OC-0356: Long terms results of permanent breast seed implants (PBSI) as partial breast irradiation
Bibliographic record
Abstract
explore impact of modality of boost radiotherapy (electron vs. HDR interstitial brachytherapy) on long term cosmesis.Material and Methods: 194 early breast cancer patients (T1N0, T2N0, T1N1) underwent BCS (Lumpectomy =125, Quadrentectomy = 69) + N3 nodal dissection in our unit between July 2004 and March 2010 after metastatic work up.Clips (4 or 5) were placed in all for subsequent delineation of radiotherapy target.Receptor status (including Her 2 neu) was detected for all.All patients received post BCS adjuvant chemotherapy -FEC for 'low risk' cases and EC X 4 then taxane X 4 for 'intermediate' and 'high risk' cases.Whole breast radiotherapy was given to all (50 Gy/ 25 fractions with CT-based planning).145/194 patients also received boosteither 15 Gy/ 6 fractions electron or 10 Gy/ single fraction HDR interstitial implant (2 or 3-planes) with individualized CT-based planning and geometrical optimization.DVH was analyzed in each for D90, Coverege index, Dose received by skin, DNR and COIN.Cosmetic outcome was analyzed in each follow up visit using 4-point scale (excellent, good, fair, poor).Results: Out of evaluable 173/ 194 patients (4 died of metastasis, 17 lost to follow up) with minimum duration of follow up of 36 months, 86 did receive electron boost and 38 received HDR.Local recurrence was in none so far.The PTV differed significantly -median 38 cc with HDR vs. median 90 cc with electron.Cosmetic outcome was significantly different -only 48/86 patients receiving electron boost have 'excellent and good' cosmesis compared to 31/38 receiving HDR brachytherapy (P = 0.008).Grade 1-2 fibrosis was seen in 39/86 (46%) with electron and 6/38 with brachytherapy (P= 0.002).Grade 1-2 telengiectasia was also significantly lower with HDR brachy 3/38 vs 29/86 with electron (P= 0.0019).Arm oedema was negligible in all patients -only 2.8%. Conclusion:For best cosmetic outcome after BCS, HDR brachytherapy (with CT-based 3D planning) for patients requiring boost radiotherapy appears to be much better option compared to electron unless the tumour is very superficial.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 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".