EFFECT OF RADIATION DOSE AND VOLUME ON SURVIVAL AND RECURRENCE OUTCOMES IN BLADDER CANCER PATIENTS TREATED WITH RADIATION THERAPY
Notice bibliographique
Résumé
In bladder cancer patients undergoing curative-intent radiation treatment at a single centre the benefits of higher dose and/or incorporating pelvic lymph node irradiation have been unclear. We sought to compare the outcomes of patients receiving higher (>60 Gy) versus lower (<=60 Gy) dose and bladder-only versus bladder and pelvic lymph node irradiation. We conducted a retrospective study of patients treated at Tom Baker Cancer Centre between 2010 and 2022. Patients included in this study received curative-intent radiation therapy with or without neoadjuvant or concurrent chemotherapy. Patients were identified through the provincial cancer registry. Data were collected from the cancer registry and electronic medical record systems. Disease recurrence was identified by cystoscopy or diagnostic imaging. Univariate Cox proportional hazards analysis was used to evaluate the effect of radiation dose and treatment on invasive recurrence and overall survival. Overall, 22 patients were included with median follow-up of 60.7 months (IQR 32.1-89.3) for patients who did not have a recurrence. Gender was male in 19 (86%) and median age at diagnosis was 70 years (IQR 65-83). There were 14 (63.6%) patients with Stage T2 disease, 1 (4.5%) with T4a, and 7 (31.8%) with unknown T Stage. N Stage was N0 in 13 (59%), N2 in 1 (4.5%), and NX in 8 (36%). Radiation dose was >60 Gy in 8 (36%) patients, and <=60 Gy in 14 (64%). There were 19 (86%) patients who received chemotherapy. Thirteen (59%) of patients received bladder-only irradiation and 9 (41%) received bladder and pelvic lymph node irradiation. Median recurrence-free survival was 45 months [95% CI: (26.9, not reached)] and overall survival was 49.1 months [95% CI: (38.2, not reached)]. Univariate Cox analysis did not find significant differences in odds ratio (OR) for death [0.49; 95% CI 0.13-1.83; p=0.29] or invasive recurrence [0.40; 95% CI 0.08-1.98; p=0.263] with higher radiation dose. Similarly, bladder + pelvic lymph node radiation was not associated with a significant difference in OR for death [0.46; 95% CI 0.12-1.71; p=0.247] or invasive recurrence [0.63; 95% CI 0.16-2.56; p=0.521]. No significant differences in overall survival or recurrence-free survival were observed with respect to higher dose or pelvic lymph node radiation. However, due to the small sample size, this study had limited statistical power. We are currently expanding our population to include all patients treated in the province to facilitate multivariable analysis and increased power.
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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 | 0,001 | 0,006 |
| 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 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 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 ».