Patient-reported outcomes after ipsilateral radiation therapy for N2b tonsillar squamous cell carcinoma
Bibliographic record
Abstract
BACKGROUND: Previous studies have reported excellent disease control and survival in patients with well-lateralized, American Joint Committee on Cancer (AJCC)-7 T1-2N2b tonsillar squamous cell carcinoma (SCC). The reduced treatment volume is associated with lower rates of physician-assessed toxicity. Patient-reported outcomes (PROs) have been proposed as a similarly reliable measure, but the body of literature is limited for unilaterally treated patients. Our goal was to review PROs of such patients who had reduced treatment volumes. METHODS: We reviewed PROs of patients with AJCC-7 T1-2N2b disease treated with ipsilateral radiation therapy (RT), with or without surgery or chemotherapy before RT. PROs were measured using the MD Anderson Symptom Inventory for head and neck cancer after a median of 28.9 months. RESULTS: Forty-eight patients were included in the study: 36 (75%) had human papillomavirus-positive disease, 20 (42%) had ≥ 2 nodal levels involved, 15 (31%) had extranodal extension and all patients had N2b disease. Most patients reported no symptoms; a median 72.9% for all 10 head-and-neck symptoms, 75.0% for all 12 core symptoms, and 83.3% for all 6 interference symptoms reported a score of “0”. The most common head-and-neck and core symptoms were dry mouth (n = 33, 69%) and fatigue (n = 23, 48%). Treatment mostly interfered with general activities. PROs were not affected by receipt of surgery; however, receipt of systemic therapy was associated with worse general activity (P = 0.044). Longitudinal analyses revealed mildly worse dry mouth (from 0 of 10 points to 1.5 of 10, P = 0.012) and numbness/tingling (from 0 of 10 to 0.5 of 10, P = 0.020). CONCLUSIONS: Ipsilateral neck RT for N2b tonsil SCC was associated with only a mild PRO symptom burden after at least 18 months, and therefore, a well-tolerated toxicity reduction strategy for appropriate patients.
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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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| 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".