ATRT-10. EARLY POST RADIATION CHANGES AND EFFICACY IN CHILDREN WITH ATRT TREATED ON COG ACNS 0333: A COMPARISON OF PROTON VS PHOTON THERAPY
Bibliographic record
Abstract
BACKGROUND/OBJECTIVES: COG ACNS0333 is a prospective study evaluating surgery, intensive chemotherapy and radiation therapy (RT) in the management of ATRT. The therapy sequence was based on patient age, disease location and extent. Both proton RT (PRT) and photon RT (XRT) modalities were permitted. In this study the early post-RT changes and efficacy of PRT and XRT were compared. METHODS: All RT plans were reviewed centrally. Pre-operative, post-operative, pre-RT and first post-RT MRI scans were available and reviewed. Patient characteristics, treatment sequence, RT plan, tumor volume, brain and brainstem dosimetric parameters were evaluated. RESULTS: 41 of 65 evaluable patients on protocol received RT between 5/2009 and 11/2013 (14 PRT, 27 XRT). Median age at RT was 1.7y (range 0.6 – 13.9y). 6/41 patients received craniospinal RT. Median tumor dose was 50.4Gy (range 45-54Gy). All patients had >1 post-RT MRI scans available. At a median post-diagnosis follow up of 9 months, tumor control was equivalent after PRT and XRT (p=0.83). At a median post-RT follow up of 5 months (range 1.4–36.1) 10/42 patients had in-field MRI changes of varying severity (3 PRT, 7 XRT) in the absence of clear tumor progression. These MRI changes were noted between 2–6 months post-RT. Patients with post-RT MRI changes tended to have larger tumors with larger pre-operative tumor volume (median 137 cc vs 57 cc) and larger CTV’s (median 257cc vs 125 cc); however, the difference was not statistically different (p=0.21). CONCLUSION: In this early analysis of COGACNS 0333 there were no detectable differences in tumor control between the patients treated with PRT vs XRT. Reactive changes were seen with both modalities but were not excessive with either.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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) | 0.000 | 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 teacher head, 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".