MDB-03. Outcome of Group 4 medulloblastomas of early childhood treated with high dose chemotherapy and craniospinal irradiation sparing approach.
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Abstract Background Group 4 medulloblastoma (MB) are rare in young children and their outcome when treated with radiation avoidance strategies is unknown. Method This retrospective international cohort included children with molecularly characterized group 4 treated with high-dose chemotherapy(HDC) and CSI sparing approach. Results The cohort includes 38 patients (26M/12F) diagnosed at a median age of 46.4 months (25.9-78). Twenty-four (63.2%) were M0 and 26(68.4%) underwent initial gross total resection. The most common consolidation used was three cycles of HDC (carboplatin, thiotepa) in 76.3% or one cycle of HDC (carboplatin, etoposide, thiotepa) in 21.1%. Twenty patients (52.6%) relapsed at a median time of 24.9 months from diagnosis, providing a 5 years PFS of 40.9%(±9.2%). Patients who underwent 3 cycles of HDC, who received carboplatin and thiotepa or who achieved complete response at treatment completion had a better PFS. High-dose methotrexate during induction and metastatic status did not impact PFS. Relapse was local in 45%. Eighteen patients underwent radiation-based salvage therapy (2 focal, 16 CSI) in intent to cure. The median dose of CSI was 36 Gy (18-36). However, 7(43.7%) patients received CSI dose< 24 Gy. The 5 years post-relapse survival was 60.3% (±14.8%). At median follow-up of 39.9 months from diagnosis, 29 (76.3%) patients were alive, seven died of disease and two of toxicity, leading to 5 years OS of 72.7% (±8.6%). Using the SIOP-Boston scale, grades 2, 3 and 4 ototoxicity were reported in 18.7%, 31.2% and 25%. Mean FSIQ for patients without relapse or evaluated prior relapse was 86.5 (range 69-97; N = 6) and 2 had age appropriate cognitive and intellectual skills. Conclusions HDC and CSI sparing approaches led to a high rate of relapse (52.6%). However, 72.2% patients were salvaged with radiation-based therapy given at a median time of 2 years after initial diagnosis.
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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 | 0.001 |
| 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 it