GC-17THE CHILDREN'S ONCOLOGY GROUP (COG) CURRENT TREATMENT APPROACH FOR CHILDREN WITH NEWLY DIAGNOSED CENTRAL NERVOUS SYSTEM (CNS) LOCALIZED GERMINOMA (ACNS1123 STRATUM 2)
Bibliographic record
Abstract
Germinomas account for two-thirds of intracranial germ cell tumors. It is hypothesized that pre-irradiation chemotherapy may allow for a safe reduction in irradiation dose and volume while maintaining high survival rates. Stratum 2 of COG study ACNS1123 is evaluating whether chemotherapy (carboplatin 600mg/m2 on day 1 and etoposide 150mg/m2 on days 1-3) every 21 days x 4 cycles, followed by response based whole ventricular irradiation (WVI) is effective in treating patients with localized primary CNS germinoma allowing for elevation of hCG□ ≤100 mIU/mlbut mandating negative AFP in CSF and serum. Patients achieving a complete response following chemotherapy receive 18Gy WVI and a boost of 12Gy to the primary tumor. Patients with >0.5 cm (suprasellar) or >1 cm (pineal) but ≤1.5 cm residual, not undergoing second-look surgery, will be treated with WVI to 24Gy followed by local boost of 12Gy to a total dose of 36Gy. Mandatory enrollment on ALTE07C1 with prospective neuropsychological evaluation at 9, 30 and 60 months after diagnosis is also required. To-date, 93 eligible patients have been enrolled. The median age at diagnosis is 14.62 years with a male to female ratio of 3:1. Bifocal disease is present in 15 patients. Forty eight patients had hCG□ levels between 5-50mIU/ml and two patients between 50-100 mIU/ml. Toxicities included expected myelosuppression and electrolyte abnormalities with no deaths attributable to the therapy. Thus far, this strategy of chemotherapy followed by response-based WVI is tolerable. Additionally, with 93 patients enrolled, no stopping rules have been met.
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.014 | 0.002 |
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".