Concomitant Treatment for Brain Metastases in Non-Small Cell Lung Cancer Patients: Our Clinical Experience
Bibliographic record
Abstract
Purpose: Aim of this study was to evaluate tumor response, Quality of life (QoL) and median survival of concomitant chemotherapy (P/E) protocol with WBRT (whole brain radiotherapy) followed by P/E protocol until progression or appearance of serious adverse effects in NSCLC patients with multiple brain metastases. Methods: From December 2012 to April 2014, 12 patients were enrolled in this study. All of the patients received previous treatments. Selected patients had multiple brain metastases detected on CT and/or MRI, and the brain is only one site of disease dissemination and patients were at younger age. External beam radiotherapy was administered with two lateral opposed fields. Concurrently with WBRT, patients received P/E protocol and after 4 weeks, followed by P/E protocol repeated on 21 days until progression or appearance of serious adverse effects. Tumor response was assessed according to RECIST criteria. Assessment of QoL was performed by patients’ subjective answers, subjective improvement in emesis, ataxia, headache and seizures and without subjective improvement. Adverse effects were performed according to WHO criteria. Overall survival was analyzed from the beginning of the concomitant treatment until death or patient’s last control. Results: Common adverse events were neurotoxicity and hematology toxicity according to WHO criteria. No patient was withdrawn from the study because of the adverse events. All patients reported subjective improvements. Overall median survival was 7.5 months (95% CI 6.32-8.73). Conclusions: WBRT plus chemotherapy can improve the efficacy and QoL in NSCLC patients, because of synergistic effect and current evidence that the blood-brain barrier is damaged in patients with BM. Considering our clinical results, we recommend this treatment as safe and effective for selected NSCLC patients.
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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 | 0.001 | 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".