Long-Term Outcomes of Neoadjuvant Intraarterial Chemotherapy for Locally Invasive Lacrimal Gland Carcinoma ex Pleomorphic Adenoma
Bibliographic record
Abstract
PURPOSE: There is no current standard treatment regimen for carcinoma ex pleomorphic adenoma (CXPA) of the lacrimal gland. Neoadjuvant intraarterial cytoreductive chemotherapy (IACC) followed by multimodal therapy has achieved good locoregional control in adenoid cystic carcinoma of the lacrimal gland. The authors reviewed their experience with neoadjuvant IACC followed by multimodal therapy for CXPA of the lacrimal gland. METHODS: Three patients with CXPA of the lacrimal gland treated with neoadjuvant ICAA therapy followed by multimodal therapy at the University of Michigan were retrospectively reviewed. RESULTS: Three patients had stage T4cN0M0 CXPA of the lacrimal gland (American Joint Committee on Cancer 8th ed). The first patient underwent 2 cycles of neoadjuvant IACC followed by multimodal therapy (exenteration, chemoradiotherapy, and adjuvant systemic chemotherapy). At 10 years of follow-up, there was no local recurrence or systemic metastasis. The second patient underwent 1 cycle of neoadjuvant IACC with multimodal therapy (systemic chemotherapy, globe-sparing orbital surgery, and chemoradiotherapy). After 5-year follow-up, there was no local recurrence or systemic metastasis. The third patient underwent 2 cycles of neoadjuvant IACC followed by multimodal therapy (globe-sparing orbital surgery, chemoradiotherapy, and adjuvant systemic chemotherapy). After 2 years, he developed parotid and retromandibular metastasis and underwent total parotidectomy with total neck dissection followed by chemoradiation and systemic anti-androgen therapy. After 7 years, he did not have any local recurrence or systemic metastasis. CONCLUSIONS: Neoadjuvant IACC with multimodal therapies can achieve favorable outcomes with locoregional control and improve disease-specific survival in patients with locally invasive advanced-stage CXPA of the lacrimal gland.
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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".