European Journal of Cancer最新文献

{"title":"Sex-specific survival in advanced metastatic melanoma – a DeCOG study on 2032 patients of the multicenter prospective skin cancer registry ADOREG","authors":"Anna-Sophia Leven ,&nbsp;Triinu Peters ,&nbsp;Luisa Sophie Rajcsanyi ,&nbsp;Michael Weichenthal ,&nbsp;Peter Mohr ,&nbsp;Friedegund Meier ,&nbsp;Imke von Wasielewski ,&nbsp;Ralf Gutzmer ,&nbsp;Jochen Utikal ,&nbsp;Patrick Terheyden ,&nbsp;Rudolf Herbst ,&nbsp;Sebastian Haferkamp ,&nbsp;Claudia Pföhler ,&nbsp;Ulrike Leiter ,&nbsp;Andrea Forschner ,&nbsp;Alexander Kreuter ,&nbsp;Christoffer Gebhardt ,&nbsp;Stine Lutze ,&nbsp;Carsten Weishaupt ,&nbsp;Stephan Grabbe ,&nbsp;Selma Ugurel","doi":"10.1016/j.ejca.2025.115668","DOIUrl":"10.1016/j.ejca.2025.115668","url":null,"abstract":"<div><h3>Background</h3><div>Females and males differ in their innate and acquired immune responses. Thus, it is hypothesized that the efficacy of anti-tumor immunotherapies may differ by sex. This study aimed to investigate sex-specific survival differences upon different therapy types in metastatic melanoma.</div></div><div><h3>Patients and Methods</h3><div>Patients with unresectable metastatic melanoma (stage IV, AJCCv8) of the skin or unknown primary, who had received first-line PD-1-based immune checkpoint inhibition (ICI) or BRAF/MEK-directed targeted therapy (TT) were identified from the prospective multicenter DeCOG skin cancer registry ADOREG. Study endpoints were progression-free survival (PFS) and overall survival (OS).</div></div><div><h3>Results</h3><div>A total of 2032 patients, 1274 males (62.7 %) and 758 females (37.3 %), received ICI (n = 1484) or TT (n = 548) between May 2010 and December 2020. At median follow-up of 28.6 months, no significant sex-specific differences in survival could be detected, neither in the total cohort nor by treatment type: PFS (total, p = 0.86; ICI, p = 0.46; TT, p = 0.21), OS (total, p = 0.60; ICI, p = 0.20; TT, p = 0.30). Multivariable Cox regression analyses also did not show a relevant prognostic influence by sex. Subgroup analyses were performed according to ICI therapy type. In n = 872 patients treated with PD-1 monotherapy, a survival advantage (PFS, p = 0.041; OS, p = 0.07) could be detected for males by univariable and multivariable analyses, whereas no sex-specific survival differences were found for n = 456 patients who received combination immunotherapy.</div></div><div><h3>Conclusion</h3><div>No overall sex-specific survival differences were detected for metastatic melanoma patients in the first-line therapy setting. According to subgroup analyses males show a trend towards a survival advantage over females.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"227 ","pages":"Article 115668"},"PeriodicalIF":7.1,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter Re: Dose-individualisation of fluoropyrimidines based on pre-treatment serum uracil levels","authors":"V. Boige,&nbsp;C. Narjoz,&nbsp;G. Le Teuff,&nbsp;M.A. Loriot","doi":"10.1016/j.ejca.2025.115662","DOIUrl":"10.1016/j.ejca.2025.115662","url":null,"abstract":"","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"227 ","pages":"Article 115662"},"PeriodicalIF":7.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter Re: Evaluation of screening mammography effectiveness: The IARC recommendations of 2015 need revision","authors":"Paolo Giorgi Rossi,&nbsp;Francesco Venturelli","doi":"10.1016/j.ejca.2025.115659","DOIUrl":"10.1016/j.ejca.2025.115659","url":null,"abstract":"","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"227 ","pages":"Article 115659"},"PeriodicalIF":7.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of screening mammography effectiveness: The IARC recommendations of 2015 need revision","authors":"Philippe Autier ,&nbsp;Karsten Juhl Jørgensen ,&nbsp;Henrik Støvring","doi":"10.1016/j.ejca.2025.115657","DOIUrl":"10.1016/j.ejca.2025.115657","url":null,"abstract":"<div><div>Breast cancer screening effectiveness is measured by its ability to reduce breast cancer mortality in real world settings. A viewpoint issued by the International Agency for Research on Cancer (IARC) in 2015 considered that observational studies (cohort and case-control) are the preferred methods to evaluate the effectiveness of mammography screening. A statistical method was deemed to correct for differences in personal characteristics between