Cooperative groups

In providing a correctly optimized and accurate control system, all sections of the professional team involved in the project have to work together as a fully cooperating group. This includes persons who have a working knowledge of the process and those who are responsible for the automation and the electrotechnical aspects of the project. 

The ABCD acronym is a helpful mnemonic for recognizing the signs and symptoms of early MM (Fig. 94—2). It was devised in 1985 by clinicians working in the Melanoma Clinical Cooperative Group at New York University School of Medicine and is used to educate health care professionals who are not dermatologists in differentiating common moles from cancer.34 It is... 

Harmonisation with countries outside the ICH remit. This enlargement process was mediated through an expanded ICH Global Cooperation Group (GCG). The new members include representatives from... 

This pediatric cancer stands as an example of how cooperative group studies (NWTS and SIOP) have been able to integrate both chemotherapy and radiation into standard therapy while minimizing side-effects and dramatically improving cure rates as seen in the improvement of the 5-yr relative survival rates from 74% in 1974-1976 to 93% in 1989-1996 (60). The fifth NWTS trial began in 1995 and is expected to continue until 2003 (see Table 5) (60). This study will search for biological prognostic factors and examine the rates of cancer and birth defects in children born to survivors of Wilms tumor. 

Bartehnk H, Roelofsen F, Eschwege F, et al. Concomitant radiotherapy and chemotherapy is superior to radiotherapy alone in the treatment of locally advanced anal cancer results of a phase III randomized trial of the European Organization for Research and Treatment of Cancer Radiotherapy and Gastrointestinal Cooperative Groups. J Clin Oncol 1997 15 2040-2049. 

Horiot JC, Le Fur R, N Guyen T, et al. Hyperfractionation versus conventional fractionation in oropharyngeal carcinoma final analysis of a randomized trial of the EORTC cooperative group of radiotherapy. Radiother Oncol 1992 25 231-241. 

Lefebvre JL, Chevalier D, Luboinski B, et al. Larynx preservation in pyriform sinus cancer preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group. J Natl Cancer Inst 1996 88 890-899. 

Radiation therapy s main role is in the treatment of LD. Because radiation only offers locoregional control, chemotherapy is necessary to destroy the micrometastatic disease that invariably is present. Multiple cooperative group trials have been performed to establish the role of radiation therapy in SCLC (3-7). 

Roussel A, Jacob JH, Haegele P, et al. Controlled clinical trial for the treatment of patients with inoperable esophageal carcinoma a study of the EORTC Gastrointestinal Tract Cancer Cooperative Group. Recent Results Cancer Res 1988 110 21-29. 

Klinkenbijl JH, et al. Adjuvant radiotherapy and 5-fluorouracil after curative resection of cancer of the pancreas and periampullary region phase III trial of the EORTC gastrointestinal tract cancer cooperative group. Ann Surg 1999 230(6) 776-782 discussion 782-784. 

Loehrer PJ, Einhom LH, Elson PJ, et al. A randomized comparison of cisplatin alone or in combination with methotrexate, vinblastine, and doxorubicin in patients with metastatic urothelial carcinoma a cooperative group study. J Clin Oncol 1992 7 1066-1073. 

The locoregional delivery and efficacy limit the potential therapeutic benefit of Ad-p53 in metastatic Stage IV NSCLC patients except perhaps in a palliative role with low-dose radiation therapy. Currently, ECOG is evaluating the feasibility of Ad-p53 (INGN 201) in combination with 30 Gy of radiation therapy for recurrent or previously radiated NSCLC. This trial initiated by Choy is the first Ad-p53 study to be performed in a cooperative group setting. 

Despite the overwhelming evidence for short-term effectiveness, only recently have studies begun to address long-term benefits of stimulant treatments. Prospective randomized controlled trials with durations of 12 to 24 months and doses up to 60 mg/day of MPH have been conducted to address this issue. The largest of these studies, the National Institute of Mental Health (NIMH)-sponsored Multimodal Treatment Study of Attention-Deficit Hyperactivity Disorder (MTA Study), showed that stimulants (either by themselves or in combination with behavioral treatments) lead to stable, long-term improvements in ADHD symptoms as long as the medication is taken (MTA Cooperative Group, 1999). 

Greenhill, L.L. and MTA Cooperative Group. (1999) Chronic stimulant treatment effects of weight acquisition rates of ADHD children. 39 26-27. 

MTA Cooperative Group (1999) Moderators and mediators of treatment response for children with ADHD the MTA study. Arch Gen Psychiatry 56 1088—1096. 

The Multimodal Treatment of ADHD (MTA) Study, a large, multisite study of ADHD treatment (MTA Cooperative Group, 1999), highlights the importance of this therapeutic alliance. When outcome was measured only in terms of the child s inattention, stimulant medication alone did as well as medication plus psychosocial treatment. However, the combination of medication and psychotherapy had the best outcome in parent satisfaction and in reducing disruptive behaviors (Hinshaw et ah, 2000), which are important factors in longer-term compliance with treatment and outcome. 

MTA Cooperative Group (1999a) A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Multimodal Treatment Study of Children with ADHD. Arch Gen Psychiatry 56 1073-1086. 

More recent studies have examined combinations of medical and nonmedical treatments for ADHD, usually in an effort to determine whether one form of treatment is superior to, or enhances the effectiveness of, another. The largest-scale study examining the relative and combined effectiveness of medical and nonmedical interventions for ADHD is the recently completed MTA study (MTA Cooperative Group, 1999). In this 5-year, six-site project, 579 elementary school-age children with ADHD were randomly assigned to one of four 14-month treatment conditions behavioral treat-... 

Table 5a Worldwide Charged Particle Patients Totals (HTCOG—Hadron Therapy Cooperative Group Janet Sisterson, 2001)...

The Cooperative Group on MRS Applications in Cancer conducted a multi-institutional trial to demonstrate the utility and reproducibility of... 

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