JCO oncology practice最新文献

{"title":"Palliative Care Consultation and End-of-Life Care Among Patients With Esophageal Cancer and Inpatient Mortality.","authors":"Suriya Baskar, Udhayvir Singh Grewal","doi":"10.1200/OP-24-01092","DOIUrl":"https://doi.org/10.1200/OP-24-01092","url":null,"abstract":"<p><strong>Purpose: </strong>Palliative care (PC) is an important facet of treatment for patients with advanced esophageal cancer because of symptom burden, low overall 5-year survival rate, and significant impact on quality of life. This patient population experiences high hospitalization burden. The purpose of this study was to analyze the effect of PC on end-of-life (EoL) hospitalizations and evaluate racial differences in EoL care.</p><p><strong>Methods: </strong>The National Inpatient Sample (NIS) was queried between 2016 and 2020 for hospitalizations with esophageal cancer that ended with inpatient death. The primary EoL outcomes that were identified include inpatient PC consultation (PCC), do not resuscitate (DNR) code status, and utilization of certain medical interventions (mechanical ventilation, blood transfusion, vasopressor administration, and chemotherapy). Secondary outcomes include symptom burden, length of stay (LOS), and total hospital charges.</p><p><strong>Results: </strong>Seventeen thousand seven hundred forty-five hospitalizations were included, of which 10,370 (58.4%) received PCCs and 7,375 (41.6%) did not. Age and sex were not significantly different between the patients who did and did not receive PCC. PCC cohort had a higher percentage of White patients (60.9% <i>v</i> 39.1%, <i>P</i> < .001). PCCs resulted in shorter LOS (7.5 <i>v</i> 8.9 days, <i>P</i> < .001), lower mean total hospital charges accumulated ($97,879 in US dollars [USD] <i>v</i> $146,128 [USD], <i>P</i> < .001), and higher rates of DNR code status (78.1% <i>v</i> 43.2%, <i>P</i> < .001). Inpatient PCC was also associated with lower rates of medical interventions (blood transfusions, mechanical ventilation, and chemotherapy). PCC was less likely to be performed among Black patients compared with White patients (adjusted odds ratio [aOR], 0.53 [95% CI, 0.48 to 0.58]). Black patients were also less likely to be DNR compared with White patients (aOR, 0.81 [95% CI, 0.74 to 0.90]).</p><p><strong>Conclusion: </strong>PCCs at EoL were associated with higher rates of DNR and lower rates of medical interventions.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2401092"},"PeriodicalIF":4.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006118","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":"Changes in Cost of Guideline-Concordant Cancer Treatment: Observations and Implications.","authors":"Judy J Wang, Sonia Persaud, Sara Tabatabai, Nirjhar Chakraborty, Pranam Dey, Niti U Trivedi, Aaron Philip Mitchell","doi":"10.1200/OP-24-00995","DOIUrl":"10.1200/OP-24-00995","url":null,"abstract":"<p><strong>Purpose: </strong>Cost of cancer care in the United States is substantial. Previous studies have explored pricing comparisons at the level of individual cancer drugs but not that of clinical indications. This study evaluates cost patterns for providing the best guideline-concordant therapy for solid tumor treatment indications.</p><p><strong>Methods: </strong>We identified all National Comprehensive Cancer Network guideline-concordant treatment indications for the 17 most common solid tumor malignancies in 2017 and 2021. Best-available treatments were determined for each indication using National Comprehensive Cancer Network Evidence Block scores. We grouped treatments by (1) those administered on an ongoing basis (priced per month) and (2) those administered for a prespecified duration (priced per course of therapy). Costs were calculated using Medicare reimbursement rates and analyzed across both time points.</p><p><strong>Results: </strong>Across all indications, median cost of the best-available cancer treatment changed from $10,784 in US dollars (USD) (IQR, $691-$16,489 [USD]) in 2017 to $17,936 (USD) (IQR, $2,640-$19,209 [USD]) in 2021 for regimens administered on an ongoing basis, and from $10,501 (USD) (IQR, $6,068-$51,365 [USD]) in 2017 to $9,038 (USD) (IQR, $5,045-$79,386 [USD]) in 2021 for regimens administered for a set duration. Among the subset of indications newly present in 2021, median costs were higher at $21,524 (USD) (IQR, $5,639-$22,369 [USD]) per month for ongoing regimens and $17,005 (USD) (IQR, $6,178-$258,284 [USD]) per course for prespecified regimens. Among the subset of indications present in both 2017 and 2021, relative change in cost of the best-available treatment was -2% (IQR, -39% to +9%). Indications for which the best-available treatment had a new generic or biosimilar entrant (N = 16), median cost decrease was substantially larger at -57% (IQR, -78% to -44%).</p><p><strong>Conclusion: </strong>This study observed an increase in absolute median cost of cancer therapy on a treatment indications level, largely driven by new biomarker-driven indications and therapies.