EFFECT OF RADIATION DOSE AND VOLUME ON SURVIVAL AND RECURRENCE OUTCOMES IN BLADDER CANCER PATIENTS TREATED WITH RADIATION THERAPY
Bibliographic record
Abstract
In bladder cancer patients undergoing curative-intent radiation treatment at a single centre the benefits of higher dose and/or incorporating pelvic lymph node irradiation have been unclear. We sought to compare the outcomes of patients receiving higher (>60 Gy) versus lower (<=60 Gy) dose and bladder-only versus bladder and pelvic lymph node irradiation. We conducted a retrospective study of patients treated at Tom Baker Cancer Centre between 2010 and 2022. Patients included in this study received curative-intent radiation therapy with or without neoadjuvant or concurrent chemotherapy. Patients were identified through the provincial cancer registry. Data were collected from the cancer registry and electronic medical record systems. Disease recurrence was identified by cystoscopy or diagnostic imaging. Univariate Cox proportional hazards analysis was used to evaluate the effect of radiation dose and treatment on invasive recurrence and overall survival. Overall, 22 patients were included with median follow-up of 60.7 months (IQR 32.1-89.3) for patients who did not have a recurrence. Gender was male in 19 (86%) and median age at diagnosis was 70 years (IQR 65-83). There were 14 (63.6%) patients with Stage T2 disease, 1 (4.5%) with T4a, and 7 (31.8%) with unknown T Stage. N Stage was N0 in 13 (59%), N2 in 1 (4.5%), and NX in 8 (36%). Radiation dose was >60 Gy in 8 (36%) patients, and <=60 Gy in 14 (64%). There were 19 (86%) patients who received chemotherapy. Thirteen (59%) of patients received bladder-only irradiation and 9 (41%) received bladder and pelvic lymph node irradiation. Median recurrence-free survival was 45 months [95% CI: (26.9, not reached)] and overall survival was 49.1 months [95% CI: (38.2, not reached)]. Univariate Cox analysis did not find significant differences in odds ratio (OR) for death [0.49; 95% CI 0.13-1.83; p=0.29] or invasive recurrence [0.40; 95% CI 0.08-1.98; p=0.263] with higher radiation dose. Similarly, bladder + pelvic lymph node radiation was not associated with a significant difference in OR for death [0.46; 95% CI 0.12-1.71; p=0.247] or invasive recurrence [0.63; 95% CI 0.16-2.56; p=0.521]. No significant differences in overall survival or recurrence-free survival were observed with respect to higher dose or pelvic lymph node radiation. However, due to the small sample size, this study had limited statistical power. We are currently expanding our population to include all patients treated in the province to facilitate multivariable analysis and increased power.
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".