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J Crowley

Publications and source records attributed to J Crowley.

At least 109 records · Page 6Linked to original sources
PubMed1990

Treatment of small-cell lung cancer with an alternating chemotherapy regimen given at weekly intervals: a Southwest Oncology Group pilot study.

We designed an intensive, weekly treatment regimen for patients with small-cell lung cancer (SCLC) using six of the most active chemotherapeutic agents for this disease (doxorubicin [DOX], cyclophosphamide [CTX], vincristine [VCR], etoposide [VP-16], cisplatin [CDDP], and methotrexate [MTX]). The goal of this program was to gain rapid, repetitive exposure to multiple, active drugs. Treatment was administered weekly for a total of 16 weeks. Seventy-six SCLC patients (limited disease, 34; extensive disease, 42) were treated. The overall complete plus partial response rate was 82%. Complete response rates of 47% and 38% were observed in patients with limited (LD) and extensive disease (ED), respectively. The median survivals for patients with LD and ED were 16.6 and 11.4 months, respectively. Toxicities were tolerable and were primarily hematologic. Twenty-six patients had one or more transient life-threatening toxicities, but only one patient developed a fatal toxicity. Eighty-four percent of the patients received 80% or greater of the intended protocol dosages over the entire 16-week treatment period. We conclude that this intensive, short-duration treatment regimen is at least as good as other "standard" regimens, and we are encouraged aged by the complete response rate and median survival in patients with ED SCLC.

Adult↗
PubMed1990

Chemotherapy is superior to sequential hemibody irradiation for remission consolidation in multiple myeloma: a Southwest Oncology Group study.

Six hundred fourteen previously untreated patients with multiple myeloma were evaluated on this phase III Southwest Oncology Group (SWOG) trial. For remission induction, two noncross-resistant drug combinations (vincristine, melphalan, cyclophosphamide, and prednisone [VMCP] and vincristine, carmustine [BCNU], Adriamycin [doxorubicin; Adria Laboratories, Columbus, OH], and prednisone [VBAP]) were administered with either a direct alternating or a syncopated schedule. Pretreatment serum beta-2 microglobulin (beta 2M) was the single most important prognostic factor for survival (P less than .0001). There was no difference in toxicity, response, or survival by induction chemotherapy schedule (P greater than .7). For consolidation, 180 eligible and responsive patients were randomized to receive either an additional year of VMCP or sequential hemibody radiation (HBI) with vincristine and prednisone (VP) administered between the two HBI courses. Relapse-free survival (26 months) and overall survival (median, 36 months) were better with VMCP than with HBI (median, 20 months and 28 months; P = .04 and .018, respectively). HBI was also evaluated on a nonrandomized basis in 66 patients who achieved either a partial response (PR) or who were nonresponders to induction therapy. While HBI converted 24% of the PR patients to remission status, this effect was only seen in 5% of nonresponding patients. The survival of responsive and nonresponding patients receiving HBI was similar. All HBI groups had an inferior outcome to those receiving VMCP consolidation. Myelosuppression was also significantly worse after HBI. Survival from the time of relapse did not differ between patients randomized to receive VMCP or HBI. Thus HBI induced less durable remissions, but did not render patients less amenable to postrelapse chemotherapy. Our findings do not support the use of HBI in either chemotherapy responsive or nonresponding patients with multiple myeloma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Quality of life end points in cancer clinical trials: review and recommendations.

In this presentation, issues that influenced the development of policies for inclusion of quality of life end points in certain Southwest Oncology Group clinical trials are reviewed. The key policies recommended by us and adopted by the Cancer Control Research Committee of the Southwest Oncology Group are as follows: (a) Begin assessment of quality of life in specific types of phase III protocols. (b) Always measure physical functioning, emotional functioning, symptoms (general and protocol specific), and global quality of life separately. (c) Include measures of social functioning and additional protocol-specific measures if resources permit. (d) Use patient-based questionnaires with psychometric properties that have been documented in published studies. In this review, we also recommend specific questionnaires. Our recommendations may prove useful for other cancer clinical trials groups and for multi-institution trials of treatment for chronic diseases.

Clinical Trials as Topic↗
PubMed1989

Treatment of acute myocardial infarction with recombinant tissue-type plasminogen activator.

