Notice bibliographique
Résumé
We appreciate the opportunity to respond to the letter by Rocco et al, in which they address several issues in our recently published article1 that would benefit from further clarification. At the time when this trial was conducted, options for salvage therapy of local failure after radiotherapy were very limited because salvage radical prostatectomy was considered a morbid procedure associated with a high risk of incontinence. Given a choice, patients entering our clinical trial would have avoided this procedure and even today it is not widely practiced in Canada. The question of whether some patients might have been prematurely declared as having failed therapy due to the phenomenon of prostate-specific antigen (PSA) bounce after external beam radiation is unlikely to be relevant in our study. As we reported previously,2 the mean time from irradiation to the initiation of treatment was 4.6 ± 0.3 years. Eligible patients were required to have a rising serum PSA of at least 6.0 μg/L. In fact, the mean pretreatment serum PSA level was 21.2 ± 1.6 μg/L and 83.7% of the patients had a positive biopsy at the time of registration. The mean pretreatment serum testosterone level was 13.2 ± 0.4 nmol/L and there was no suggestion of fluctuations that might have erroneously resulted in an elevation of the serum PSA. Undoubtedly, these patients had failed radiotherapy. In the overview of the randomized trials of maximum androgen blockade by the Prostate Cancer Trialists' Collaborative Group,3 the difficulty of interpreting survival relative to different forms of androgen withdrawal therapy is emphasized given the range of uncertainty, which runs from approximately 0% to approximately 5% with a margin of benefit of only 2% to 3%. However, this problem does not arise in our study,1 which focused on patients with locally advanced cancer and not metastatic disease as in the meta-analysis of randomized trials. To our knowledge, there is no evidence that cyproterone acetate in doses of 100 to 200 mg daily is detrimental in men with local disease recurrence. In addition, the data arising from our trial yield a survival rate equivalent to that observed in a similar population of healthy men (unpublished data), a finding that is consistent with the absence of major drug-related morbidity. Nicholas Bruchovsky MD, PhD, MD*, Laurence Klotz MD , Juanita Crook MD , * The Prostate Center at Vancouver General Hospital Division of Urology Department of SurgeryUniversity of British Columbia, Vancouver British Columbia, Canada, Department of Urology Sunnybrook Medical Center, Toronto Ontario, Canada, Department of Radiation Oncology Princess Margaret HospitalToronto, Ontario, Canada.
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 | 0,005 | 0,056 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,003 |
| Communication savante | 0,004 | 0,005 |
| Science ouverte | 0,003 | 0,003 |
| Intégrité de la recherche | 0,026 | 0,032 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,027 | 0,023 |
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 ».