International Journal of Clinical Oncology最新文献

{"title":"Trends in fertility preservation treatments in Japan until 2023: analysis of the Japan Oncofertility Registry.","authors":"Takao Kawai, Miyuki Harada, Yoko Urata, Yuko Sanada, Youtaro Kaneda, Yasushi Takai, Yutaka Osuga, Nao Suzuki","doi":"10.1007/s10147-025-02725-1","DOIUrl":"10.1007/s10147-025-02725-1","url":null,"abstract":"<p><strong>Background: </strong>Fertility preservation for patients with cancer or other diseases who receive gonadotoxic treatment has gained importance as cancer survival rates increase. In Japan, a database for registering all fertility preservation patients, named the Japan Oncofertility Registry (JOFR), was established in 2018. This study aimed to analyze recent trends in fertility preservation in Japan utilizing data from the JOFR.</p><p><strong>Methods: </strong>Data was extracted from the JOFR for patients who consulted fertility preservation teams until May 2024. A descriptive analysis was conducted to examine trends in patient demographics, cancer types, fertility preservation treatments, complications, and outcomes. The data covered the period from diagnosis to fertility preservation and subsequent usage or disposal of frozen specimens.</p><p><strong>Results: </strong>A total of 11,510 patients were recorded, with 9491 undergoing fertility preservation treatments. The number of patients increased steadily after 2006. After 2021, the number of female patients was much higher than the number of male patients. The most common primary diseases were breast cancer among women and testicular tumors and leukemia among men. There were some complications including ovarian hyperstimulation syndrome (5.0%), bleeding (0.12%), and infections (0.05%) for women. Seven hundred and sixty clinical pregnancies were recorded, with 440 using preserved specimens. The discard rate was 16.3% for men and 3.7% for women.</p><p><strong>Conclusion: </strong>The study highlights recent trends in the growing number of cases undergoing fertility preservation in Japan. It also identifies several issues to be solved in fertility preservation in Japan, regarding its efficacy and safety, as well as the medical provision system.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"684-695"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic efficacy of immune-oncology combination therapy in advanced renal cell carcinoma without prior nephrectomy.","authors":"Kosuke Ueda, Naoki Ito, Yuya Sakai, Satoshi Ohnishi, Taishi Hirano, Hirofumi Kurose, Katsuaki Chikui, Keiichiro Uemura, Kiyoaki Nishihara, Makoto Nakiri, Shigetaka Suekane, Tsukasa Igawa","doi":"10.1007/s10147-025-02710-8","DOIUrl":"10.1007/s10147-025-02710-8","url":null,"abstract":"<p><strong>Background: </strong>Immuno-oncology (IO) combination therapies, including IO + IO or IO + vascular endothelial growth factor targeted therapies (VEGF-TT), have become the standard first-line treatment for advanced renal cell carcinoma (RCC). However, the optimal regimen for patients without prior nephrectomy remains unclear.</p><p><strong>Methods: </strong>Data from 99 patients with advanced RCC without nephrectomy, treated with VEGF-TT, IO + IO, or IO + VEGF-TT between May 2008 and May 2024, were retrospectively reviewed and analyzed. Patients were divided into VEGE-TT, IO + IO, and IO + VEGF-TT groups based on their first-line treatment, and survival and tumor response were compared.</p><p><strong>Results: </strong>All patients included in this study were categorized as either intermediate or poor risk according to the International Metastatic RCC Database Consortium risk classification. Among the 99 included patients, 41 initiated first-line therapy with VEGF-TT, 36 with IO + IO, and 22 with IO + VEGF-TT. The objective response rates were 17.5% for VEGF-TT, 38.9% for IO + IO, and 61.9% for IO + VEGF-TT. Notably, the IO + VEGF-TT group showed the greatest shrinkage of target kidney lesions (p = 0.0042). In multivariate analyses, bone metastasis (hazard ratio (HR) = 1.812, 95% confidence interval (CI) 1.017-3.228, p = 0.0436) and the first-line regimen (VEGF-TT vs IO + VEGF-TT: HR = 0.129, 95% CI 0.045-0.369, p = 0.0001) were independent prognostic factors for progression-free survival. The first-line regimen (VEGF-TT vs IO + VEGF-TT: HR = 0.303, 95% CI 0.104-0.879, p = 0.0279) independently affected overall survival.</p><p><strong>Conclusion: </strong>IO combination therapy, especially IO + VEGF-TT, has demonstrated a higher anti-tumor response in patients with advanced RCC without nephrectomy and may also be highly effective against primary renal tumors. Therefore, further studies are needed to improve patient survival and validate efficacy of IO combination therapy.