Treating the Contents and Not the Container: Dosimetric Study of Hair-sparing Whole Brain Intensity Modulated Radiation Therapy
Bibliographic record
Abstract
Hematogenous metastatases are the most common adult central nervous system malignancies. The standard treatment of these patients continues to include whole brain radiation. An unavoidable toxicity of this treatment is acute iatrogenic alopecia. This alopecia is a significant cause of patient distress. Our purpose was to quantify the sparing of the hair bearing skin that could be achieved by using a complex hair-sparing approach. To achieve this goal, we treat an anthropomorphic phantom with both conventional and inverse-planned intensity-modulated portals. The skin dose was evaluated through dose-volume histograms and thermo-luminescent dosimetry. The median calculated dose was reduced by 38%. The average measured dose at five surface points was reduced by 53%--from 95% of the prescription dose with the conventional plan, to 44%, with the IMRT plan. This sparing was achieved while maintaining adequate target coverage. Because of the low radiation tolerance of the hair follicle, this dose reduction is not expected, on its own, to eliminate radiation alopecia but bears promise in combination with other toxicity-sparing strategies.
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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 | 0.000 |
| 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".