Concomitant use of tamoxifen with radiotherapy enhances subcutaneous breast fibrosis in hypersensitive patients

Concomitant use of adjuvant tamoxifen (TAM) and radiation therapy (RT) is not widely accepted. We aim to assess whether this treatment is associated with an increased risk of developing subcutaneous fibrosis after conservative or radical surgery in breast cancer patients. We analysed 147 women with breast cancer treated with adjuvant RT, and who were included in the KFS 00539-9-1997/SKL 00778-2-1999 prospective study aimed at evaluating the predictive value of CD4 and CD8 T-lymphocyte apoptosis for the development of radiation-induced late effects. TAM (20 mg day(-1)) with concomitant RT was prescribed in 90 hormone receptor-positive patients. There was a statistically significant difference in terms of complication-relapse-free survival (CRFS) rates at 3 years, 48% (95% CI 37.2-57.6%) vs 66% (95% CI 49.9-78.6%) and complication-free survival (CFS) rates at 2 years, 51% (95% CI 40-61%) vs 80% (95% CI 67-89%) in the TAM and no-TAM groups, respectively. In each of these groups, the CRFS rates were significantly lower for patients with low levels of CD8 radiation-induced apoptosis, 20% (95% CI 10-31.9%), 66% (95% CI 51.1-77.6%), and 79% (95% CI 55-90.9%) for CD8 </=16, 16-24, and >24%, respectively. Similar results were observed for the CFS rates. The concomitant use of TAM with RT is significantly associated with an increased incidence of grade 2 or greater subcutaneous fibrosis; therefore, caution is needed for radiosensitive patients

Compressive failure of finite size unidirectional composite laminates with a region of fibre waviness

The compressive behaviour of finite unidirectional composites with a region of misaligned reinforcement is investigated via finite element analyses. Models with and without fibre bending stiffness are compared, confirming that compressive strength is accurately predicted without modelling fibre bending stiffness for real composite components which typically have waviness defects of several millimetres wavelength. Various defect parameters are investigated. Results confirm the well-known sensitivity of compressive strength to misalignment angle, and also show that compressive strength falls rapidly with the proportion of laminate width covered by the wavy region. A simple empirical equation is proposed to model the effect of a single patch of waviness in finite specimens. Other parameters such as length and position of the wavy region are found to have a smaller effect on compressive strength. The modelling approach is finally adapted to model distributed waviness and thus determine the compressive strength of composites with realistic waviness defects. © 2011 Elsevier Ltd. All rights reserved