BMRK-04 EFFECT OF PRIMARY CANCER SITE AND EXTRACRANIAL PROGRESSION ON DEVELOPMENT OF BRAIN METASTASES IN PATIENTS TREATED WITH STEREOTACTIC BODY RADIOTHERAPY FOR OLIGOMETASTATIC SOLID TUMORS
Bibliographic record
Abstract
Abstract BACKGROUND Patients with oligometastatic disease (OMD) may achieve long-term control with stereotactic body radiation therapy (SBRT). However, those who develop brain metastases (BrM) often have poor outcomes. We aimed to investigate variables associated with development of BrM in this population. METHODS Patients with ≤5 extracranial metastases from solid tumors treated with SBRT from 2008-2016 at Sunnybrook Odette Cancer Centre were included. We investigated the association between covariates and CIBrM (cumulative incidence of BrM) using Fine-Gray analysis with death as a competing risk, and progression-free survival (PFS) and overall survival (OS) using Cox regression. We investigated the association between widespread extracranial progression (≥5 sites) and CIBrM using a time-based conditional competing-risks analysis. RESULTS Among 404 patients, the most common primary sites were lung (32%), colorectal (26%), prostate (13%), breast (10%) and kidney (7%). Median follow-up was 49 months. Median PFS was 25 months and median OS was 70 months. 58 patients developed BrM, and 5-year CIBrM was 16%. The 5-year CIBrM was highest among patients with breast cancer (22%), lung cancer (15%) and kidney cancer (15%), and lowest among those with colorectal cancer (5%) and prostate cancer (0%). On multivariable analysis, primary site was associated with CIBrM (p<0.001), with colorectal cancer (HR 0.34) and prostate cancer (HR 0.00) associated with lower CIBrM compared to lung cancer. Time from primary diagnosis to OMD, number of extracranial metastases, location of metastases, and total planning target volume (PTV) were not associated with CIBrM. Development of widespread extracranial progression within 24 (HR 4.1, p=0.004), 36 (HR 3.7, p=0.013), 48 (HR 5.9 p=0.009) and 60 (HR 23, p=0.017) months of OMD diagnosis was independently associated with higher CIBrM. CONCLUSIONS Primary site and extracranial progression, but not baseline measures of OMD volume and distribution, are associated with development of BrM in patients with OMD treated with SBRT.
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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 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".