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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| 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 | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".