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Biomedical subjects

R L Priore

Publications and source records attributed to R L Priore.

At least 37 records · Page 2Linked to original sources
PubMed1988

Hormone-refractory metastatic prostatic cancer treated with methotrexate, cyclophosphamide plus adriamycin, cis-platinum plus 5-fluorouracil plus cyclophosphamide. National Prostatic Cancer Project randomized trial.

From 1982 to 1985, the National Prostatic Cancer Treatment Group conducted a randomized prospective trial of single-agent or combination chemotherapy in 180 patients with metastatic prostatic disease refractory to hormonal therapy. All three of the treatment regimens, methotrexate, Adriamycin plus cyclophosphamide, cis-platinum plus 5-fluorouracil plus cyclophosphamide, showed similar survival and progression-free survival intervals. Future studies utilizing these or other agents, in similar or modified dosage schedules or delivery mechanisms, should note these results. Protocols designed to address subjective quality of life measures and other benefit ratios can be effectively employed considering this report.

Acid Phosphatase↗
PubMed1987

Experience with the use of generalized data base management systems in cooperative group clinical trials (a project of the Gynecologic Oncology Group).

Roswell Park Management Information System (RPMIS) is a formatted video-based system of programs for file creation, data entry, editing, updating, retrieval, and report generation. It has been utilized in more than 800 intrainstitutional research studies at Roswell Park. The Gynecologic Oncology Group (GOG) is a multiinstitutional, multidisciplinary cooperative group. Its clinical trials encompass the planning, initiation, execution, analysis, and presentation of results of management and treatment of patients with gynecologic cancer. The GOG Statistical Office, located at Roswell Park Memorial Institute, is responsible for data management and analysis of all patients entered into GOG protocols. Present annual accrual is approximately 2000 patients per year; 38 protocols are actively accruing patients while follow-up continues on 14 studies that are closed to patient entry. A previous paper (J Med Syst 7:235-242, 1983) described a time study comparing use of RPMIS and a paper batch processing system in GOG data management. The time study results and potential advantages of RPMIS warranted a gradual total conversion to this system. Presently GOG maintains 43 separate, self-contained applications of RPMIS and routinely develops a new system in conjunction with each new study initiated. This paper documents GOG experience with RPMIS during the past 4 years.

Clinical Trials as Topic↗
PubMed1986

Prostatic cancer. Treated at a categorical center, 1980-1983.

This report covers the experience from 537 patients with prostatic cancer seen at Roswell Park Memorial Institute (RPMI) from 1980 through 1983. This is a look at experiences in the early 1980s and is a continuation of the series covering the decades of the 1950s, 1960s, and 1970s. Referrals continue to dominate the series (85% of cases) but are now only slightly younger (65 years) than in-house diagnoses (66 years), of which one third were diagnosed at autopsy. Survival rates in this series, although limited in follow-up, were similar at two years to those in the 1970s and in the extensive series collected by the survey of the American College of Surgeons. Multiple primary tumors were observed in 22 per cent of this series, most frequently involving the bladder in addition to the prostate. Treatments continue to involve chemotherapy earlier in the course of disease as part of a succession of therapeutic modalities that include transurethral resection of prostate (TURP) or prostatectomy, lymph node dissection, external irradiation, castration, and hormones.

Age Factors↗
PubMed1986

Relative reliability of five serially measured markers for prognosis of progression in prostate cancer.

During an 8-year period, 1,065 serum specimens were collected from 79 patients with prostate cancer of stages B2 to D1 (group I) and 51 patients with newly diagnosed stage D2 prostate cancer (group II) to evaluate statistically the relative reliability of elevated tumor-associated markers for progressive disease in prostate cancer. Forty of the group I patients and 21 of the group II patients presented a clinical progression of disease during follow-up. With the use of Gail's modification of Cox's regression model, serial acid phosphatase (AcP), total alkaline phosphatase (TAP), bone alkaline phosphatase (BAP), prostatic acid phosphatase (PAP), and prostate-specific antigen (PA) were analyzed. Results from group I patients revealed that only PA (P = .0002) and PAP (P = .0684) were prognostically important markers for detection of imminent disease progression. However, all markers were prognostically important in group II patients. Comparative studies indicated that PA (P = .0052) and PAP (P = .0359) were the more reliable markers for group I patients, whereas PA (P less than .0001), BAP (P = .0007), and PAP (P = .0206) were the more reliable markers for group II patients. Multivariate analyses revealed that, after adjustment for the effect of PA, no other marker was significantly related to the risk of progression. Elevated PA levels were predictive of increased risk 6 months before disease progression in group I patients only (P less than .0001). Overall, the apparent order of prognostic reliability for disease progression was found to be PA greater than PAP greater than BAP greater than AcP greater than TAP.

