Impact of total cisplatin dose on outcomes in locally advanced oropharyngeal squamous cell carcinoma.
Bibliographic record
Abstract
e17035 Background: De-intensification of chemoradiotherapy is being explored in HPV+ oropharyngeal squamous cell carcinoma (SCC). We evaluated the impact of total cisplatin dose on disease free survival (DFS) and overall survival (OS) in locally advanced oropharygeal SCC. Methods: A retrospective chart review was conducted of all patients referred to four centers at the BC Cancer Agency with stage III-IVB oropharyngeal SCC treated with concurrent, curative intent cisplatin and radiotherapy (XRT) from September 2008- September 2011. Results: 185 patients were identified. Baseline characteristics: male 85%, median age 57, ECOG performance status (PS) 0-1 95%, stage III, 19%, IVA 73% and IVB 8%. Smoking status: never or < 10 pack years, 40%, > 10 pack years, 49%, unknown 11%. P16 staining: positive 71%, negative 15%, unknown 14%. Ang risk classification (RC): low 40%, intermediate 34%, high 12%, unknown 14%. Treatment planned: 70 Gy/35 fractions 90%, 60 Gy/25 9% and 66 Gy/33 1%. Total planned cisplatin: 300 mg/m2 in 67%, 150 mg/m2 in 31% and other in 2%. 96% of pts received all of the planned XRT and 50% of patients received all the planned cisplatin. Actual total cisplatin dose delivered was < 200 mg/m2 in 41%, 200-299 mg/m2 in 31% and 300 mg/m2 in 28%. Grade > = 3 toxicity (oral mucositis, nausea and vomiting, radiation dermatitis) was noted in 58%. Clinical complete remission was obtained in 94% of patients. 3 yr DFS and OS were 70% and 75% for total cisplatin dose < 200 mg/m2, 81% and 85% for 200-299 mg/m2 and 86% and 90% for 300 mg/m2 (p = 0.075 for DFS, 0.028 for OS). Multivariate analysis demonstrated that poor PS, higher RC, lower XRT dose and total cisplatin dose 200-299 mg/m2, were associated with recurrence. Poor PS, higher RC, total cisplatin dose 200-299 mg/m2 but not XRT dose, were associated with higher risk of death. Conclusions: Our retrospective study suggests that higher total cisplatin dose was associated with better OS in a population with predominantly low to intermediate risk oropharyngeal SCC.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| 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) | 0.002 | 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".