Elderly Patients with Painful Bone Metastases. The Impact of Comorbidity on the Choice of Radiation Therapy Regimen
Bibliographic record
Abstract
Background: The aim of this study was to demonstrate comparable pain relief with two schedules of radiotherapy(RT) for painful bone metastases in elderly patients assessed at baseline with the Cumulative Illness Rating Scale for Geriatrics (CIRS-G). Materials and methods: 132 elderly were analyzed. 77 received a single 8-Gy fraction and 55 received 20 Gy in 5 fractions. The choice of the treatment schedule was related to comorbidity, disability, target size and compliance. Pain intensity was measured with Numeral Rating Scale (NRS: 0=no pain; 10=high pain). Complete response was defined a pain reduction >3 of three points, partial response as a pain reduction ≥2 (2 ≤ pain reduction ≤ 3), no response was defined by pain score<2. Pain evaluation was recorded at baseline and at 1-4-8 weeks after completing RT. Results: overall response: 90.3% in 8 Gy arm (49.8% complete and 40.5% partial), 94.6% in 20 Gy arm (44.6% complete and 50%partial). No high grade toxicity were reported. The relief of pain was attained faster with single fraction (p-value ~ 0.2). We observed maximum response of pain control after 8 weeks and no significant differences were noted between two groups. The re-treatment rate was 17.6% vs. 11.1% respectively. Conclusions: no significant differences between the two arms in terms of pain response, pain control and toxicity. Our experience showed that not influenced by age, but in the elderly, life expectancy, comorbidities evaluated with the CIRS-G, and compliance, are crucial in selecting of shorter treatment.
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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".