LG-66CLINICAL AND TREATMENT FACTORS DETERMINING LONG-TERM OUTCOMES FOR ADULT SURVIVORS OF CHILDHOOD LOW-GRADE GLIOMA: A POPULATION-BASED STUDY
Bibliographic record
Abstract
PURPOSE: To uncover clinical determinants and impact of radiotherapy on outcomes in adult survivors of paediatric low grade glioma (PLGG). METHODS: Population-based long-term follow up information on all PLGG patients in Ontario, Canada for period of 1985-2012 (n = 1202) was collected to determine factors affecting outcomes. The impact of upfront radiation treatment on overall survival (OS) was determined for an Ontario cohort and an independent reference cohort from the Surveillance, Epidemiology and End Results (SEER) database (n = 2402). RESULTS: At a median follow-up of 12.73 (0.02-33) years only 93 deaths (7.7%) were recorded with 20-year OS of 90.1% ±1.1%. Children with neurofibromatosis type-1 had excellent survival and no tumor- related deaths during adulthood. Adverse risk factors included pleomorphic xanthoastrocytoma tumor type (p < 0.001) and thalamic location (p < 0.001). For patients with unresectable tumors surviving more than 5 years after the diagnosis, upfront radiotherapy was associated with an approximately 3-fold increased risk of overall late deaths (hazard ratio [HR], 3.3; 95% confidence interval [CI], 1.6-6.6; P = 0.001) and an approximately 4-fold increased risk of tumor-related deaths (HR, 4.4; 95% CI, 1.3-14.6; P = 0.01). A similar association between radiotherapy and late deaths was observed in SEER cohort (P < 0.001). In contrast to early deaths, associated with PLGG progression, late mortality was associated with tumor transformation and non-oncological causes. CONCLUSION: The chronic clinical course of PLGG is associated with excellent long-term survival and is hampered by increased delayed mortality in patients receiving upfront radiotherapy. These observations should be considered while deciding treatment options for these 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 | 0.001 |
| 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) | 0.001 | 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".