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2400995"},"PeriodicalIF":4.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006147","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":"Staff Perspectives on Normalizing and Sustaining Electronic Patient-Reported Outcomes Monitoring at Six US Health Systems.","authors":"Roshan Paudel, Hajime Uno, Christine Cronin, Don S Dizon, Hannah Hazard-Jenkins, Jessica Bian, Raymond U Osarogiagbon, Sandra L Wong, Deborah Schrag, Michael J Hassett","doi":"10.1200/OP-25-00049","DOIUrl":"https://doi.org/10.1200/OP-25-00049","url":null,"abstract":"<p><strong>Purpose: </strong>We assessed the perspectives of staff from six health systems to understand how electronic Symptom Management (eSyM), an eSyM program that supports patients during chemotherapy and after surgery, is normalized and sustained.</p><p><strong>Methods: </strong>Starting in 2019, we integrated eSyM into routine clinical practice and assessed its effectiveness using a cluster randomized stepped-wedge trial design. At least 1 year after implementation, we administered cross-sectional surveys to elicit the perspectives of physicians, nurses, advanced practice providers (APPs), hospital administrators, information technology, and research staff using the Normalization MeAsure Development (NoMAD) and the Clinical Sustainability Assessment Tool (CSAT).</p><p><strong>Results: </strong>Of the 211 staff who initiated the survey, 169 (80%) completed it. Respondents included 64 nurses (38%), 38 physicians (23%), 20 research staff (12%), 17 APPs (10%), 16 administrators (10%), and nine information technologists (5%). The mean NoMAD familiarity score was 5.90 (standard deviation [SD], 3.06) and the mean score for eSyM becoming a part of routine practice was 4.84 (SD, 3.21), scored on a 0-10 scale. Compared with physicians, nurses reported higher familiarity scores and lower NoMAD domain scores for <i>coherence</i>, <i>cognitive participation</i>, and <i>reflexive monitoring</i>. CSAT scores (scored 1-7) demonstrated moderate sustainability (mean 4.52, SD, 1.61), ranging from a mean of 3.28 (SD, 1.48) among APPs to 5.75 (SD, 0.69) among IT staff. Of the CSAT items, <i>engaged staff</i> and <i>leadership</i> and <i>organizational readiness</i> had the highest (mean 4.89, SD, 1.73) and lowest (mean 4.18, SD, 1.73) scores, respectively (<i>P</i> < .05).</p><p><strong>Conclusion: </strong>Clinical staff reported moderate levels of normalization and capacity for sustainability. Nurses and APPs reported lower levels of sustainability compared with physicians and administrators. Future studies should explore novel workflows and tools that support clinical staff who provide symptom management support.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500049"},"PeriodicalIF":4.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006136","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":"Systemic Therapy in Patients With Metastatic Castration-Resistant Prostate Cancer: ASCO Guideline Clinical Insights.","authors":"Rohan Garje, Irbaz Bin Riaz, Syed Arsalan Ahmed Naqvi, R Bryan Rumble, Rahul A Parikh","doi":"10.1200/OP-25-00747","DOIUrl":"https://doi.org/10.1200/OP-25-00747","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500747"},"PeriodicalIF":4.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000579","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":"Erratum: Diabetes and Acute Care Use Among Patients With Metastatic Prostate Cancer Treated With Androgen Receptor Signaling Inhibitors.","authors":"Michael A Liu, Rohit Raghunathan, Karie Runcie, Shikun Wang, Jason D Wright, Alexander Z Wei, Mark Stein, Dawn L Hershman","doi":"10.1200/OP-25-00773","DOIUrl":"https://doi.org/10.1200/OP-25-00773","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2500773"},"PeriodicalIF":4.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992430","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":"Health Information Disparities Among Asian American People With Cancer.","authors":"Stephanie Wang, Khushi Kohli, Ethan David Shin, Erin Jay G Feliciano, Lisa C Diamond, Edward Christopher Dee","doi":"10.1200/OP-24-00498","DOIUrl":"10.1200/OP-24-00498","url":null,"abstract":"","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1235-1239"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12272348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467966","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":"Expanding Germline Hereditary Cancer Gene Panel Testing by Nongenetics Providers: 3-Year Experience in Large Integrated Health Care Delivery System.","authors":"Trevor L Hoffman, Farah M Brasfield, Devansu Tewari, Jeffery D Greenberg, Hilary B Kershberg, John Goff, Reina Haque, Monica Alvarado","doi":"10.1200/OP-24-00717","DOIUrl":"10.1200/OP-24-00717","url":null,"abstract":"<p><strong>Purpose: </strong>Demand for germline hereditary cancer genetic testing has increased because of reduced cost, gene discovery, expanding indications, and precision cancer therapies. The traditional model for germline testing, where a genetics provider performs all steps of the testing process (pretest counseling, test ordering, results disclosure, and post-test counseling), is no longer able to meet testing needs especially for patients with cancer needing timely germline testing for treatment decisions. Mainstreaming has emerged as an alternative approach to increase testing capacity and efficiency, where nongenetics providers perform these steps and genetics providers focus on post-test counseling for positive results.