In Ireland, to date, coronary thrombolytic therapy has been confined almost exclusively to the use of streptokinase. However, a large body of evidence suggests that, in comparison to streptokinase, the agent recombinant tissue-type plasminogen activator (rt-PA) may be more effective in lysing coronary thrombi and achieving coronary reperfusion and causes fewer disturbances of the coagulation system. With these considerations in mind, we undertook a study to explore the future potential role of rt-PA in our particular clinical practice. Sixteen patients presenting to our centre with clinical and ECG features suggestive of acute myocardial infarction were treated with rt-PA and heparin infusion within 3.8 +/- 1.3 (mean +/- SD) [range 0.6 - 5.3] hours of the onset of their symptoms. Reperfusion, as assessed by clinical, electrocardiographic and biochemical criteria, was achieved in 15 of these 16 patients. One patient developed reocclusion that was successfully treated with repeat thrombolytic therapy. Follow up coronary angiography, performed in eight patients, confirmed successful reperfusion in seven. One patient developed an intracranial haemorrhage. The result of this pilot study highlight the importance of considering thrombolytic therapy in all patients presenting with suspected acute myocardial infarction (AMI). Our observations also suggest that rt-PA is very effective in restoring myocardial perfusion in patients with AMI who present at an early stage. As with all thrombolytic agents, it may be associated with haemorrhagic complications. Determination of the precise role of rt-PA, as opposed to other thrombolytic agents, awaits the results of ongoing clinical trials.

Adult↗
PubMed1989

A general class of nonparametric tests for survival analysis.

Tarone and Ware (1977, Biometrika 64, 156-160) developed a general class of s-sample test statistics for right-censored survival data that includes the log-rank and modified Wilcoxon procedures. Subsequently, many authors have considered two- and s-sample classes in detail. In this paper a family of nonparametric statistics is shown to unify existing and generate new test statistics for the s (greater than or equal to 2)-sample, s-sample trend, and single continuous covariate problems.

Actuarial Analysis↗
PubMed1988

Evaluation of fludarabine phosphate in small cell carcinoma. A Southwest Oncology Group Study.

Fludarabine phosphate was given as a 5 day bolus infusion to eleven evaluable patients with recurrent small cell lung carcinoma. Patients had failed on one prior treatment regimen. There were no responses in the eleven evaluable patients. Severe neurologic toxicity occurred in one patient. Fludarabine phosphate as given in this protocol was not an effective agent in recurrent small cell lung carcinoma.

Adult↗
PubMed1988

Whole brain irradiation and intrathecal methotrexate in the treatment of solid tumor leptomeningeal metastases--a Southwest Oncology Group study.

From 1981 through 1985 the Southwest Oncology Group (SWOG) conducted a study evaluating the natural history and the effectiveness of standard therapy in those patients with leptomeningeal carcinomatosis from non-hematologic malignancies. Twenty-six patients were evaluated for the effectiveness of treatment; those who responded to therapy by one month exhibited a median additional survival of 5.7 months and those who were not responders at one month exhibited a median additional survival of 1.8 months. We were unable to identify pre-treatment clinical characteristics which would predict for a favorable response to therapy. Aggressive treatment in some patients may be indicated, as those patients who respond to treatment may have a survival benefit. The overall prognosis in this patient group remains exceedingly poor.

Combined Modality Therapy↗
PubMed1987

Abortion.

Explore the source record for details and available documents.

Abortion, Legal↗
PubMed1987

Effect of verapamil on in vitro cytotoxicity of adriamycin and vinblastine in human tumor cells.

Verapamil has been shown to reverse acquired drug resistance to Adriamycin (ADR) and vinblastine in the P388 leukemia and Ehrlich ascites carcinoma model systems. Because of its potential clinical application, we evaluated the ability of verapamil to modulate the effect of ADR and vinblastine on the in vitro cloning of fresh human tumor cells. Fifty-three tumors were cloned in a soft agar system. Continuous exposure to verapamil at concentrations of 1.0, 5.0, and 10.0 micrograms/ml, did not significantly modulate the overall inhibitory activity of ADR and vinblastine (P greater than 0.05). There was no evidence of an effect when results were analyzed by tumor type or previous treatment except in the subgroup of 13 tumors obtained from patients who previously had a clinical response to ADR but were relapsing at the time the tumor specimen was obtained. In this population, at three concentrations of ADR, there was a significant modulation of drug effect (P = 0.10, 0.03, 0.03, respectively). In each subgroup, some tumors showed marked modulation of drug effect by verapamil. These results suggest that the mechanisms of acquired in vivo resistance to ADR may be similar to those occurring in cell lines. However, the effect on human tumors was minor as compared to the results with cell lines. The in vivo significance of this finding remains to be determined.

