Does stereotactic body radiation improve outcomes compared to conventional radiation for liver cancer patients?
Bibliographic record
Abstract
Introduction: Over the past decade, there has been a paradigm shift to higher doses per fraction of liver stereotactic body radiotherapy (SBRT). However, this shift may not be due to evidence alone, but rather result of convenience and remuneration. This prospective cohort study aims to compare outcomes of patients who received moderately hypofractionated and hypofractionated radiotherapy treatments for liver tumours. Methods: Patients treated for liver cancer with radiotherapy between 2004 and 2020 were prospectively entered in this study. Patients were stratified into two groups: hypofractionation group of patients receiving an average of 5 fractions, and moderate hypofractionation group of patients receiving an average of 17 fractions. Other components of precision radiotherapy such as image guidance were the same between groups. The primary outcome was 2-year overall survival. The secondary outcomes were (1) change in toxicity as assessed by the Radiation Therapy Oncology Group (RTOG) toxicity criteria from baseline to 3 months, and from baseline to 6 months; and (2) change in Child Pugh score from baseline to 3 months. Type I error was prespecified at 0.05. Results: = 0.010); no difference was noted at the 1-year time point. Mean toxicity change in RTOG symptoms from baseline to 3 and 6 months, and in Child Pugh score from baseline to 3 months, were not statistically different between the two groups. Conclusion: When compared to conventional radiation fractionation, liver SBRT tends to be associated with a significant overall survival benefit, justifying a randomized trial to confirm. The concern that the trend to higher dose per fraction may result in increased toxicity, specifically in the treatment of high-risk liver patients, appears to be unfounded. The hypofractionated component of SBRT may be the critical dosimetric factor impacting on survival.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| 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) | 0.001 | 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 teacher head, 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".