Adjuvant pelvic radiation therapy and high dose rate brachytherapy for pathologic stage III endometrial cancer
Bibliographic record
Abstract
5157 Background: There is a paucity of data regarding the use of adjuvant external beam radiotherapy (RT) and high dose rate (HDR) brachytherapy in the treatment of patients with stage III endometrial cancer. Methods: A retrospective review of 40 pathologic FIGO stage III endometrial cancer patients treated between 1996 and 2003 at McGill University was performed. Patients with papillary serous and clear cell carcinomas were excluded. All patients underwent surgery followed by adjuvant RT. Nodal sampling was performed in 25 patients (63%). External beam RT of 45 to 50.4 Gy in 23 to 28 fractions was delivered to the whole pelvis in all patients and with extended fields in one patient (5%) with positive para-aortic nodes. HDR brachytherapy of 6 to 18 Gy in 1 to 3 fractions was delivered to the vaginal vault in 30 patients (75%). Results: Median age at diagnosis was 58 years. Patients had stage IIIA disease in 24 cases (60%), stage IIIB in 2 cases (5%), and stage IIIC in 14 cases (35%). Tumors were histologic grade one in 11 patients (28%), grade two in 15 patients (38%), and grade three in 14 patients (35%). Lymphatic and vascular space involvement was present in 13 patients (33%) and 25 patients (63%), respectively. Five-year actuarial disease-free survival was 52% and 5-year actuarial overall survival was 53%. Local (pelvic) failures occurred in 10 patients (25%), including distal vaginal failures in 2 patients (5%), central pelvis failure in 1 patient (3%), and lateral pelvis (side wall or pelvic nodal) failures in 6 patients (15%). Distant failures occurred in 6 patients (15%), including abdominal failures in 4 patients (10%). No local failures and only one distant failure (3%) were observed in patients without vascular space involvement. Acute adverse events were observed in two patients (5%) who developed RTOG grade 3 genitourinary toxicity. One patient (3%) developed late RTOG grade 4 gastrointestinal toxicity. No treatment-related deaths were observed. Conclusions: Adjuvant pelvic RT and vaginal vault HDR brachytherapy is effective and well tolerated in the treatment of patients with stage III endometrial cancer. No significant financial relationships to disclose.
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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) | 0.000 | 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".