243 Evaluating the Discussion of Late Effects and Screening Recommendations in Survivors of Adolescent and Young Adult (AYA) Lymphoma
Notice bibliographique
Résumé
Purpose: There is a relative lack of literature documenting late effects in oncology patients treated as adolescents and young adults (AYA) compared to as pediatric patients.The objective of this study was to describe and quantify the incidence of treatmentinduced late effects in AYA patients treated for lymphoma. Materials and Methods:Patients diagnosed with Hodgkin lymphoma (HL) at 15-24 years of age or non-Hodgkin lymphoma (NHL) at 15-29 years of age were identified in the Lymphoid Cancer Database.All patients in the province who received RT as part of their lymphoma management from 1974-2014 with a minimum five-year survival post-RT were included.Late effects were defined as documented health complications persistent or arising beyond five years post-RT.For the analysis of cardiac disease, patients who received mediastinal RT and/or anthracycline chemotherapy were included.For infertility, patients who received pelvic RT and/or chemotherapy agents with the risk of infertility were included.Analyses of all other late effects included only survivors who received RT to the relevant anatomical site.Late effects were analyzed using Kaplan-Meier method and reported as cumulative incidence (CI) ± standard error.Results: Of the 378 patients studied, 226 patients (60%) were diagnosed with HL and 152 patients (40%) with NHL.Median follow-up was 7.2 years (range, 0.2-37).Median age at diagnosis was 22 years.34 patients (9%) were treated with RT only and 344 patients (91%) were treated with RT and chemotherapy.305 patients (81%) received one course of RT and 73 patients (19%) received ≥2 courses.Eighty-five patients (22%) had at least one relapse of lymphoma and 59 patients (16%) were deceased by last follow-up.Of the late effects studied, radiation-induced (RI) hypothyroidism was the most prevalent, with a CI of 19.8±2.5% at five years and 30.4±3.3% at 10 years.The CI of in-field second malignancy was 0.4±0.4% at five years and 1.1±0.8% at 10 years, of which the most common types were skin cancer (n=4) and sarcoma (n=3).The five-year CI of symptomatic RI lung damage was 4.8±1.4% and 10-year CI was 6.8±1.8%.RI esophageal complications occurred at a CI of 1.2±0.7% at five years and 1.9±1% at 10 years.CI of RI xerostomia and/or dental decay was 5.2±1.7% at five years and 7.1±2.1% at 10 years.Treatment-induced cardiac disease occurred at a CI of 1.9±0.8% at five years and 3.7±1.3%at 10 years.CI of reported infertility was 6.9±1.5% at five years and 11.1±2.1% at 10 years.Conclusions: Even with relatively limited follow-up, this study demonstrates that survivors of AYA lymphoma are significantly affected by long-term complications of treatment.The diverse clinical presentation and high incidence of late effects in a young population necessitate focused follow-up and screening when appropriate.Patients and primary care providers need to be informed to ensure proper management.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,012 | 0,075 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».