women choosing to attend or to not attend screening (self-selection bias). But we showed in a systematic review of observational studies that, compared to women who never attend screening, attenders have a 45 % reduction in their risk of breast cancer death (95 % CI: 40–50 %) and a 46 % reduction (95 % CI: 42–50 %) in their risk of death from a cause other than breast cancer. Screening mammography has no known beneficial influence on causes of death other than breast cancer. If screening mammography reduced the risk of breast cancer death, one would expect a much greater percentage reduction in the risk of breast cancer death than in the risk of all-cause death. Our results suggest that screening mammography attendance is an indicator of personal characteristics associated with a lower risk of dying from any cause, including from breast cancer, which observational studies have misinterpreted as a screening effect. This paper calls into question the IARC 2015 recommendations and advocates the reinstatement of recommendations made by the IARC in 2002 which were based on the use of descriptive and comparative studies.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"227 ","pages":"Article 115657"},"PeriodicalIF":7.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the current perspective: Evaluation of screening mammography effectiveness: The IARC recommendations of 2015 need revision","authors":"Beatrice Lauby-Secretan","doi":"10.1016/j.ejca.2025.115658","DOIUrl":"10.1016/j.ejca.2025.115658","url":null,"abstract":"","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"226 ","pages":"Article 115658"},"PeriodicalIF":7.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic factors of early mortality in children and adolescents with relapsed/refractory solid tumors participating in dose-finding trials in the targeted and immune therapies era: An ITCC study","authors":"Fernando Carceller ,&nbsp;Francisco Bautista ,&nbsp;Harm Van Tinteren ,&nbsp;Alicia Castañeda ,&nbsp;Aurore Surun ,&nbsp;Ajla Wasti ,&nbsp;Gabriel Revon-Rivière ,&nbsp;Luca Bergamaschi ,&nbsp;Marta Cortés ,&nbsp;Raquel Hladun-Álvaro ,&nbsp;Irene Jiménez ,&nbsp;Cécile Giraud ,&nbsp;Gerard Millen ,&nbsp;Quentin Campbell-Hewson ,&nbsp;Antonio Juan-Ribelles ,&nbsp;Jasper Van der Lugt ,&nbsp;Loredana Amoroso ,&nbsp;Nicoletta Bertorello ,&nbsp;Darren Hargrave ,&nbsp;Lorena Vega-Piris ,&nbsp;Lucas Moreno","doi":"10.1016/j.ejca.2025.115627","DOIUrl":"10.1016/j.ejca.2025.115627","url":null,"abstract":"<div><h3>Introduction</h3><div>Phase I/II trials are essential to introduce novel agents for children with cancer. Defining risk factors of early mortality could maximize the efficiency of such trials.</div></div><div><h3>Methods</h3><div>Patients &lt; 18 years with relapsed/refractory solid tumors in their first phase I/II trial were eligible in retrospect. Mortality at 30 and 90 days on treatment (30-DM, 90-DM) were calculated. Clinical/laboratory parameters and adult prognostic scores (Royal Marsden Hospital -RMH-, MD Anderson Cancer Center -MDACC-) were assessed at baseline and correlated with 90-DM (univariate analysis, logistic regression) to devise a pediatric-specific prognostic score (ITCC).</div></div><div><h3>Results</h3><div>N = 507. Median age 11.6 years (range 0.5–17.9); 45 % females. 30-DM and 90-DM (95 %CI) were 4.7 % (3.1–7.0 %) and 22.9 % (19.3–26.8 %), respectively. RMH (n = 348) and MDACC (n = 345) scores correlated with 90-DM (p &lt; 0.001). Performance status ≤ 80 %, no school attendance and lactate dehydrogenase (LDH) above normal levels strongly correlated with higher 90-DM, constituting the ITCC score (1 point each). The 90-DM with ITCC score (n = 306) of 0, 1, 2 and 3 was 2.7 %, 10.7 %, 36.4 % and 80.0 %, respectively. Odds ratios (95 %CI) for 90-DM with 1, 2 and 3 points were 4.23 (1.28–19.1); 20.0 (6.55–87.4); and 140 (37.4–720), respectively. Among patients with predicted risk of 90-DM ≥ 75 %, those who ultimately died within 90 days represented 1.4 % (RMH, MDACC) versus 7.8 % (ITCC) of the sample; p &lt; 0.001.</div></div><div><h3>Conclusions</h3><div>The early mortality rates reported here will serve as a reference for future phase I/II trials. Risk scoring based on performance status, school attendance and LDH levels can estimate 90-DM in oncology phase I/II trials.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"227 ","pages":"Article 115627"},"PeriodicalIF":7.