Locally advanced squamous cell carcinoma of the head and neck (SCCHN): Can the treatment results achieved in clinical trials be reproduced in an unselected patient population?
Bibliographic record
Abstract
5548 Background: Clinical trials performed in highly selected patients demonstrate that concurrent chemo-radiotherapy (CCRT) improves outcome compared to radiotherapy alone in locally advanced SCCHN. We reviewed the experience at the Ottawa Hospital Regional Cancer Centre, an academic comprehensive cancer centre, to determine how outcomes of CCRT in a less selected patient cohort compare with the published literature. Methods: Eligible patients were those diagnosed with SCCHN who received CCRT between 01/00 and 12/03, excluding salivary primaries and WHO type III nasopharyngeal carcinoma. The charts were reviewed for patient demographics, staging, prognostic factors, toxicity and treatment outcome. Results: Among 200 patient charts screened, 70 were eligible. Seven patients did not begin treatment: 2 opted for a clinical trial, 4 refused, 1 had disease progression. Sixty-three patients received CCRT (median age 56, 68% male, 84% oropharyngeal primary). Clinical stages were III/IVA/IVB in 7/48/8 patients. The median radiotherapy dose was 70 Gy (44–70 Gy), and the majority received platinum-based chemotherapy, as a single agent (49) or in combination with 5-FU (10). Due to toxicity, only 48% received all planned courses of chemotherapy; there was one toxic death (sepsis). Thirty-three patients required a feeding tube, upon which 10 remained dependent 3 months following completion of therapy; 24 had a >10% loss of pre-treatment weight. The clinical complete and partial response rates were 67% and 25%. With a median follow-up of 14 months, the median survival was 23 months and the 2-year overall survival rate was 48%. Conclusions: Published data suggest a 2- year overall survival rate of 42 to 60% for locally advanced SCCHN. In a non-clinical trial patient cohort, CCRT was acceptable in terms of outcome, safety and tolerance. CCRT is a feasible treatment option for carefully monitored patients with SCCHN in a tertiary care setting. No significant financial relationships to disclose.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.134 | 0.255 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| 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".