NEURO-ONCOLOGY • NOVEMBER 2017 racy, precision, recall, and F1 measure were calculated for the NLP method. RESULTS: The manual review was completed in 27 days; mean discordance rate was 36.2%. The overall accuracy of the best logistic regression classifier was 84.6% on the training data and 82.8% on the hold-out test data. The precision and recall were both 83%, and the F1-score was 0.83. The algorithm required 28.9 minutes for training, after which it is able to classify the entire dataset in a less than 0.2 second. The model was incorporated into a user-friendly interface that allows for future report classification. CONCLUSION: NLP is a powerful method for the high-throughput evaluation of free-text radiology reports that can have high sensitivity and specificity. Use of NLP can accelerate retrospective clinical research with improved accuracy over manual chart review.

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Background. Radiotherapy after breast conserving surgery increases local control. Standard radiotherapy includes whole breast irradiation delivered in a daily fashion over 5 or 5½ weeks. All patients may not require entire breast treatment. We tested the feasibility of limited surgery with limited irradiation using interstitial brachytherapy to the tumor bed in a selected group of patients with stage I breast cancer in a phase II trial. Methods. Women aged 55 years or older with low or intermediate grade stage I tumors were treated with placement of interstitial catheters at the time of lumpectomy and axillary node dissection. The tumor bed was treated peri-operatively, using either low-dose-rate or high-doserate brachytherapy with Iridium-192 to deliver 16 to 25 Gy to the tumor bed over one to two days. Results. Ninety-five breasts (94 women) were treated on the protocol. There were four (4%) local recurrences in the breast at a median follow-up interval of 66 months (range, 2.8 -152). Cosmetic appearance ranged between good to excellent. There were no long-term radiation related complications. Conclusions. In a selected group of patients, lumpectomy and immediate peri-operative lowdose interstitial brachytherapy to the tumor bed yielded local control equivalent, without significant morbidity, to that observed in a historical series of whole breast irradiation. KJM 2009; 2(2):33-40.

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