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between pretreatment emotional distress and response to tumor-infiltrating lymphocyte therapy in advanced melanoma","authors":"Mees D. Egeler ,&nbsp;Sebastian Klobuch ,&nbsp;Willemijn S. Tak ,&nbsp;Maartje W. Rohaan ,&nbsp;Troels H. Borch ,&nbsp;Inge. M. Noringriis ,&nbsp;Renaud Tissier ,&nbsp;Minke W. Lucas ,&nbsp;Winan van Houdt ,&nbsp;Alexander C.J. van Akkooi ,&nbsp;Inge Jedema ,&nbsp;Marco Donia ,&nbsp;Christian U. Blank ,&nbsp;Inge Marie Svane ,&nbsp;John B.A.G. Haanen ,&nbsp;Lonneke V. van de Poll-Franse","doi":"10.1016/j.ejca.2025.115640","DOIUrl":"10.1016/j.ejca.2025.115640","url":null,"abstract":"<div><h3>Aims</h3><div>Adoptive cell therapy (ACT) using tumor-infiltrating lymphocytes (TILs) has demonstrated benefit for patients with advanced melanoma refractory to first-line immune checkpoint inhibitors (ICIs). However, predictive biomarkers for TIL therapy response are limited. Preclinical studies suggest that emotional distress (ED) may impair antitumor immune responses. We conducted a post-hoc analysis of the phase III TIL trial (NCT02278887) to evaluate the association between pretreatment ED and TIL therapy outcomes.</div></div><div><h3>Methods</h3><div>ED was evaluated using a composite score derived from the Impact of Event Scale and the emotional functioning subscale of the EORTC QLQ-C15-PAL. Patients were stratified into elevated ED (n = 32) or normal ED (n = 40) groups using a median split approach. To evaluate whether the obtained results were dependent on the ED classification method, a sensitivity analysis was conducted to compare TIL therapy outcomes between patients with composite ED scores in the lowest tertile (normal ED, n = 26) and highest tertile (elevated ED, n = 25).</div></div><div><h3>Results</h3><div>Elevated ED was associated with a reduced objective response rate (37 % vs. 69 %; adjusted odds ratio, 0.28; 95 % confidence interval [CI], 0.19–0.75; P = 0.013) and decreased progression-free survival rates at 1-year (31 % vs. 58 %) and 2-years (16 % vs. 35 %; adjusted hazard ratio, 1.84; 95 % CI, 1.03–3.26; P = 0.038). Sensitivity analysis using the tertile grouping method showed a similar trend (odds ratio, 0.35; 95 % CI, 0.11–1.08, P = 0.072).</div></div><div><h3>Conclusion</h3><div>Our findings suggest that elevated ED before TIL therapy is associated with reduced therapeutic outcomes, underscoring the need for further investigation into the stress-immune-cancer axis.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"227 ","pages":"Article 115640"},"PeriodicalIF":7.6,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to letter to the editor on “Patient-reported outcomes with adjuvant nivolumab versus placebo after complete resection of stage IIB/C melanoma in the randomized phase 3 CheckMate 76K trial”","authors":"John M. Kirkwood","doi":"10.1016/j.ejca.2025.115636","DOIUrl":"10.1016/j.ejca.2025.115636","url":null,"abstract":"","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"227 ","pages":"Article 115636"},"PeriodicalIF":7.6,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic impact of the BRAF V600E mutation in patients with MSI-high metastatic colorectal cancer treated with immune checkpoint inhibitors","authors":"Claire Gallois ,&nbsp;Margherita Ambrosini ,&nbsp;Sara Lonardi ,&nbsp;Emily Alouani ,&nbsp;Rosine Guimbaud ,&nbsp;Michael J. Overman ,&nbsp;Frank Sinicrope ,&nbsp;Thibault Mazard ,&nbsp;Marie Decraecker ,&nbsp;Javier Ros ,&nbsp;Elena Elez ,&nbsp;Simon Pernot ,&nbsp;Chiara Cremolini ,&nbsp;Alice Boilève ,&nbsp;Pauline Parent ,&nbsp;Priya Jayachandran ,&nbsp;Marie Dutherage ,&nbsp;Mathilde Mercier ,&nbsp;Clémence Flecchia ,&nbsp;Marwan Fakih ,&nbsp;David Tougeron","doi":"10.1016/j.ejca.2025.115645","DOIUrl":"10.1016/j.ejca.2025.115645","url":null,"abstract":"<div><h3>Introduction</h3><div>The prognostic impact of the <em>BRAF</em> V600E mutation in patients with deficient mismatch repair (dMMR)/microsatellite instability (MSI) metastatic colorectal cancer (mCRC) treated with immune checkpoint inhibitors (ICI) is poorly understood.</div></div><div><h3>Material and methods</h3><div>This retrospective international study included patients with dMMR/MSI mCRC treated with ICI all lines between 2014 and 2023, and available <em>BRAF</em> mutation status.