LG-03 * RADIATION THERAPY IS ASSOCIATED WITH INCREASED LATE MORTALITY IN LONG-TERM ADULT SURVIVORS OF CHILDHOOD LOW GRADE GLIOMA: A POPULATION BASED STUDY
Bibliographic record
Abstract
PURPOSE: To uncover clinical risk factors and the impact of radiotherapy on children and adult survivors of childhood low grade glioma (PLGG). METHODS: We collected long-term follow-up information for all PLGG patients diagnosed in all Ontario, Canada from 1985–2012 (n = 1202) and determined factors affecting long-term survival. The impact of upfront (first line) radiation treatment on overall survival was determined in a discovery cohort of clinically relevant (incompletely resected) Ontario PLGG patients and an independent population based validation cohort from the Surveillance, Epidemiology and End Results (SEER) database (n = 2402). RESULTS: At a median follow-up of 12.73 (0.02-33) years; only 93 deaths (7.7%) were recorded with 20 years overall survival (OS) of 90.1% + 1.1%. Children with NF1 had excellent survival and no tumor-related deaths during adulthood. Adverse risk factors included pleomorphic xanthoastrocytoma tumor type (p<0.001) and thalamic location (p<0.001). For patients surviving >5 years post-diagnosis, upfront radiotherapy was associated with three-fold increased risk of overall late deaths (p = 0.001) and four-fold increased risk of tumor-related deaths (p = 0.013). On multivariate analysis radiation therapy was the most significant factor associated with late all deaths and tumor-related deaths (HR 3 [1.3–7.0; p = 0.012] and HR 4.4 [1.3–14.6; p = 0.014] respectively). Similar association of radiotherapy and late deaths was observed in the validation cohort (p < 0.001). In contrast to early deaths, late mortality was not associated with PLGG progression but rather tumor transformation (54%), secondary malignancy (11%) and other non-oncological causes (35%). CONCLUSION: The chronic clinical course of PLGG is associated with excellent long-term survival and is hampered by increased delayed mortality in patients receiving upfront radiotherapy. These observations should be considered while deciding treatment options for these patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".