1,720,966 research outputs found
An exceptional overall survival using bevacizumab beyond progression in a patient with Non-small cell lung cancer
No full textNon-small cell lung cancer (NSCLC) is the most common malignancy and the leading cause of cancer death worldwide. In this report, we describe a patient with NSCLC who was treated with continuation of Bevacizumab (Bev) beyond progression to first-line Bev-based chemotherapy. The prolonged treatment with Bev by continuing the inhibition of VEGF beyond first-progression has a strong rationale. Nevertheless, few data exist regarding the efficacy and safety of Bev beyond first line of chemotherapy progression in NSCLC patients. Further studies including a large number of patients are needed, in order to select patients who could benefit from this approach
Assessing ChatGPT-4 as a clinical decision support tool in neuro-oncology radiotherapy: a prospective comparative study
No full textBackground and purpose: Large language models (LLMs) such as ChatGPT-4 have shown potential for medical decision support, but their reliability in specialized fields remains uncertain. This study aimed to evaluate ChatGPT-4’s performance as a clinical decision support tool in neuro-oncology radiotherapy by comparing its treatment recommendations for patients with central nervous system tumors against a multidisciplinary tumor board’s decisions, an independent specialist’s opinion, and published guidelines. Materials and methods: We prospectively collected 101 neuro-oncology cases (May 2024–May 2025) presented at a tertiary-care tumor board. Key case details were entered into ChatGPT-4 with a standardized query asking whether to recommend radiotherapy and, if so, the target volumes and dose. The AI’s recommendations were recorded and compared to the tumor board’s consensus, a blinded radiation oncologist’s recommendation, and ESMO guideline indications when applicable. Concordance rates (percentage agreement) and Cohen’s kappa were calculated. Sensitivity and specificity were assessed using the reference decisions as ground truth. McNemar’s test was used to evaluate any bias in discordant recommendations. Results: ChatGPT-4 matched the tumor board’s radiotherapy recommendations in 76% of cases (κ = 0.61). Agreement with the independent specialist was 79% (κ = 0.58). In 61 low-complexity cases with clear guidelines, ChatGPT-4 concurred with guideline-based indications in 76.7% of cases, missing some recommended treatments (sensitivity 73%, specificity 100%). In intermediate-complexity scenarios, concordance with the tumor board was 70.8%, with most discrepancies due to the AI recommending treatment that experts did not (sensitivity 85.7%, specificity 64.7%). In high-complexity cases, agreement was 90.9% (sensitivity 100%, specificity 83.3%). Overall, ChatGPT-4 showed an overtreatment bias, more often recommending radiotherapy when the human experts chose observation (p < 0.05 for AI vs. tumor board discordances). Its overall agreement (76%) was lower than that of the human specialist (90%). Conclusion: ChatGPT-4 can reproduce many expert radiotherapy decisions in neuro-oncology, reflecting substantial absorption of standard clinical practice. However, it cannot substitute for human judgment: the AI omitted some indicated treatments in straightforward cases and suggested unnecessary therapy in some borderline cases, indicating a lack of nuanced clinical reasoning. Careful human oversight is essential if such models are to be used for clinical decision support
Angiogenesis inhibitors in gastric and gastroesophageal junction cancer
No full textDespite significant improvements in systemic chemotherapy during the past two decades, the prognosis of patients with advanced gastric and gastroesophageal junction adenocarcinoma remains poor. Because of molecular heterogeneity, it is essential to classify tumors based on the underlying oncogenic pathways and to develop targeted therapies acting on individual tumors. Unfortunately, although a number of molecular targets have been studied, very few of these agents can be used in a clinical setting. In this review, we summarize the available data on anti-angiogenic agents in advanced/metastatic gastric cancer
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
Five years of stable disease with maintenance therapy using bevacizumab and tamoxifen in a patient with metastatic breast cancer
No full textBevacizumab and Tamoxifen are valid therapeutic options for metastatic breast cancer (mBC) patients. In this report, we describe a 47 year old woman with mBC successfully treated with a maintenance therapy with Bevacizumab+Tamoxifen. A maintenance approach using 2 different drugs with different targets and mechanism of action, such as anti-angiogenic and anti-hormonal treatment is particularly intriguing because they affect different pathways involved in mBC progression. Further studies including a large number of patients are needed, in order to select women who could benefit from this maintenance approach
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