Robotic radiosurgery and the “fingers of death”
Bibliographic record
Abstract
Background: Stereotactic body radiotherapy is emerging as an effective and efficient method for treating liver tumors, including hepatocellular carcinoma. With the widespread application of this complex treatment modality, new toxicities are encountered. Case Presentation: We present the case of a patient treated with stereotactic body radiotherapy for a hepatocellular carcinoma who developed unexpected Grade 3 dermatitis in the contralateral axilla. Discussion: In this paper we examine some of the intricacies of robotic stereotactic body radiotherapy, noting potential sources of unexpected toxicity. We assess the treatment plan and delivery method in our patient to determine potential causes of the dermatitis. We found that the contralateral axilla was not included in the calculation grid, and therefore, the high dose region was not reported. Conclusions: We present simple practice methods to prevent unexpected “fingers of death” from affecting other patients: calculating the dose to the entire CT volume and limiting the monitor units per node treated.
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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 | 0.002 |
| 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 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".