How surgery, radiotherapy and chemotherapy each contribute to the outcome of treatment for adult patients with Glioblastoma?
Bibliographic record
Abstract
ABSTRACT Introduction: glioblastoma is a common condition associated with high morbidity and mortality; most of newly diagnosed patients willdie within two years. The current standard therapy is maximal surgical resection followed by radiotherapy plus concomitant and adjuvanttemozolamide. Objective: it is the aim of this review to evaluate how determinant surgical resection, radiotherapy and chemotherapy areto the outcome of patients with glioblastoma. Methods: a literature search is done to identify trials evaluating the outcome of adults withglioblastoma after being treated with surgery, radiotherapy or chemotherapy. The Oxford Centre for Evidence-based Medicine Levels ofEvidence model is used to grade the quality of the available evidence. Results: 18 articles, reporting results of 15 studies were included.Five trials evaluated the effect of surgery in survival. Surgical provides as much as 4.9 months benefit in overall survival in cases in whichcomplete resection is possible. A systematic review and four clinical trials reported that radiotherapy increases the mean overall survivalin a range from three to five months. The European organization for research and treatment of Cancer and The National Cancer Instituteof Canada Clinical Trials Group (EORT-NCIC) described in 2005 an increase of the survival by two - three months on patients receivingconcomitant and adjuvant TMZ compared to patients receiving radiotherapy alone. Addittion of a novel chemotherapeutic agent seemsto improve the outcome of patients compared to the current standard of care. Conclusion: surgery, radiotherapy and chemotherapy, each have a modest effect in the outcome of adults with glioblastoma. (MED.UIS. 2012;25(3):209-19). Key words: Glioblastoma. General Surgery. Radiotherapy. Chemotherapy. Treatment Outcome. Cirugia, radioterapia y quimioterapia, ?como cada uno contribuye al resultado del tratamiento en adultos con glioblastoma? RESUMEN Introduccion: el glioblastoma es un tumor frecuente asociado a alta morbilidad y mortalidad, la mayoria de pacientes mueren antesde 2 anos desde el diagnostico. La terapia estandar actual es reseccion quirurgica maxima asociada a radioterapia mas temozolomida concomitante y coadyuvante. Objetivo: evaluar que tan determinantes son la reseccion quirurgica, radioterapia y quimioterapia para el resultado del tratamiento en pacientes con glioblastoma. Metodologia de busqueda: una revision de la literatura es hecha para identificar estudios que evaluen el resultado del tratamiento de adultos con glioblastoma tras ser tratados con cirugia, radioterapia o quimioterapia. El modelo de niveles de evidencia del Centro de Medicina basada en la evidencia de Oxford es usado para calificar la calidad de la evidencia encontrada. Resultados: 18 articulos, reportando resultados de 15 estudios son incluidos. Cinco estudios evaluan el efecto de cirugia en la sobrevida. La reseccion quirurgica provee un beneficio tan alto como 4,9 meses en la sobrevida global en los casos en que la reseccion maxima es posible. Una revision sistematica y cuatro ensayos clinicos han reportado que la radioterapia incrementa el promedio de sobrevida global en un rango de tres a cinco meses. La organizacion Europea para la investigacion y manejo del Cancer y el grupo de ensayos clinicos del instituto Nacional de Cancer de Canada (EORT-NCIC) describio en el 2005 un incremento en la sobrevida global en dos a tres meses en pacientes que reciben tratamiento concomitante y coadyuvante con temozolomida en comparacion con pacientes que solo reciben radioterapia. La adicion de uno de los nuevos agentes quimioterapeuticos parece mejorar el resultado del manejo comparado con el actual tratamiento estandar. Conclusion: el tratamiento quirurgico, la radioterapia y la quimioterapia; cada uno tiene un efecto modesto en el resultado del tratamiento de pacientes con glioblastoma. (MED.UIS. 2012;25(3):209-19). Palabras clave: Glioblastoma. Cirugia General. Radioterapia. Quimioterapia. Resultado del Tratamiento.
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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 | 0.004 | 0.026 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".