LGG-17. IMPACT OF STROKE AND STROKE RECURRENCE ON LATE MORTALITY AS WELL AS PSYCHOLOGICAL AND SOCIOECONOMIC OUTCOMES IN CHILDHOOD CANCER SURVIVORS
Bibliographic record
Abstract
BACKGROUND: Survivors of childhood cancer treated with cranial radiation therapy (CRT) are at high risk for stroke and stroke recurrence. However, the impact of stroke on psychological and socioeconomic outcomes and late mortality is not known. METHODS: Using the Childhood Cancer Survivor Study cohort, mortality rates (IR) per 100 person-years and 95% confidence intervals (CI) were calculated across three time periods: (1) prior to stroke (stroke free); (2) after first stroke but before recurrent stroke (post stroke); and (3) post recurrent stroke. Associations between stroke and psychological (neurocognitive function, emotional distress, health-related quality of life) and socioeconomic outcomes (education, income, employment, marital status, and independent living) were assessed using multivariable logistic regression adjusted for sex, age at diagnosis, and maximum CRT dose to calculate odds ratios (OR). RESULTS: Among 14,311 5+ year survivors (median age at survey 34.2 years, range 5.6–58.0; median time from diagnosis 26.2 years, range 5.0–38.0) 222 had a stroke ≥ 5years from diagnosis (single n=169; recurrent n=53). Based on 2,021 deaths, the all-cause late mortality rate increased from 0.67 (CI 0.64–0.70) in the stroke-free time period to 3.5 (CI 2.1–6.0) post recurrent stroke. Among 7,205 survivors with longitudinal follow-up, those with history of stroke were: more likely to live with a caregiver (single stroke OR 2.2 (CI 1.4–3.7); recurrent stroke OR 5.1 (CI 1.6–16.0)); limited physical function (single stroke OR 3.0 (CI 1.8–5.1); recurrent stroke OR 10.4 (CI 3.6–30.4)); and increased body pain (single stroke OR 2.0 (CI 1.2–3.4); recurrent stroke OR 3.1, CI 1.1–8.8)). Risk was increased for memory impairment, OR 3.4 (CI 1.1–10.2) and depression OR 4.8 (CI 1.7–13.7) after recurrent stroke. Stroke and stroke recurrence contribute to late mortality and negatively impacts longterm outcome in pediatric cancer survivors. Improved understanding of the pathogenesis of post-CRT stroke is needed to improve stroke prevention strategies.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".