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"770-779"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative stereotactic body radiotherapy for spinal and non-spinal bone metastases: combining tradition and innovation.","authors":"Kei Ito, Naoki Nakamura","doi":"10.1007/s10147-025-02750-0","DOIUrl":"https://doi.org/10.1007/s10147-025-02750-0","url":null,"abstract":"<p><p>Bone metastases can cause pain, fractures, radiculopathy, and metastatic epidural spinal cord compression, all of which substantially impair patients' quality of life. Conventional external beam radiotherapy (cEBRT) has been the standard treatment for symptomatic bone metastases. While the effectiveness and safety of cEBRT are well established, it has certain limitations, including a short duration of pain relief, limited long-term tumor control, and suboptimal efficacy against radioresistant tumors. Over the past decade, stereotactic body radiotherapy (SBRT) has been explored as a palliative treatment for bone metastases. SBRT enables the delivery of high doses of radiation to bone lesions by maximizing dose conformality. This treatment characteristic yields several clinical advantages, including considerable pain relief, durable tumor control, and efficacy against radioresistant tumors. SBRT has the potential to overcome the limitations of cEBRT and represents a promising approach that could revolutionize the treatment of bone metastases. This review addresses three clinical scenarios: painful spinal metastases, painful non-spinal bone metastases, and metastatic epidural spinal cord compression. For each scenario, we summarized the evidence for cEBRT and SBRT, highlighting the utility and potential of SBRT as an emerging treatment option.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simple definition of biologically borderline resectable colorectal liver metastases based on early surgical failure.","authors":"Kenei Furukawa, Masashi Tsunematsu, Koichiro Haruki, Shinji Onda, Kyohei Abe, Michinori Matsumoto, Tomohiko Taniai, Mitsuru Yanagaki, Yoichi Toyama, Toru Ikegami","doi":"10.1007/s10147-025-02752-y","DOIUrl":"https://doi.org/10.1007/s10147-025-02752-y","url":null,"abstract":"<p><strong>Background: </strong>The benefit of neoadjuvant chemotherapy (NAC) in patients with resectable colorectal liver metastasis (CRLM) is debatable. This study aimed to establish a definition of biologically borderline resectable CRLM based on early surgical failure.</p><p><strong>Methods: </strong>One hundred forty-two patients who underwent upfront surgery for resectable CRLM were examined. Potential predictors of early surgical failure were investigated to establish a definition of biologically borderline resectable CRLM. The impact of NAC on overall survival (OS) in patients with borderline resectable CRLM was examined, as were predictors of OS.</p><p><strong>Results: </strong>Extrahepatic lesions (p < 0.01) and tumor ≥ 30 mm with carcinoembryonic antigen (CEA) concentration ≥ 20 ng/mL (p = 0.02) were independent predictors of early surgical failure. Borderline resectable CRLM was defined as extrahepatic lesions or tumor size ≥ 30 mm with CEA concentration ≥ 20 ng/mL. Fifty-eight patients had borderline resectable CRLM. Three-year OS was significantly higher in borderline resectable CRLM patients who received NAC than in those who did not (71.8% vs. 52.7%) and 5-year survival was also significantly higher in this group (62.8% vs. 25.5%).</p><p><strong>Conclusion: </strong>We have proposed a simple definition of biologically borderline resectable CRLM based on early surgical failure. NAC could be a good indication for patients who met the definition.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic profiling and personalized treatment strategies for skin malignancies: findings from the center for cancer genomics and advanced therapeutics database.","authors":"Tokimasa Hida","doi":"10.1007/s10147-025-02755-9","DOIUrl":"https://doi.org/10.1007/s10147-025-02755-9","url":null,"abstract":"<p><p>Immune checkpoint inhibitors and molecular-targeted therapies have dominated recent cancer treatment. However, these treatments face challenges, such as primary and acquired resistance, indicating that not all patients benefit from them. Therefore, the search for new molecular targets is crucial. In addition, immune checkpoint inhibitors have exhibited racial differences in their effectiveness for certain neoplasms. Hence, understanding the genomic landscape of cancers in various racial groups is important. In Japan, health insurance has covered comprehensive genomic profiling since 2019, and the Center for Cancer Genomics and Advanced Therapeutics (C-CAT) has accumulated genetic abnormalities along with clinical data of patients with various cancers. These data are crucial for advancing cancer research and drug development. This review discusses the genetic abnormalities of the major skin malignancies including melanoma, cutaneous squamous cell carcinoma (cSCC), and extramammary Paget's disease (EMPD), and proposes potential treatment strategies by comparing C-CAT data analysis with other genetic studies. The C-CAT data have emphasized unique genetic alterations in tumors of the Japanese population, particularly racial differences in tumor mutational burden in cutaneous melanoma and cSCC, indicating the importance of personalized treatment strategies that consider racial differences.