Acid Phosphatase↗
PubMed1985

A comparison of estrogen and androgen receptor levels in human prostatic tissue from patients with non-metastatic and metastatic carcinoma and benign prostatic hyperplasia.

Estrogen receptors (ER, N = 72) and androgen receptors (AR, N = 33) were determined by high pressure liquid chromatography (HPLC) in 72 human prostatic tissues obtained at prostatectomy, and exploratory statistical analyses of the resulting data were performed. To facilitate use of these data as well as other pertinent information from the patient charts, a program for a comparatively large data base was implemented on a Wang minicomputer. The median values of cytosolic AR in the four cancer stages examined were statistically different from each other (P = 0.01), with AR increasing from stages A through D. Even though ER differences between the four stages were not significant (P = 0.13), there was a trend, in the data examined, for median ER values to decrease with stages B through D. On the other hand, median BPH values for both ER and AR were found to lie mid-scale compared with the respective cancer stages, leading to the conclusion that receptor measurements probably cannot distinguish between CA and BPH in human prostatic tissue, at least as measured by competitive binding techniques.

Binding, Competitive↗
PubMed1985

Relationship between leukemic cell retention of cytosine arabinoside triphosphate and the duration of remission in patients with acute non-lymphocytic leukemia.

Bone marrow cells were obtained from patients with acute non-lymphocytic leukemia immediately prior to the administration of cytosine arabinoside/anthracycline antibiotic remission induction therapy. The ability of the leukemic cells to take up and phosphorylate cytosine arabinoside (araC) and to retain cytosine arabinoside triphosphate (araCTP) was measured and compared to the outcome of remission induction therapy and the duration of remission. While the outcome of remission induction therapy was unrelated to cellular metabolism of araC, the duration of remission was highly correlated with araCTP retention. A comparison of the remission durations of patients treated on successive chemotherapeutic protocols suggests that the benefits of intensive remission consolidation therapy may be limited to patients whose leukemic cell retention of araCTP is low and that aggressive consolidation chemotherapy may reduce the prognostic significance of araCTP retention.

Acute Disease↗
PubMed1985

Postoperative respiratory complications in patients with Hodgkin's disease: relationship to the size of the mediastinal tumor.

Postoperative respiratory complications were investigated in patients with Hodgkin's disease, stages I-III, presenting with a mediastinal mass. By measuring the ratio between the widest diameter of the mediastinal mass and the width of the thorax at T5-6 (mediastinal thoracic ratio, MTR) in a PA chest X-ray, patients were divided into three groups: I: MTR less than 0.35 (41 patients); II: MTR 0.35-0.49 (33 patients); and III: MTR greater than 0.50 (23 patients). Five patients of group II and eight of group III received preoperative radiation therapy (RT) to the mediastinum due to severe clinical or radiological findings associated with the mediastinal mass. No patient of group I received preoperative RT. Without preoperative RT, group III had a significantly higher incidence of respiratory complications (7/15) compared to groups I (7/41) and II (2/28). Respiratory complications were not significantly different after preoperative RT in group III (1/8) compared to that observed in groups I plus II without preoperative RT (9/69).

Adolescent↗
PubMed1985

Prognostic factors in patients with advanced stage prostate cancer.

The relationships of 13 potential prognostic factors to objective response to treatment and survival time were investigated, using data gathered on 1,020 patients with advanced stage prostate cancer who have participated in the clinical trials of the National Prostatic Cancer Project. Multivariate statistical analyses revealed that previous hormone response status, analgesics, pain, elevated acid phosphatase, and anemia were the important, independent prognostic factors for objective response to treatment. For survival time, the significant prognostic factors were previous hormone response status, anorexia, elevated acid phosphatase, pain, elevated alkaline phosphatase, obstructive symptoms, tumor grade, performance status, anemia, and age at diagnosis. It is recommended that future treatment protocols for advanced stage prostate cancer take into account heterogeneity of the treatment groups with respect to these factors, either through the design of the protocol, or at the time of analysis.

Acid Phosphatase↗
PubMed1983

The clonogenic assay as a reproducible in vitro system to study predictive parameters of treatment outcome in acute nonlymphoblastic leukemia.

