PATH-45. OUTCOMES OF AN IRRADIATION SPARING APPROACH IN MEDULLOBLASTOMA BY SUBGROUP IN YOUNG CHILDREN: AN INSTITUTIONAL REVIEW
Bibliographic record
Abstract
Abstract OBJECTIVE To describe disease outcomes including overall survival and relapse patterns by subgroup in young pediatric patients treated for medulloblastoma with an irradiation-sparing approach. METHODS Retrospective analysis of clinical outcomes including treatment, relapse and salvage therapy and late effects in children treated for medulloblastoma with a radiation-sparing approach at British Columbia Children’s Hospital (BCCH) between 2000 and 2020. RESULTS There were 30 patients (median age 2.8 years, 60% male) treated for medulloblastoma with a radiation-sparing approach at BCCH. Subgroups included Sonic Hedgehog (SHH, (n=14), Group 3 (n=7), Group 4 (n=6) and indeterminate status (n=3). Three and 5-year event-free survival (EFS) and overall survival (OS) were 49.0% (30.2 and 65.4%) and 42.0% (24.2-58.9%) and 62.5% (42.4 and 77.2%) and 66.0% (95% CI 46.0-80.1%) and 62.5% (95% CI 42.5 and 77.2%) respectively, with a median follow up of 9.5 years. Relapse occurred in 12/25 patients following a complete response, of whom six (Group 4: n=4, Group 3: n=1, unknown: n=1) were successfully salvaged with craniospinal axis (CSA) RT and remain alive at a median follow up of seven years. Disease/treatment-related morbidity included endocrinopathies (n=8), hearing loss n=16), and neurocognitive abnormalities (n=9). CONCLUSIONS This radiation sparing treatment approach for young patients with medulloblastoma resulted in a durable cure in most patients with SHH subgroup medulloblastoma. In those patients with Group 3 and 4 medulloblastoma, relapse rates were high; however, most Group 4 patients were salvaged with RT.
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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 | 0.004 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".