Compliance of adjuvant chemotherapy in non-small cell lung cancer (NSCLC); No longer an issue
Bibliographic record
Abstract
7154 Background: Poor compliance has been a common feature in clinical trials of adjuvant chemotherapy for NSCLC with only 48%-69% of patients completing all planned cycles. This may have been due to lack of perceived benefit by patients and physicians and toxicity of the regimens employed. We retrospectively evaluated compliance and toxicity of platinum-based chemotherapy in the two years following the recent reports of successful adjuvant chemotherapy trials for NSCLC. Methods: Following institutional ethics approval, patients who received adjuvant chemotherapy after complete resection of NSCLC between May 2003 and May 2005 were analyzed retrospectively. Patients were identified using an institutional cancer registry. Patient demographics, ECOG status, stage, pathologic subtype and type of surgery were recorded. The number of chemotherapy cycles, delays, dose reductions and change of chemotherapy were all reported. Results: A total of 50 patients were identified. The median age was 62. 38% were stage I, 18% stage II, 30% stage III and 14% had multiple primary tumors of variable stages. 20% were ECOG PS2 and the rest ECOG 0–1. Only 12% had undergone pnemonectomy. 41 patients (82%) started cisplatin /vinorelbine (3 switched to carboplatin because of nephrotoxicity, and one switched to carboplatin/paclitaxel because of fatigue and vomiting). 3 patients received other cisplatin-based combinations. 6 received carboplatin-based treatment (one because of advanced age, one because of cardiac dysfunction and 4 because of preexisting neuropathy). 80% completed all treatment. 40% required dose reduction. 58% required delays in treatment. 6 events of febrile neutropenia were reported in 5 patients. 7 patients required admission. There were no toxic deaths. Multivariate analysis showed no effect of age, gender, extent of surgery or ECOG status on compliance, need for treatment modification or toxicity. Conclusions: Compared to historical trials, adjuvant platinum-based chemotherapy for resected NSCLC is well tolerated and is now accepted by patients and physicians with a high degree of compliance. No significant financial relationships to disclose.
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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 | 0.018 | 0.076 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 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".