RTHP-30. MANAGEMENT OF GLIOBLASTOMA IN THE ELDERLY - A 10-YEAR ANALYSIS OF THE BC CANCER AGENCY POPULATION
Bibliographic record
Abstract
PURPOSE: Glioblastomas (GBM) are the most common primary tumours of the brain and carry an extremely poor prognosis. Despite recent publications, management of the elderly remains heterogeneous. We investigate the impact of patient characteristics and treatment modalities on the outcome of elderly patients with GBM in British Columbia (BC) from 2005–2015. Using the BC Cancer Agency patient registry, 822 adults diagnosed from 2005–2015, age 60 with histologically confirmed GBM ICD-O-3 codes (9440/3, 9441/3, 9442/3) were identified. Univariate, multivariate and Kaplan-Meier analyses were performed on patient characteristics and treatment modalities for overall survival (OS). Median OS was 6.57 months (0.03–99.93). 60% of the patients were male, mean age at diagnosis was 70 (60–90). Patients were aged 60–64 (26%), 65–69 (27%), 70–74 (20%), 75 (27%). 65% of the cohort was diagnosed between 2011–2015 vs. 35% between 2005–2010. 96% of patients had a diagnosis of glioblastoma with the remainder giant cell glioblastoma and gliosarcoma. MGMT promoter methylation status was available in 11% of patients. Resection status was GTR/STR (72%), biopsy (28%). 41% of patients received chemotherapy, 77% of patients received radiation therapy (RT). 20% of patients did not receive treatment beyond surgical intervention. Patient management involved concurrent chemoirradiation (CRT) (40%), RT alone (37%), chemo alone (1.5%). Younger patients aged 60–69, concurrent CRT and maximal safe resection (GTR/STR) resulted in improved OS (p<0.0001). Year of diagnosis and RT dose fractionation (60/30 (38%) vs. 40/15 (36%)) were not associated with a difference in OS. Elderly patients with GBM treated in BC 2005–2015 achieved similar outcomes to those of existing published data. Younger age, aggressive resection and concurrent CRT were associated with improved OS. Ongoing analysis is directed at further correlation of patient and treatment factors, features of RT and chemotherapy administration, progression-free survival and patterns of failure.
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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 | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| 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".