction: Unveiling the strong interaction among hadrons at the LHC

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    Correction to: Nature https://doi.org/10.1038/s41586-020-3001-6Published online 09 December 2020 In Fig. 1c of this Article, owing to an error during the production process, the equation incorrectly began ‘C(k*, r*) = 
’ instead of ‘C(k*) = 
’. In addition, in affiliation 71 ‘Dipartimento di Fisica dell’Università degli studi di Bari Aldo Moro’ has been corrected to read ‘Dipartimento di Fisica dell’Università degli studi di Cagliari’. The original Article has been corrected online

    Multiplicity dependence of π, K, and p production in pp collisions at √s = 13 TeV

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    This paper presents the measurements of π±, K±, p and pÂŻ transverse momentum (pT) spectra as a function of charged-particle multiplicity density in proton-proton (pp) collisions at s√ = 13 TeV with the ALICE detector at the LHC. Such study allows us to isolate the center-of-mass energy dependence of light-flavour particle production. The measurements reported here cover a pT range from 0.1 GeV/c to 20 GeV/c and are done in the rapidity interval |y|<0.5. The pT-differential particle ratios exhibit an evolution with multiplicity, similar to that observed in pp collisions at s√ = 7 TeV, which is qualitatively described by some of the hydrodynamical and pQCD-inspired models discussed in this paper. Furthermore, the pT-integrated hadron-to-pion yield ratios measured in pp collisions at two different center-of-mass energies are consistent when compared at similar multiplicities. This also extends to strange and multi-strange hadrons, suggesting that, at LHC energies, particle hadrochemistry scales with particle multiplicity the same way under different collision energies and colliding systems

    Measurement of isolated photon–hadron correlations in √sNN = 5.02 TeV pp and p–Pb collisions

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    This paper presents isolated photon-hadron correlations using pp and p-Pb data collected by the ALICE detector at the LHC. For photons with |η| < 0.67 and 12 < pT < 40 GeV/c, the associated yield of charged particles in the range |η| < 0.80 and 0.5 < pT < 10 GeV/c is presented. These momenta are much lower than previous measurements at the LHC. No significant difference between pp and p-Pb is observed, with PYTHIA 8.2 describing both data sets within uncertainties. This measurement constrains nuclear effects on the parton fragmentation in p-Pb collisions, and provides a benchmark for future studies of Pb-Pb collisions

    Measurements of mixed harmonic cumulants in Pb–Pb collisions at sNN\sqrt {s_{NN}} = 5.02 TeV

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    Correlations between moments of different flow coefficients are measured in Pb–Pb collisions at sNN\sqrt {s_{NN}} = 5.02 TeV recorded with the ALICE detector. These new measurements are based on multiparticle mixed harmonic cumulants calculated using charged particles in the pseudorapidity region |η|<0.8 with the transverse momentum range 0.2 < pTp_T < 5.0 GeV/c . The centrality dependence of correlations between two flow coefficients as well as the correlations between three flow coefficients, both in terms of their second moments, are shown. In addition, a collection of mixed harmonic cumulants involving higher moments of v2v_2 and v3v_3 is measured for the first time, where the characteristic signature of negative, positive and negative signs of four-, six- and eight-particle cumulants are observed, respectively. The measurements are compared to the hydrodynamic calculations using iEBE-VISHNU with AMPT and TRENTo initial conditions. It is shown that the measurements carried out using the LHC Run 2 data in 2015 have the precision to explore the details of initial-state fluctuations and probe the nonlinear hydrodynamic response of v2v_2 and v3v_3 to their corresponding initial anisotropy coefficients Δ2Δ_2 and Δ3Δ_3 . These new studies on correlations between three flow coefficients as well as correlations between higher moments of two different flow coefficients will pave the way to tighten constraints on initial-state models and help to extract precise information on the dynamic evolution of the hot and dense matter created in heavy-ion collisions at the LHC

    Long- and short-range correlations and their event-scale dependence in high-multiplicity pp collisions at s=13\boldsymbol{\sqrt{{\textit s}}}=13 TeV

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    Two-particle angular correlations are measured in high-multiplicity proton-proton collisions at s \sqrt{s} = 13 TeV by the ALICE Collaboration. The yields of particle pairs at short-(∆η ∌ 0) and long-range (1.6 < |∆η| < 1.8) in pseudorapidity are extracted on the near-side (∆φ ∌ 0). They are reported as a function of transverse momentum (pT_{T}) in the range 1 < pT_{T}< 4 GeV/c. Furthermore, the event-scale dependence is studied for the first time by requiring the presence of high-pT_{T} leading particles or jets for varying pT_{T} thresholds. The results demonstrate that the long-range “ridge” yield, possibly related to the collective behavior of the system, is present in events with high-pT_{T} processes as well. The magnitudes of the short- and long-range yields are found to grow with the event scale. The results are compared to EPOS LHC and PYTHIA 8 calculations, with and without string-shoving interactions. It is found that while both models describe the qualitative trends in the data, calculations from EPOS LHC show a better quantitative agreement for the pT_{T} dependency, while overestimating the event-scale dependency
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