MMAP-09 CHARACTERISTICS CORRELATING WITH SURVIVAL IN PATIENTS TREATED FOR LARGE BRAIN METASTASES
Bibliographic record
Abstract
Abstract BACKGROUND We aimed to identify factors predicting survival following treatment to large (>4cc) BrM. METHODS From a prospective registry database, we identified 364 adult patients treated for brain metastases (BrM) or surgical cavities larger than >4 cc: 127 and 237 treated with surgery plus stereotactic radiosurgery (S+SRS) and SRS alone, respectively. We compared the 2 treatment arms using propensity score-matched (PSMA) and multivariate analyses (MVA). P values <0.05 were considered statistically significant. RESULTS Median target volume was 6.6cc (4-36.9cc) for intact BrM and 15cc (4-54) for cavities. Median OS was 19 and 12 months for the S+SRS and SRS groups, respectively [HR 1.73 (1.35-2.22) (P<0.001)]. On UVA, number of BrM [HR 1.13 (1.06-1.22) (P<0.001)], ECOG 3-4 [HR 2.78 (1.73-4.46) (P<0.001)], and extracranial disease (ECD) at BrM treatment [HR 1.82 (1.37,2.40) (P<0.001)], correlated inversely with OS. GPA [HR 0.61 (0.52,0.70) (P<0.001)] and receipt of systemic therapy after BrM treatment[HR 0.58 (0.45-0.75) (P<0.001)] correlated to improved OS. On MVA, S+SRS [HR 1.81 (1.19,2.74) (P<0.0054)], reduced target volume [HR 1.03 (1.01,1.06) (P<0.0042)], and receipt of immune/targeted therapy [HR 0.68 (0.50,0.93) (P<0.015)] correlated with OS. PSMA comparing the treatment arms matched by ECD, number of BrM, ECOG, and SRS target volume, demonstrated that treatment arm remained correlated to OS [HR 1.62 (1.20-2.19) (P=0.0015)]. The cumulative incidence (CI) of LF requiring surgical resection at 12 months was 3% versus 7% for S+SRS and SRS groups, respectively [(HR 2.04 (0.89-4.69) (P =0.091)]. CI of PMD at 12 months was 16% versus 0% for S+SRS and SRS groups, respectively. CONCLUSION Reduced SRS target volume, treatment with systemic therapy following BrM treatment, and surgical resection prior to SRS correlate with survival in patients with large BrM. PMSA supports the hypothesis that surgery prior to SRS improves survival in patients with large BrM.
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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) | 0.001 | 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) | 0.000 | 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".