Clinical review and treatment outcome in Glioblastoma: Saskatchewan experience
Bibliographic record
Abstract
Introduction: Glioblastoma multiforme (GBM) accounts for up to 60% of all malignant primary brain tumors in adults, occurring in 2-3 cases per 100,000 in North America. In 2005 maximum safe surgical resection, followed by radiotherapy with concomitant temozolomide (TMZ), followed by adjuvant TMZ became the standard of care for glioblastoma (GBM). We adopted new standard of care in 2007 in the province of Saskatchewan. Material and Methods: A historical cohort of 393 patients with pathologically proven GBM, who had been registered in the Province of Saskatchewan from 2000 to 2010, was examined. Survival analysis was performed using Kaplan-Meier curves and a log-rank test for comparing subgroups. The independent effect of factors that predicted survival at the bivariate level was determined using a Cox proportional hazard model. Results: Median age at diagnosis in females was 67 years and males were 63 years. The median overall survival was 13.8 months (95% CI: 12.6, 15.1 months). Based on a literature review and after the univariate analysis, the following variables were included in the Cox's multivariable model: age at diagnosis, ECOG status (dichotomous variable created), type of surgery (complete vs. sub-total), whether chemotherapy and radiotherapy were done after surgery and KPS score. Patients who received chemotherapy had better median survival 18.1 months' vs 11.3 months. This however was not replicated in multivariate analysis. On multivariate analysis, independent predictors of survival included age and performance status. Patients younger than 50 years with good performance status did better than elderly population. For fit elderly patients > 70 years, 11.0 months median survival was achieved. Contrary to common belief in literature, patients with headache do not have a worse survival (Figure 4) and patients who presented with seizure survived better Conclusion: This paper failed to demonstrates improved survival outcomes consistent with those published in the literature for the addition of concurrent and adjuvant TMZ to radical RT for the treatment of GBM. This can be explained as practice between 2000-2006 was adjuvant radiation post-surgery which confounded data. Age and performance status were strong Open Access Abstract
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.006 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".