Breast Neoplasms↗
PubMed1987

Serum antibodies to HTLV-I in human demyelinating disease.

Serum HTLV-I antibodies were measured in 17 MS patients and 2 closely matched control groups by 2 different independent assays. A highly sensitive particle agglutination test was used to detect HTLV-I core protein antigens and an immunoblot assay with E. coli-expressed P21E transmembrane protein was employed to detect antibodies to HTLV-I evelope antigens. No serologic evidence of prior HTLV-I infection in our population of multiple sclerosis (MS) or Guillain-Barré Syndrome (GBS) patients was found.

Adult↗
PubMed1987

Molecular cloning of 99% of measles virus genome, positive identification of 5' end clones, and mapping of the L gene region.

Molecular probes specific for paramyxovirus 3' and 5' end sequences are essential for studying viral transcription and replication and the role of defective interfering particles in these processes. We have constructed from measles virus genomic RNA an ordered series of overlapping clones containing over 99% of measles virus genetic information. Clones corresponding to the 3' and 5' ends of the genome were identified by means of a probe made from 'capped' genomic RNA, and their location was confirmed by primer extension experiments. Clones representing the N, P/C, M, F, and H genes were identified by reference to previously characterized clones, and their positions in the genome were defined by restriction analysis and S1 nuclease mapping of intercistronic clones. The L gene region was characterized by site-to-site restriction mapping and measured as 6,550 nucleotides in length.

Chromosome Mapping↗
PubMed1987

The effects of distance from primary treatment centers on survival among patients with multiple myeloma.

Twenty-one comprehensive cancer centers participated in a national reporting system of common data items, recording information on all patients seen between 1977 and 1982. There were 240,531 patients who had data abstracted. This report describes 1,479 patients with multiple myeloma. Parameters that may effect the type of treatment given during the initial episode of therapy in the center and the effect of these characteristics on survival were studied. In the univariate analysis, age, treatment, and distance traveled to the center were statistically associated with survival. In a multivariate analysis adjusting for potentially confounding covariates, blacks survive better than whites and the effects of sex and socioeconomic status (SES) on survival approach significance. Survival consistently improved with increasing distance traveled to treatment centers. This may be a serious confounding variable in assessing the results by both single and multiinstitution clinical trials.

Adult↗
PubMed1987

Experimental folliculitis with Pityrosporum orbiculare: the influence of host response.

The aetiology of the folliculitis associated with seborrhoeic eczema is unclear, though the yeast, Pityrosporum orbiculare has been implicated. P. orbiculare was applied under occlusion to normal forearm skin of patients with seborrhoeic eczema (SE), seborrhoeic eczema and folliculitis (SEF), and normal controls. There were significant differences in response to occlusion between the three groups. Those patients with previous clinical evidence of folliculitis (SEF) developed folliculitis at the site of occlusion more frequently than either of the other two groups (p less than 0.001), in whom only one patient developed skin changes. This difference was not explained by the response to occlusion alone, nor by natural carriage of yeasts. These results suggest that the yeast P. orbiculare is necessary for the development of folliculitis, but that the nature of the host response determines those patients prone to follicular inflammation.

Dermatitis, Seborrheic↗
PubMed1986

Education and the physician's office laboratory.

The field of physicians' office laboratory testing has witnessed an increase in test volume and advances in technology, but little attention to educational issues. If this field is to continue to grow and to perform high-quality testing, primary care physicians will need to be trained in the role of laboratory director. Office staff will require "in the office" continuing education. Formal technician and technologist training will need to focus some attention on office test procedures. The development of these new educational programs will require the cooperative efforts of primary care physician educators, pathologists, allied health faculty, and the diagnostic equipment industry.

Education, Medical, Graduate↗