RARE-06. CANADIAN PATTERNS OF PRACTICE FOR INTRACRANIAL GERM CELL TUMOURS IN ADOLESCENTS AND YOUNG ADULTS
Bibliographic record
Abstract
To describe Canadian patterns of practice for intracranial germ cell tumours (IGCT) in adolescents and young adults (AYA), and to determine factors associated with treatment approaches in this disease. A survey was written containing questions on the management of two 17-year old males, one with localized pineal germinoma and the other with localized pineal non-germinoma germ cell tumor (NGGCT). An invitation to participate anonymously in the survey was e-mailed to 119 oncologists who treat brain tumors across Canada. Seventy-two (61%) of the 119 oncologists participated in the study. For the germinoma case, the most common treatment approaches were whole ventricular radiotherapy (WVRT) and chemotherapy (CH) (57%), WVRT without CH (15%), and craniospinal radiotherapy (CSRT) without CH (10%); of those who recommended WVRT+CH, 57% recommended 24Gy, 20% recommended 18Gy, 9% recommended 36Gy, and 9% stated that the radiation dose would depend on tumour response to chemotherapy. Chemotherapy was included in the treatment of germinoma by 96% of pediatric physicians vs. 54% of adult physicians (P=0.001). The most common treatment approaches for NGGCT were CSRT+CH (38%), WVRT+CH (18%), and pineal gland radiotherapy and CH (13%); of those who chose CSRT+CH, 74% recommended 36Gy, 15% recommended 24Gy, and 4% recommended 18Gy. The selection of craniospinal vs. smaller-volume radiotherapy was not associated with the physicians’ specialty, percentage of practice treating brain tumours, number of IGCT seen in the past 5 years, or size of institution. There is wide variation in the management of IGCT in AYA across Canada. A 17-year old male with a localized pineal germinoma is highly likely to receive chemotherapy if managed by a pediatric physician, while the same patient is much less likely to receive chemotherapy if managed by an adult physician. Future efforts should focus on improving consistency in the management of IGCT in AYA.
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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 | 0.000 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.014 | 0.001 |
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".