Seven institutions studied the cloning pattern of leukemic cells from pretherapy bone marrows of 273 patients with newly presenting and relapsed acute nonlymphoblastic leukemia. The cloning assay was done in all centers using an identical double-layer agar method with a common source of colony-stimulating factor. Cells were incubated for seven days, and clones were identified visually with an inverted microscope. All centers were able to obtain clonal growth in a substantial proportion of patients. Differences in growth pattern were observed between the major contributing center and the pooled results for all other centers. However, an analysis of clinical results suggested that in vitro differences were more likely related to differences in the patient populations than to variability in laboratory technique. The proportion of marrows in which leukemic cells formed colonies (greater than 40 cells) and large clusters (20-40 cells) was greater in relapsed patients than in newly presenting patients (P less than .06). A progressive improvement in induction treatment outcome was seen with decreasing clonal growth. Patients whose marrows did not produce clones had a complete remission (CR) rate of 83% versus 50% for those patients whose marrow leukemic cells formed colonies and/or large clusters (P = .05). In vitro drug sensitivity studies with cytosine arabinoside and adriamycin were performed on bone marrow cells of patients treated with this combination clinically. The percent killing of clonogenic cells in this assay correlated with remission induction outcome. Complete remission was obtained in 73% of 15 patients whose bone marrow leukemic cells showed greater than 30% killing by in vitro drug exposure, and CR was obtained in only 30% of 23 patients whose marrows showed less than 30% killing (P less than .01). The results indicate that the clonogenic assay correlates with treatment outcome and can be used for drug sensitivity testing in patients with acute nonlymphoblastic leukemia. The limitations of the assay are discussed.

Acute Disease↗
PubMed1983

Recognition of drug resistance during remission induction therapy for acute non-lymphocytic leukemia: utility of day 6 bone marrow biopsy.

While the majority of patients under 70 years of age with acute non-lymphocytic leukemia enter remission when treated with a combination of cytosine arabinoside and an anthracycline antibiotic, 20-45% of patients do not. The reasons for treatment failure in these patients vary from drug resistant disease to death from infection or bleeding shortly after remission induction therapy is initiated. Clearly, more intensive remission induction therapy should be administered only to those patients for whom the therapy being employed is of insufficient intensity. Bone marrow biopsies after six days of therapy have been performed on 53 patients who received 65 courses of remission induction therapy. Eighty-eight per cent of the remissions occurred in patients whose marrow cellularity was less than 62.5% on day 6 while 78% of patients who had drug resistant disease had day 6 marrow cellularities which exceeded 62.5%. Hence, a bone marrow biopsy performed after six days of therapy permits the recognition of the majority of patients who will enter complete remission or alternatively who need more aggressive therapy.

Acute Disease↗
PubMed1983

Skin pressure measurements on various mattress surfaces in cancer patients.

Twenty-eight patients with histologically proven carcinoma were studied on two dynamic and six static mattress surfaces to determine which mattress surface would provide the least skin surface pressure at the sacrum, dorsal spine, trochanter and heels. Measurements were taken with an especially designed inflatable bladder, and the mean of the maximum skin surface pressures was determined for the static and dynamic surfaces in the inflated and deflated state. Using less than or equal to 32 mm Hg as the skin surface pressure at which the arteriolarcapillary blood flow is interrupted, we concluded that the mud gel bed generally tended to record the lowest skin surface pressure for all of the sites. Although some of the static surfaces recorded pressures less than or equal to 32 mm Hg at the sacrum and dorsal spine, the deflated dynamic surfaces were superior to the remaining static surfaces in reducing the skin surface pressures.

Bedding and Linens↗
PubMed1982

Phase I trial and pharmacokinetics of a daily x 5 schedule of 3-deazauridine.

The uridine analog 3-deazauridine has been given to 19 patients in a phase I and pharmacokinetic study. Only mild toxicity was seen at doses less than 1200 mg/m2/day for 5 days. At a dose of 1200 mg/m2/day x 5, leukopenia (mean wbc count nadir of 2650/mm3) was seen in nine of 12 patients and thrombocytopenia (mean platelet count nadir of 47,000/mm3) in five of 12 patients. Nausea and vomiting and oral toxicity were each seen in two patients, and diarrhea and skin toxicity occurred in one patient each. Pharmacokinetic studies indicate a biphasic plasma decay with a beta-half-life of 6.9 hours and urinary excretion, mostly of unchanged drug, as the most important route for drug elimination. A dose of 1200 mg/m2/day x 5 is recommended for phase II studies and great caution is advised in administering the drug in the presence of renal impairment.

3-Deazauridine↗
PubMed1981

Prostate cancer mortality among Catholic priests.

