Favorable outcomes with chemoradiation and surgery for locally advanced non-small cell lung cancer: The BC Cancer Agency Vancouver experience.
Bibliographic record
Abstract
7020 Background: The role of surgery following concurrent platinum-based chemotherapy and radiation for locally advanced non-small cell lung cancer (NSCLC) remains controversial, with high surgical mortality rates reported in a large randomized clinical trial. In this retrospective study, we evaluated the safety and efficacy of concurrent chemoradiation with or without surgery over an 11 period at the BC Cancer Agency. Methods: Patients were identified by the Vancouver Centre Pharmacy database. Charts were reviewed and data extracted included patient characteristics, weight loss, performance status, and method of mediastinal staging. Outcome measures were overall survival, pathological response rate, and treatment-associated morbidity and mortality. Results: Between January 1999-2010, 177 patients were identified with locally advanced NSCLC (stage IIIA/B) treated with platinum and etoposide and ≥40Gy radiation therapy, with or without surgical resection. The majority of treatment plans were reached by a multidisciplinary conference consensus. 74% (n=131) of patients received chemoradiation alone (bimodality therapy) and 36% (n=46) received chemoradiation followed by surgical resection (trimodality therapy). Among the trimodality therapy group, 16 patients underwent pneumonectomy and 30 lobectomy. Conclusions: In this series, bimodality therapy for patients with locally advanced NSCLC had similar treatment associated mortality and survival outcomes as reported in the literature. Trimodality therapy was associated with low treatment mortality rates and favourable survival. These two groups cannot be directly compared in this retrospective study. However, these results support a multidisciplinary approach to identify and carefully select patients with locally advanced NSCLC to undergo additional surgical resection following concurrent chemoradiation. [Table: see text]
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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 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| 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".