Radiotherapy with concurrent and adjuvant temozolomide: a new standard of care for glioblastoma multiforme
Bibliographic record
Abstract
Key words: temozolomide; glioblastoma; clinical trial; neurotherapeutics; radiotherapy; quality of life. Introduction and Overview Glioblastoma multiforme is the most common and devastating of all primary brain tumors, with median survival typically in the range of 9–12 months with multi-modality treatment (DeAngelis, 2001; Burger & Scheithauer, 1994). Even with aggressive therapeutic approaches to prevent and manage tumor progression, and intense efforts to develop better treatments, survival for patients with glioblastoma has changed little in 30 years. Most patients experience local tumor progression, and usually succumb within months of recurrence. Standard accepted initial therapy for this disease has been maximal feasible surgical resection followed by conformal fractionated radiotherapy. Although not generally considered a chemosensitive tumor, glioblastoma occasionally responds to chemotherapeutic agents, particularly when these drugs are administered for recurrent disease (Brada et al ., 2001; Yung et al ., 2000). However, no drugs are predictably active against this disease, and most patients with glioblastoma who receive chemotherapy are usually treated with alkylating agents, historically nitrosoureas and most recently temozolomide (Lesser & Grossman, 1994). Efforts to improve survival for patients with glioblastoma have included advances in surgical techniques that enable more complete tumor resection, and more sophisticated ways of delivering radiotherapy to the tumor bed while comparatively sparing normal brain; these technical advances have made treatment safer, but have not had a definitive impact on extending survival. Chemotherapy has also been evaluated as initial treatment with surgery and radiotherapy in an attempt to improve dismal survival statistics for glioblastoma. The choice of potential agents for evaluation in glioblastoma has been limited by concerns surrounding effective drug penetration into the central nervous system (CNS), which is protected by a blood–brain barrier that renders tumors at least partly impervious to most drugs.
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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 | 0.001 | 0.000 |
| 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 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".