MB-91OUTCOMES FOR YOUNG CHILDREN WITH BRAIN TUMOURS TREATED ACCORDING TO THE HEAD START PROTOCOLS: A SINGLE-CENTRE EXPERIENCE
Bibliographic record
Abstract
INTRODUCTION: Young children with brain tumours at British Columbia Children's Hospital are commonly treated with radiation-sparing Head Start protocols. METHODS: This was a retrospective chart review. All patients treated on Head Start protocols from 1998-2011 [n = 37, 13 on-study, ages 0-93 months (median 28.6 months)] were identified from a clinical database and analyzed for treatment outcomes and late effects. RESULTS: Diagnoses included medulloblastoma (n = 18), ependymoma (n = 6), PNET (n = 5), ATRT (n = 3), high-grade glioma (n = 3), anaplastic DNET (n = 1) and high-grade neuroepithelial tumour (n = 1). Twelve of 37 (32%) patients had metastases at diagnosis. Sixty-two percent (n = 23) had gross total resections and 38% (n = 14) had post-operative residual. Four-year progression-free survival was 33%, radiation-free survival 39% and overall survival (OS) 56%. Forty-six percent (n = 17) relapsed, 22% (n = 8) progressed on therapy and there was one treatment-related death. Six of 25 progressions were salvaged with radiation and 3 without radiation, the remainder died. Two of three patients salvaged without radiation had high-grade gliomas that relapsed as low-grade gliomas. Overall survival was affected by the presence of CSF metastasis (13% vs. 66%, p = 0.01) but not underlying diagnosis or degree of upfront resection. Thirty-one of 33 patients (94%) with audiology results available had hearing loss. Among survivors, 60% have cognitive impairment and 30% have at least one endocrine deficit. CONCLUSIONS: Head Start chemotherapy cured one-third of treated patients. Only 36% of patients with relapse/progression were salvaged. Analysis of factors predicting survival was limited by sample size. Late effects were common among survivors.
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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 | 0.002 |
| 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) | 0.002 | 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, 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".