Bibliographic record
Abstract
Background: Survival in Wilms tumour(WT) is excellent, even in resource limited settings.However,depending on the treatment received, there is varying burden of late toxicities including cardiac and renal dysfunction.There is very little data on survivors of WT from India.Method: Weanalyzed all 5-year survivors ofnon-syndromic,unilateralWT enrolled in the After Completion of Therapy(ACT)Clinic of our unit, who had received doxorubicin based chemotherapy.Demographic, treatment and follow-up details were extracted from the prospectively maintained database.Late effects were graded as per National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAEv4.03)Results: Of the210 survivors of WT registered in ACT Clinic, 169fit the inclusion criteria.The median age at diagnosis was 3 years (1-15 years), and median age of survivors is 15 years (6-38 years).The median follow-up is 11 years (range 5-30 years)withmale:female ratio1.7:1.All survivors had undergone nephrectomy and multi-drug chemotherapy;70 children hadadditional radiation.At initial registration in ACT clinic, whilst 91%(159) of survivorshad no significant toxicity 5.7%(10) and 3%(5)of survivors had grade 2(moderate/requiring intervention) and grade 3(chronic/severe) late effects respectively.However on followup,this had increased to 9.8%(17) and 3.4%(6) respectively.Additionally,4 survivors had second malignancy (2 Ewing sarcoma,1 high gradetumour with epithelial differentiation, 1fibrosarcoma) and 1 survivordied of pulmonary tuberculosis.Of 17(10%) survivors with cardiac toxicities of varying degrees, 6 required treatment.Eight (5%) survivors were on treatment for chronic viral hepatitis and one had chronic liver disease.Of the 8 (5%) survivors with abnormal renal function, 1 had end-stage renal disease.Significant scoliosis was noted in 5 survivors.Conclusions: Continuous refinement of chemotherapy and radiation protocols over decades has resulted in improvement in outcomes and reduction in treatment related late toxicities, yet there is a need for assiduous monitoring for toxicity during survivorship care.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.006 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.015 | 0.002 |
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".