R.R. Borchers

BACKGROUND: Survival from metastatic cutaneous melanoma is substantially lower than for localized disease. Treatments for metastatic melanoma have been limited, but remarkable clinical improvements have been reported in clinical trials in the last decade. We described the characteristics of US patients diagnosed with cutaneous melanoma during 2001-2013 and assessed trends in short-term survival for distant-stage disease. METHODS: Trends in 1-year net survival were estimated using the Pohar Perme estimator, controlling for background mortality with life tables of all-cause mortality rates by county of residence, single year of age, sex, and race for each year 2001-2013. We fitted a flexible parametric survival model on the log-hazard scale to estimate the effect of race on the hazard of death because of melanoma and estimated 1-year net survival by race. RESULTS: Only 4.4% of the 425 915 melanomas were diagnosed at a distant stage, cases diagnosed at a distant stage are more commonly men, older patients, and African Americans. Age-standardized, 1-year net survival for distant-stage disease was stable at approximately 43% during 2001-2010. From 2010 onward, survival improved rapidly, reaching 58.9% (95% confidence interval = 56.6% to 61.2%) for patients diagnosed in 2013. Younger patients experienced the largest improvement. Survival for distant-stage disease increased in both Blacks and Whites but was consistently lower in Blacks. CONCLUSIONS: One-year survival for distant-stage melanoma improved during 2001-2013, particularly in younger patients and those diagnosed since 2010. This improvement may be a consequence of the introduction of immune-checkpoint-inhibitors and other targeted treatments for metastatic and unresectable disease. Persistent survival inequalities exist between Blacks and Whites, suggesting differential access to treatment.

Cross sections have been measured for the emission of protons, deuterons, and alpha particles for 15-MeV neutrons on $^{54,56}\mathrm{Fe}$, $^{58,60}\mathrm{Ni}$, $^{50,52}\mathrm{Cr}$, and $^{63,65}\mathrm{Cu}$, as well as on natural iron, nickel, and chromium. A quadrupole spectrometer served to detect particles with energies as low as 1 MeV. For some of the targets, a substantial fraction of the charged-particle spectrum is at energies below the Coulomb barrier. Cross sections and spectra are compared with statistical and pre-equilibrium model predictions.NUCLEAR REACTIONS $^{50,52}\mathrm{Cr}$, Cr, $^{54,56}\mathrm{Fe}$, Fe, $^{58,60}\mathrm{Ni}$, Ni, $^{63,65}\mathrm{Cu}$, ($n$,$p$), ($n$,$d$), ($n$,$\ensuremath{\alpha}$), $E=14.8$ MeV; measured $\ensuremath{\sigma}({E}_{p},\ensuremath{\theta})$, (${E}_{d}$, $\ensuremath{\theta}$), (${E}_{\ensuremath{\alpha}}$, $\ensuremath{\theta}$), enriched and natural targets. Hauser-Feshbach analysis, deduced reaction mechanism.

Received 12 January 1968DOI:https://doi.org/10.1103/PhysRevLett.20.424©1968 American Physical Society

The continuous neutron spectra produced by deuteron bombardment of D, T, and ${\mathrm{He}}^{4}$ have been studied at deuteron energies near 9 MeV with a time-of-flight spectrometer. Angular distributions of the continuous spectra from D+$d$ and ${\mathrm{He}}^{4}$+$d$ were obtained for deuteron energies of 9 and 10 MeV. The center-of-mass angular distributions are peaked forward for neutrons of all energies. Two maxima present in the 0\ifmmode^\circ\else\textdegree\fi{} spectrum from ${\mathrm{He}}^{4}$+$d$ at ${E}_{d}=10$ MeV are consistent with the interpretation that ${\mathrm{He}}^{5}$ and ${\mathrm{Li}}^{5}$ are produced in their ground states as alternative intermediate steps in the reaction. Two maxima are also present in the continuous neutron spectrum from T+$d$. The higher energy maximum occurs near the maximum possible neutron energy from the $\mathrm{T}(d, np)\mathrm{T}$ reaction and cannot be caused by the $\mathrm{T}(d, 2n){\mathrm{He}}^{3}$ reaction. If this peak is caused by an excited state in ${\mathrm{He}}^{4}$, it would correspond to an excitation in ${\mathrm{He}}^{4}$ of 20.0\ifmmode\pm\else\textpm\fi{}0.2 MeV, and be unbound.