Bimodality versus trimodality therapy for locally advanced non-small cell lung cancer (NSCLC) at the British Columbia Cancer Agency: Favorable outcomes and low treatment-related mortality with multidisciplinary patient selection
Bibliographic record
Abstract
7233 Background: The benefit of surgical resection after induction chemoradiation for locally advanced NSCLC is controversial. The purpose of this retrospective study was to examine the feasibility, safety and efficacy of combined modality therapy. Methods: Between 1998 and 2004, 68 patients with stage IIB (n=2) and III (n=66) NSCLC, median age 57, good performance status and minimal weight loss were selected by a multidisciplinary team. 20 patients were inoperable at diagnosis and received concurrent chemoradiation alone. 48 patients received chemoradiation, followed by surgery if feasible. 25/48 patients were candidates for surgery after their induction chemoradiation. 1 patient refused surgery and 3 patients were inoperable at thoracotomy. Results: In total, 43 patients received concurrent chemoradiation alone (18 received higher dose 50–61Gy radiation and 25 received 40–45Gy). The median survival for all bimodality patients was 21 months with a 4-year survival of 28%. Patients receiving a higher dose of radiation had a median survival of 24 months and a 4-year survival of 48% as compared to 17 months and 16% for patients receiving lower dose radiation. For trimodality patients, the median survival was 47 months with a 4-year survival of 44%. 20/21 (95%) of patients who underwent resection had pathologic downstaging of their tumor (6 patients with no residual disease). There were no treatment-related deaths. Conclusions: Combined modality therapy is safe and feasible in selected patients. Bimodality patients receiving higher dose radiotherapy appeared to have a longer median survival and higher 4 year survival rate. The observed pathologic complete response rate (29%) was similar to previous reports. The favorable results seen with the trimodality approach reflect careful multidisciplinary patient selection. No significant financial relationships to disclose.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: yes · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 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) | 0.002 | 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, unvalidatedLabeled directly by 2 models reading the full record.
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".