Prospective Study of Patients Treated with Palliative Radiation Therapy While on Immunotherapy
Bibliographic record
Abstract
Purpose: To prospectively document the outcomes of patients treated with palliative radiation therapy (RT) who are receiving immunotherapy. Methods and Materials: Patients with advanced cancer receiving or planning to commence immunotherapy within 28 days who were referred for palliative RT at our center between January 2017 and September 2019 were screened for participation in this prospective observational study. Demographic and treatment data, along with patient-reported outcomes (PROs) using the Edmonton Symptom Assessment Scale for cancer, were collected at baseline, after 1 month, and then every 3 months for up to 1 year or until death. RT dose and fractionation were at the discretion of the treating radiation oncologist. Immunotherapy was given as per the standard of care protocol. The primary outcome was 3-month toxicity. Secondary outcomes included response evaluation criteria in solid tumors version 1.1 (RECIST v1.1) response on computed tomography scan performed 1, 3, and 6 months post-RT. The feasibility of enhancing PRO compliance using caregiver-aided PROs and virtual PRO collection was explored. Results: Thirty-nine patients who received 50 courses of palliative RT (most often for pain) and who also received immunotherapy within 28 days of RT were evaluated for toxicity at 3 months post-RT. The most common primary cancer was non-small cell lung cancer (38%), followed by melanoma (36%). The most common RT dose was 20 Gy in 5 fractions (42%). 87% of patients (34/39) received a programmed cell death protein 1 inhibitor alone. An interval of <14 days between RT and immunotherapy. No grade 3 or higher toxicity was attributable to combined treatment. The median survival for the cohort was 11 months. At 3 months, 26 patients had imaging available for RECIST v1.1; 14 of 26 (54%) had an in-field response, and 3 of 26 (12%) had stable disease (with mixed out-of-field response). Compliance with PROs was 79% (31/39) at 1 month and 69% (27/39) at 3 months. Ten of the 31 patients (32%) and 11 of 31 patients (41%) used caregiver-aided PRO collection. Conclusions: Palliative RT appears safe in patients receiving immunotherapy with no apparent increase in toxicity because of the combination. Responses out of irradiated volumes were no better than expected than with immunotherapy alone. Caregiver-aided PROs improved compliance with PRO data collection and were feasible.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 |
| 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".