</div></div><div><h3>Results</h3><div>Of 909 patients included, 345 (38 %) had <em>BRAF</em> V600E dMMR/MSI mCRC. In multivariable analysis, BRAFm was not associated with a shorter progression-free survival (PFS) and overall survival (OS) from ICI start compared to BRAFwt patients (median PFS: 25.0 vs 41.5 months, adjusted hazard ratio (adjHR)= 0.97, p = 0.8 and OS: 55.1 months vs not reached adjHR= 0.98, p = 0.9). However, in patients treated with ICI in first line, the rate of secondary resistance, defined as the progression after the first 6 months of treatment, was higher in BRAFm patients (20 % vs 11 %, p = 0.02). In patients with disease control for 6 months in 1st line, the PFS and OS from this point onwards were significantly shorter in BRAFm patients (adjHR for PFS 2.09, p = 0.03 and adjHR for OS 2.80, p = 0.019). The poor prognostic value of the <em>BRAF</em> mutation was no longer observed in patients treated with anti-PD1 and anti-CTLA4 combination.</div></div><div><h3>Conclusions</h3><div>In patients with dMMR/MSI mCRC, the <em>BRAF</em> V600E mutation is not associated with a shorter PFS/OS on ICI treatment in the overall population across all lines. However, specifically in patients treated in the first-line setting, our results suggest that the <em>BRAF</em> mutation is associated with a higher rate of secondary resistance, suggesting that a combination of PD1 and CTLA4 inhibitors upfront may be of particular interest in these patients.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"227 ","pages":"Article 115645"},"PeriodicalIF":7.6,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating tissue and liquid biopsy comprehensive genomic profiling to predict efficacy of anti-EGFR therapies in metastatic colorectal cancer: Findings from the CAPRI-2 GOIM study","authors":"Davide Ciardiello ,&nbsp;Luca Boscolo Bielo ,&nbsp;Stefania Napolitano ,&nbsp;Eleonora Cioli ,&nbsp;Tiziana Pia Latiano ,&nbsp;Alfonso De Stefano ,&nbsp;Emiliano Tamburini ,&nbsp;Matteo Ramundo ,&nbsp;Roberto Bordonaro ,&nbsp;Alessia Erika Russo ,&nbsp;Salvatore Pisconti ,&nbsp;Claudia Nisi ,&nbsp;Claudio Lotesoriere ,&nbsp;Simona Vallarelli ,&nbsp;Sara Lonardi ,&nbsp;Viola Barruca ,&nbsp;Chiara Cremolini ,&nbsp;Giampaolo Tortora ,&nbsp;Pierosandro Tagliaferri ,&nbsp;Filippo Pietrantonio ,&nbsp;Giulia Martini","doi":"10.1016/j.ejca.2025.115642","DOIUrl":"10.1016/j.ejca.2025.115642","url":null,"abstract":"<div><h3>Introduction</h3><div>We investigated the role of integrating tissue biopsy (TBx)- and liquid biopsy (LBx)-comprehensive genomic profiling (CGP) to predict the activity of FOLFIRI plus cetuximab.</div></div><div><h3>Methods</h3><div>The CAPRI-2 GOIM study is a non-randomized phase 2 study evaluating a biomarker-driven anti-EGFR treatment in three lines of therapy in patients with <em>RAS/BRAF</em>^{<em>V600E</em>} wild type metastatic colorectal cancer. At baseline, TBx and LBx were analyzed using the FoundationOne CDx platform. Analysis of overall response rate (ORR) and median progression free survival (mPFS) according to molecular profiles were performed.</div></div><div><h3>Results</h3><div>Overall, 156 patients were evaluable for tumor response and had matched tissue and plasma-based CGP. Negatively hyper-selected patients by both TBx- and LBx-CGP showed higher ORR (79.6 % versus 44.2 %, P &lt; 0.001) and mPFS compared to mutated cases (12.4 months versus 7.4 months, P &lt; 0.001). Eight and 12 cases harbored mutations detected by TBx and LBx-CGP only, respectively. Compared to discordant cases (n = 20), concordant cases (n = 23) showed a trend for lower ORR (39.1 % versus 50.0 %, P = 0.5) and shorter mPFS (3.94 versus 11.50 months, P = 0.02). Patients with alterations detected only by TBx-CGP had significantly lower circulating tumor DNA (ctDNA) tumor fraction (TF) compared to concordant cases (1.7 % versus 23.0 %; P = 0.01). Using a ctDNA TF threshold ≥ 10 % nearly all (19 of 20) TBx detected pathogenic variants (PV) were also identified by LBx-CGP. In eight cases detected by LBx only, mPFS was 8.24 months.</div></div><div><h3>Conclusion</h3><div>In cases with high TF LBx-CGP predicts efficacy of anti-EGFR therapy, while for TF&lt; 10 % TBx-CGP provides additional data on PVs that could affect treatment efficacy.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"226 ","pages":"Article 115642"},"PeriodicalIF":7.6,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}