</p><p><strong>Methods: </strong>This study reports a 3-year experience with mainstreaming hereditary cancer gene panel testing at Kaiser Permanente Southern California. The study compared demographic characteristics, cancer diagnoses, and test results between patients tested by genetics providers (traditional model) versus nongenetics providers (mainstreaming) over 3 years. Over 32,000 germline hereditary cancer gene panels were completed, including nearly 12,000 mainstreaming tests.</p><p><strong>Results: </strong>Mainstreaming substantially increased testing volume. Patients undergoing mainstream testing were more likely to have cancer, be male, and self-report being Asian or Black. The positive test rate was slightly lower in the mainstreaming group (11%) compared with the traditional testing model (15%), with similar rates of variants of uncertain significance. Post-test genetic counseling was high in both groups for positive results.</p><p><strong>Conclusion: </strong>This study demonstrates that mainstreaming can be successfully implemented in a large health care system and significantly expand testing capacity.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1296-1305"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527945","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":"Improvement in Quality of Life and Dysphagia After Palliative External Beam Radiotherapy for Malignant Esophageal Stenosis of Esophageal Cancer.","authors":"Katsuyuki Sakanaka, Kota Fujii, Masaki Kokubo, Masakazu Ogura, Satoshi Itasaka, Takashi Sakamoto, Norio Araki, Takehisa Takagi, Yasuhiro Kosaka, Setsuko Okumura, Chikako Yamauchi, Hiroyuki Inoo, Hiroyasu Abe, Hideki Ishikawa, Takashi Mizowaki","doi":"10.1200/OP.24.00429","DOIUrl":"10.1200/OP.24.00429","url":null,"abstract":"<p><strong>Purpose: </strong>This multi-institutional prospective cohort trial aimed to demonstrate the changes in physician-evaluated dysphagia and patient-reported outcomes (PROs) after palliative external beam radiotherapy (EBRT) in patients with incurable esophageal cancer presenting with dysphagia.</p><p><strong>Materials and methods: </strong>We evaluated the rates of freedom from physician-evaluated dysphagia progression and improvement along with longitudinal changes in PROs (European Organization for Research and Treatment of Cancer [EORTC] Quality of Life-Core 30 Questionnaire [QLQ-C30] and OES-18) after palliative EBRT. Multivariate analysis was used to identify the factors associated with freedom from physician-evaluated dysphagia progression at week 13.</p><p><strong>Results: </strong>A total of 519 patients with esophageal cancer were screened; the full analysis set comprised 93 patients with a baseline median dysphagia score of 2 (IQR, 1-3) whose possible range was 1-4. Squamous cell carcinoma accounted for 94% of the full analysis set. The median prescribed dose of palliative EBRT was 40 Gy (IQR, 37.5-50). The rates of freedom from physician-evaluated dysphagia progression and improvement at 13 weeks were 76% (95% CI, 66 to 85) and 50% (95% CI, 39 to 60), respectively. Multivariate analysis suggested that high-dose palliative EBRT was more effective in preventing deterioration of physician-evaluated dysphagia than the low-dose one. Role functioning, fatigue, dyspnea, and appetite were worsened at week 4 but recovered at week 13. Patient-reported dysphagia, as represented in EORTC OES-18, demonstrated clinically significant improvement from weeks 13 through 52, relieving dysphagia-associated symptoms and enhancing global health.</p><p><strong>Conclusion: </strong>Palliative EBRT could relieve physician-evaluated and patient-reported dysphagia and dysphagia-associated symptoms and enhance global health in patients with incurable esophageal cancer, especially for squamous cell carcinoma despite transient dysfunction and aggravations of symptoms attributable to acute toxicity from palliative EBRT.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1306-1315"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624594","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":"Real-World Immune-Related Adverse Events in Patients With Early Triple-Negative Breast Cancer Who Received Pembrolizumab.","authors":"Athira Jayan, Jasmine S Sukumar, Benjamin Fangman, Tejal Patel, Akshara Singareeka Raghavendra, Diane Liu, Sarah Pasyar, Ronald Rauch, Karen Basen-Engquist, Debasish Tripathy, Yinghong Wang, Sonya S Khan, Carlos H Barcenas","doi":"10.1200/OP.24.00371","DOIUrl":"10.1200/OP.24.00371","url":null,"abstract":"<p><strong>Purpose: </strong>The addition of pembrolizumab to chemotherapy in high-risk early triple-negative breast cancer (TNBC) improves cancer outcomes. However, pembrolizumab induces varied immune-related adverse events (irAEs) where some can be severe or lifelong. This retrospective study describes real-world patterns of irAEs in patients with TNBC who received pembrolizumab.