International survey of androgen deprivation therapy (ADT) for non-metastatic prostate cancer in 19 countries.
Bibliographic record
Abstract
248 Background: ADT is commonly used for non-metastatic (M0) prostate cancer (PC) patients as primary therapy for high risk disease, adjuvant therapy together with radiation, or for recurrence after initial local therapy. Intermittent androgen deprivation (IAD) is a more recently developed alternative strategy for providing ADT that is thought to potentially reduce adverse effects, but little is known about practice patterns relating to it. We aimed to describe factors related to physicians' ADT use and modality for M0 PC patients. Methods: A 45-minute online survey was completed by urologists and oncologists from 19 countries with high or increasing prevalence of M0 PC. Respondents were responsible for treatment decisions for M0 PC, and had ≥10 patients on ADT. ADT comprises gonadotropin agonist (GnRH) treatment or bilateral orchiectomy. Results: 441 physicians completed the survey representing 98,689 PC patients under their care, of which 76,386 (77%) had M0 PC. Of M0-PC patients, 38% received ADT (37% GnRH, 2% orchiectomy); among patients on GnRH, 48% received continuous ADT (≥6 months [mos]), 25% IAD, and 26% <6 mos (table). Highest rates of ADT were reported among oncologists (62%) and in Eastern Europe (68%). PSA levels (65%), Gleason score (52%), and treatment guidelines (48%) were the most common reasons for continuous ADT whereas PSA levels (54%), patient request (48%), and patient age (38%) were cited most frequently as the reason for IAD. Conclusions: This international comparison showed that ADT modalities are commonly used in the treatment of M0 PC patients, and that the decision to use ADT is influenced by high risk criteria (PSA and Gleason) and treatment guidelines. IAD use is prevalent and often driven by patient choice and PSA levels. [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 | 0.001 | 0.002 |
| 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 | 0.001 |
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".