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved local control and survival outcomes with RADPLAT in T4 oropharyngeal cancer: a retrospective study.","authors":"Satoshi Kano, Takayoshi Suzuki, Daisuke Yoshida, Nayuta Tsushima, Hiroshi Idogawa, Ryohei Katsumata, Koichi Yasuda, Naoya Kinota, Koji Yamasaki, Yasushi Shimizu, Jun Taguchi, Hidefumi Aoyama, Akihiro Homma","doi":"10.1007/s10147-025-02751-z","DOIUrl":"https://doi.org/10.1007/s10147-025-02751-z","url":null,"abstract":"<p><strong>Backgrounds: </strong>Standard treatments for locally advanced oropharyngeal cancer (OPC) include surgery and chemoradiotherapy (CRT). While surgery offers good tumor control, it often results in significant postoperative functional impairments. Conversely, intravenous chemoradiotherapy (IV-CRT) is less effective in controlling primary tumors in T4 OPC cases and offers limited options for salvage surgery after recurrence. RADPLAT, a treatment involving intra-arterial cisplatin combined with radiotherapy, has demonstrated favorable results for other cancers and may offer an alternative treatment for OPC.</p><p><strong>Methods: </strong>This retrospective study compared the efficacy and safety of RADPLAT and IV-CRT in the patients with T4 OPC treated at Hokkaido University Hospital between 2003 and 2022. The primary endpoint was local recurrence-free survival (LRFS), and the secondary endpoint was overall survival (OS).</p><p><strong>Results: </strong>Fifty-six patients were included, with 29 in the RADPLAT group and 27 in the IV-CRT group. The RADPLAT group showed significantly better LRFS (2-year LRFS: 82.3%) and OS (5-year OS: 73.8%) compared to the IV-CRT group (2y-LRFS: 66.0%, 5y-OS: 45.7%). Multivariate analysis identified RADPLAT as an independent favorable prognostic factor for both LRFS and OS. There was no significant difference in the incidence of adverse events between the two groups, although grade 3 or higher mucositis was more common in the RADPLAT group. Swallowing function and tracheostomy rates were similar between the groups.</p><p><strong>Conclusion: </strong>RADPLAT provides superior local control and survival outcomes compared to IV-CRT for T4 OPC, with comparable safety and functional preservation. These findings suggest that RADPLAT may be a promising alternative to IV-CRT for cases with T4 OPC.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment strategies for advanced synovial sarcoma: from chemotherapy to TCR-engineered T-cell therapy.","authors":"Tomoki Nakamura, Masahiro Hasegawa","doi":"10.1007/s10147-025-02744-y","DOIUrl":"https://doi.org/10.1007/s10147-025-02744-y","url":null,"abstract":"<p><p>Synovial sarcoma (SS) is the most common soft tissue sarcoma in children and adolescents. Despite the availability of new agents such as pazopanib and trabectedin, the prognosis after recurrence remains poor. Adoptive cell therapy is an emerging therapeutic strategy based on the modulation, manipulation, and selection of autologous T-cells in vitro to overcome immune system tolerance to tumor cells. Cancer-testis antigens are particularly attractive targets for immune therapy because male germ cells lack human leukocyte antigen class I molecules, limiting T-cell responses triggered by antigen presentation. T-cell receptor (TCR) engineered T-cell therapy targeting NY-ESO-1 and MAGE-A4 holds significant promise because of the high positive expression of these antigens in tumors. This approach facilitates the reprogramming of T lymphocytes by a transgenic TCR through gene transfer of TCR α and β chains specific to tumor antigens, offering potential therapeutic advances for patients with advanced SS. Clinical trials of TCR-engineered T-cell therapy targeting NY-ESO-1 and MAGE-A4 have been conducted, with an objective response rate reported to be 40-60% across several trials. This promising efficacy suggests that TCR-engineered T-cell therapy could become an attractive novel therapeutic option for advanced SS, which has limited treatment options in later stages. However, if TCR-engineered T-cell therapy is to be used in clinical practice, the standard approach following the failure of doxorubicin-based chemotherapy in patients with advanced SS must be defined. Future studies will be critical for establishing treatment strategies in this field.