</p><p><strong>Methods: </strong>We evaluated irAEs in patients with TNBC from a comprehensive cancer center and a community hospital who received pembrolizumab with chemotherapy between 2021 and 2023, excluding those enrolled in clinical trials. We used national guidelines to grade toxicities. Logistic regression assessed the effect of clinicopathologic variables on irAEs adjusting for covariates.</p><p><strong>Results: </strong>We identified 233 patients with a median age of 51 years, 62% had stage II TNBC, 35% had stage III TNBC, 25% were Hispanic, 21% were Black, and 42% were White. Eighty patients (34%) developed 100 separate irAEs. The most common irAEs were endocrinopathies (52%) and GI (23%); there were 26 grade ≥3 irAEs, which all resulted in hospitalization, the most common being GI (13 instances); 45 required systemic steroids, 16 required additional immunosuppressive therapy, and 32 patients discontinued pembrolizumab because of irAEs. Two patients who developed colitis eventually died due to complications. Most (67 instances) irAEs were unresolved at the time of last follow-up, but 55% (37/67) had improved to grade 1. No clinicopathologic factors were associated with the development or severity of irAEs.</p><p><strong>Conclusion: </strong>In this real-world diverse population, we observed rates of irAEs comparable with KEYNOTE-522, where endocrinopathies were the most prevalent, but GI irAEs were also prevalent and severe. This emphasizes a critical issue as pembrolizumab is increasingly being used in early TNBC and could have long-term survivorship implications.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1265-1273"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12208142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400279","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":"Environmental Impact Assessment of Intravenous Versus Subcutaneous Monoclonal Antibodies: A Carbon Footprint Analysis.","authors":"Michiel Zietse, Thirza Kooijman, Ruben Malmberg, Leontine E A M M Spierings, Agnes Jager, Ron H J Mathijssen, Roelof W F van Leeuwen, Frederick W Thielen","doi":"10.1200/OP-24-00804","DOIUrl":"10.1200/OP-24-00804","url":null,"abstract":"<p><strong>Purpose: </strong>The development of subcutaneous (SC) formulations for monoclonal antibodies (mAbs), as an alternative to conventional intravenous (IV) infusion, represents a shift in health care delivery. The relative environmental impact of these two administration methods is not well understood. Minimizing the environmental footprint of health care is crucial due to its substantial contribution to greenhouse gas (GHG) emissions. This study compared the carbon footprint of SC and IV administration using pertuzumab/trastuzumab as a case example.</p><p><strong>Methods: </strong>A Life Cycle Assessment was conducted to compare the environmental impacts of IV versus SC administration of pertuzumab/trastuzumab, focusing on climate change impacts expressed in carbon dioxide-equivalents (CO₂e). The analysis included emissions from single-use medical equipment, drug manufacturing, hospital operations, patient and staff transportation, and waste disposal.</p><p><strong>Results: </strong>SC pertuzumab/trastuzumab resulted in slightly higher GHG emissions than IV administration, with 47.2 kg CO₂e for loading doses compared with 45.9 kg CO₂e, and 33.6 kg CO₂e for maintenance doses compared with 32.9 kg CO₂e. This increase was primarily due to the higher dosage required for SC delivery, with mAb production contributing the most to emissions. Nonetheless, SC administration reduced the use of single-use medical equipment and treatment-related energy consumption in health care facilities. Switching to SC pertuzumab/trastuzumab administration in the Netherlands in 2022 would have increased annual CO₂e emissions by 12.2 tons, equivalent to driving 63,212 km in a petrol-powered car.</p><p><strong>Conclusion: </strong>Both IV and SC administration routes of mAbs have substantial environmental impacts, dominated by mAb production emissions. This research provides a framework for assessing the environmental impact of health care technologies and underscores the importance of integrating environmental considerations into health technology assessments to mitigate the significant contribution of health care to global GHG emissions.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"1287-1295"},"PeriodicalIF":4.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472487","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}