Abstract PO-056: The effect of timing of post-operative radiation on outcomes in anaplastic thyroid cancer
Notice bibliographique
Résumé
Abstract Introduction: Anaplastic thyroid cancer is an aggressive malignancy for which prompt treatment is necessary. Surgical resection is the recommended initial treatment for resectable cases and most patients require postoperative radiation therapy (RT). NCCN Guidelines state that adjuvant radiation should ideally begin 2-3 weeks postoperatively, however, limited evidence exists to support this guideline. Herein, we examine the National Cancer Database (NCDB) to assess whether the time interval between surgery and RT start impacts overall survival (OS). Methods: An NCDB data file was obtained and condensed to only include stage IV A/B anaplastic thyroid cancer cases during the years 2004 to 2018. Patients were selected based on histologic features of tumors, grade and stage of tumors, whether patients received surgery followed by radiation, whether their radiation treatment commenced at least 14 days after their surgery, and whether the RT total dose was between 4500 to 7680 cGy. The surgery to RT start interval (SRI) was calculated for all patients. Kaplan Meier survival curves for OS were evaluated based on the following ten groups of SRI intervals: 14-19 days, 20-23 days, 24-27 days, 28-31 days, 32-34 days, 35-37 days, 38-42 days, 43-49 days, 50-62 days, and greater than 62 days. Each of these groups of patients contained equal numbers of patients. Univariate comparisons were conducted followed by multivariate Cox regression, which included the following covariate variables: presence or absence of chemotherapy regimen in treatment plan, total thyroidectomy or alternate surgery, total dose of radiation, post-surgery margin status, Charlson-Deyo comorbidity score, tumor stage, age, and sex. Subsequently, hazard ratios for survival were calculated for ten SRI’s with equal numbers of patients based on the Cox regression. Results: The analysis included 444 patients after exclusions that were made as above. The mean age was 66 years old. The most common surgery was a total thyroidectomy (294 patients; 66.2% of patients). There were 353 (79.5%) patients who received chemotherapy with radiation. The median SRI was 34.0 days. The cohort of patients included 246 female patients (55.4%). Kaplan Meier analyses revealed that patients who received radiation between 14-19 days of surgery had a significantly reduced survival compared to most of the other SRI groups. On both univariate and multivariate analysis, there was a trend that indicated increased survival amongst patients in the 38-42 days SRI group as this group in both analyses had the lowest hazard ratios for death (Univariate HR: 0.491 (p=0.004); Multivariate HR: 0.518 (p=0.010)) of any SRI group when the 14-19 day SRI group served as the reference category. Discussion: Within the limitations of our retrospective study, it appears that delayed start of adjuvant radiation beyond NCCN recommendations is not necessarily detrimental to OS. Further prospective analyses may be necessary to identify the ideal timing of adjuvant radiation therapy. Citation Format: Andrew B. Bonner, Herbert Chen, Sharon A. Spencer, Christopher D. Willey, Adam J. Kole. The effect of timing of post-operative radiation on outcomes in anaplastic thyroid cancer [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Innovating through Basic, Clinical, and Translational Research; 2023 Jul 7-8; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2023;29(18_Suppl):Abstract nr PO-056.
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 | 0,002 | 0,008 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,001 |
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 ».