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival paradox and effect of adjuvant chemotherapy for high-risk Stage II and low-risk Stage III colorectal cancer.","authors":"Keisuke Noda, Tetsuro Tominaga, Takashi Nonaka, Rika Ono, Kaido Oishi, Yuma Takamura, Toshio Shiraishi, Shintaro Hashimoto, Makoto Hisanaga, Hiroaki Takeshita, Mitsutoshi Ishii, Shosaburo Oyama, Kazuhide Ishimaru, Terumitsu Sawai, Keitaro Matsumoto","doi":"10.1007/s10147-025-02743-z","DOIUrl":"https://doi.org/10.1007/s10147-025-02743-z","url":null,"abstract":"<p><strong>Purpose: </strong>High-risk Stage II may have a worse prognosis than low-risk Stage III colorectal cancer and there are limited reports examining the efficacy of adjuvant chemotherapy in Stage II and III subgroups.</p><p><strong>Methods: </strong>Using a multicenter database, 598 colorectal cancer patients who underwent laparoscopic colorectal resection and were pathologically diagnosed with high-risk Stage II (T4N0) or low-risk Stage III (T1-2N1, T1-2N2, T3N1) between April 2016 and December 2022 were retrospectively reviewed.</p><p><strong>Results: </strong>Fewer patients received adjuvant chemotherapy in the T4N0 group (54.7/45.0/44.7/27.7%, p < 0.001). The T4N0 group had significantly worse 5-year relapse-free survival (RFS) (67.0 vs. 95.5%, p < 0.01) and than the T1-2N1 group. The T4N0 group had significantly worse 5-year RFS (67.0% vs. 95.5%, p < 0.01) than the T1-2N1 group. Five-year OS was significantly better in the T1-2N1 and T3N1 groups with than without adjuvant chemotherapy (p < 0.032, p < 0.001, respectively), but not in the T4N0 group.</p><p><strong>Conclusions: </strong>The present multicenter study showed that high-risk Stage II colorectal cancer may have a worse prognosis than low-risk Stage III colorectal cancer. Preoperative treatment may be considered for T4N0 colorectal cancer.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PMDA regulatory update on approval and revision of the precautions for use of anticancer drugs; approval of atezolizumab for alveolar soft part sarcoma, epcoritamab for follicular lymphoma, and isatuximab for multiple myeloma in Japan.","authors":"Noriomi Matsumura, Masaki Mandai","doi":"10.1007/s10147-025-02741-1","DOIUrl":"https://doi.org/10.1007/s10147-025-02741-1","url":null,"abstract":"","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term results of dynamic tumor-tracking stereotactic body radiotherapy with real-time monitoring using a gimbal-mounted linac for liver tumors: a multicenter observational study.","authors":"Yusuke Iizuka, Minoru Inoue, Masaki Kokubo, Takashi Sakamoto, Keiko Nemoto Murofushi, Toshiyuki Imagumbai, Takuya Shimizuguchi, Masahiro Hiraoka, Takashi Mizowaki","doi":"10.1007/s10147-025-02740-2","DOIUrl":"https://doi.org/10.1007/s10147-025-02740-2","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in liver tumor treatments, a persistent need remains for minimally invasive therapies with high efficacy and long-term outcomes. In a previous multicenter phase II study, the safety and efficacy of dynamic tumor-tracking stereotactic body radiotherapy with real-time monitoring of liver tumors were evaluated using a gimbal-mounted system. Herein, we report the updated long-term results of this technique.</p><p><strong>Methods: </strong>This observational study examined patients with a single liver tumor, respiratory movement of at least 10 mm, performance status of 0-2, and Child-Pugh score of < 9. Patients who agreed to participate in the trial underwent dynamic tumor-tracking stereotactic body radiotherapy (prescribed dose, 40 Gy in five fractions for the planning target volume [D₉₅]; 70% of the maximum dose). The primary endpoint was the 4-year overall survival rate. Secondary endpoints included 4-year local control and progression-free survival rates and the incidence of adverse events.</p><p><strong>Results: </strong>Between September 2015 and March 2019, 48 patients (median age, 74 years; median tumor diameter, 17.5 mm) underwent dynamic tumor-tracking stereotactic body radiotherapy. All lesions were successfully treated (hepatocellular carcinoma, 39 patients; liver metastases, 9 patients). The median observation period was 46 months, and the 4-year overall survival, local control, and progression-free survival rates were 67.4%, 97.9%, and 29.1%, respectively. Eight patients had grade 3 hepatobiliary enzyme elevation, hematologic toxicity, or hyponatremia; none had grade ≥ 4 adverse events.</p><p><strong>Conclusion: </strong>These findings demonstrate the long-term safety and efficacy of dynamic tumor-tracking stereotactic body radiotherapy for liver tumors, with an excellent local control rate.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}