To investigate the possible role of celibate lifestyles in the etiology of prostate cancer, analyses of mortality from cancers of the prostate and other sites among an average annual cohort of 6,226 Roman Catholic clergymen in New York State from 1965 through 1977 were conducted. The death certificates of 1006 (95%) priests were reviewed. Of these 156 deaths were attributable to malignant neoplasms. Clerics experienced mortality ratios of 15% less for all causes of death and 30% less for cancer mortality, given mortality patterns among New York State white males of comparable ages. Twelve deaths from prostatic cancer were observed while 19.8 were expected. This represents a mortality experience significantly less than that of the general noncelibate population. Lower mortality ratios were found also for cancers of the lung, colo-rectum, and stomach. Higher mortality ratios were found for malignant melanoma and unspecified respiratory organs.

Aged↗
PubMed1981

A genetic analysis of melanoma--polygenic inheritance as a threshold trait.

A total of 214 melanoma patients and 193 age- and sex-matched controls, interviewed at the Roswell Park Memorial Institute during the years 1974--1978, provided information regarding 1134 and 1043 New York State first order relatives (parents, offspring and siblings). The vital information provided was checked against the records of the New York State Tumor Registry to find cases of melanoma among relatives. Five cases of melanoma were found among the 1027 New York State relatives of melanoma index cases alive during the period 1949--1978, inclusive. No cases of melanoma were found among New York State relatives of controls. The expected number of melanomas among a cohort of relatives of identical sex and age composition for the interval was 0.625 cases, giving a ratio of observed to expected of 8.0. A similar analysis, restricted to parent-offspring pairs, yielded a ratio of observed to expected of 12.7. A search for additional melanoma cases among second degree relatives of familial index cases yielded no further affected relatives. The incidence of melanoma among relatives of melanoma cases and in a comparable general population were used to estimate the heritability of liability to melanoma as a polygenic trait. A heritability estimate of 0.49 was obtained, using parent-offspring data, indicating that nearly half of the variability in liability to melanoma in this population may be attributed to the additive action of many genes, each with small effect. Pending the replication of these findings, the 12-fold increase in incidence of melanoma among parents and offspring of melanoma cases suggests the importance of counseling and surveillance of relatives of affected individuals by the clinician.

Adult↗
PubMed1981

U.S. centralized cancer patient data system for uniform communication among cancer centers.

The evolution of the Centralized Cancer Patient Data System, a cooperative venture of the 21 comprehensive cancer centers in the United States, and its structure at the end of 3 years of data collection are described. Functions of the data system are detailed in terms of input and output. It is concluded that the short-run objective of establishing a data system to provide high-quality patient data that ae 21 comprehensive cancer centers in the United States, and its structure at the end of 3 years of data collection are described. Functions of the data system are detailed in terms of input and output. It is concluded that the short-run objective of establishing a data system to provide high-quality patient data that ae 21 comprehensive cancer centers in the United States, and its structure at the end of 3 years of data collection are described. Functions of the data system are detailed in terms of input and output. It is concluded that the short-run objective of establishing a data system to provide high-quality patient data that are comparable among cancer centers has been largely accomplished. Moreover, the very process of setting up the national data system has benefited the participating centers by upgrading their individual cancer registries. For the future, the goal is to realize the research potential of this new cooperative data collection mechanism, as well as the accumulating data themselves. Progress toward the long-term goal is just beginning.

Cancer Care Facilities↗
PubMed1980

Antitumor activity of Corynebacterium parvum and retinyl palmitate used in combination on the Lewis lung carcinoma.

The effects of Corynebacterium parvum and retinyl palmitate given at various levels, schedules, and routes of administration on primary Lewis lung carcinoma and its metastases have been evaluated in C57BL/6J mice given s.c. inoculations of 5 X 10(5) tumor cells. Single i.v., but not i.p., s.c., or i.m., administration of C. parvum (0.35 mg/mouse given on Days 0, 1, or 3) reduced growth of tumor and prolonged survival time. Retinyl palmitate (3000 IU/mouse/day) given alone i.p. either before, after, or both before and after tumor inoculation showed no effect on tumor growth, survival of mice, or lung metastases. The combination of retinyl palmitate i.p. (6 daily injections of 1500 IU/mouse after tumor implantation) and C. parvum (0.175 mg/mouse) given i.v. resulted in an increase in life span over control of 146% and appeared to be therapeutically synergistic. This combination produced 90-day cures in about 20% of the treated animals, all of which were found to be tumor free. Two nonparametric statistical procedures, the Kruskal-Wallis and the Dunn test, were used to assess the effects of treatments on survival time and tumor growth and may be generally applicable to animal tumor studies. They provide multiple comparisons of different treatments and allow the inclusion of long-term survivors into the analysis.

Animals↗