HCP-14GLIOBLASTOMA MULTIFORME AMONG ELDERLY: A SINGLE INSTITUTION EXPERIENCE
Bibliographic record
Abstract
BACKGROUND: Treatment of glioblastoma multiforme (GBM) among patients older than 70 with standard 60Gy radiotherapy (SRT) plus temozolomide (TMZ) is challenging in terms of tolerability. Hypofractionated RT (HRT) alone or combined with TMZ is proposed, but results of these prospective randomized trials with favourable KPS patients are pending. METHODS: We retrospectively reviewed all GBM patients aged over 55 treated in our institution from 2010 to 2014. Demographic and tumor characteristics were extracted. Log-rank test and Cox proportional hazards model were used to estimate Kaplan Meier survival and hazard ratio. We divided our cohort in 4 groups according to treatment: concomitant chemoradiotherapy (CCRT) with SRT; CCRT with HRT; HRT alone; TMZ alone. RESULTS: Among the 171 patients identified, the median overall survival (mOS) in patients <70 years was 14.4mo [95%CI(11.7-16.8)] compared with mOS of patients ≥70 years 11.1mo [95%CI(6.1-16.6)] (p = 0.312). 109 patients were treated with CCRT-SRT compared to 15 with CCRT-HRT, 17 with RT alone, and 7 with TMZ alone. There was no difference in the mOS of patients receiving CCRT-SRT [14.2mo 95%CI(12.2-16.8)] compared with CCRT-HRT [14.6mo 95%CI(4.0-17.9)]. Patients on TMZ monotherapy had a poor mOS [4.4mo 95%CI(1.1-7.5)], as did patients on RT alone [3.9mo 95%CI(2.2-10.2)], probably because of negative selection. After RT, 106(81.5%) patients started adjuvant TMZ and received a median of 3 cycles (0-13); 28 completed ≥6 cycles. MGMT status was known in only 24/130 CCRT patients (16 unmethylated; 8 methylated), and was not significantly associated with longer survival. However, in patients receiving an alkalyting agent, mOS in methylated patients was 10.5mo [95%CI(4.0;16.4)] vs 14.3mo [95%CI(7.0;23.6)] in unmethylated patients (p = 0.399). CONCLUSIONS: Our data suggests that either standard CCRT(60Gy) or HRT could be efficiently used in patients over 70 in a non-selected GBM population. The results of ongoing prospective studies will be needed to confirm the toxicity and overall benefit.
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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 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| 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".