Japanese journal of clinical oncology最新文献

{"title":"Endoscopy-assisted precise radical hysterectomy and perioperative chemotherapy for locally advanced cervical cancer: feasibility and clinical outcomes compared with radiotherapy.","authors":"Masato Kita, Yusuke Butsuhara, Tomomi Mizokami, Hiromi Murata, Hiroshi Shiraga, Hidetaka Okada","doi":"10.1093/jjco/hyag132","DOIUrl":"https://doi.org/10.1093/jjco/hyag132","url":null,"abstract":"<p><strong>Aim: </strong>This retrospective comparative study aimed to assess the feasibility and benefits of newly developed pneumovaginoscopy-assisted radical hysterectomy (PVRH) combined with systemic chemotherapy (neoadjuvant and adjuvant) compared to primary concurrent chemoradiotherapy in the treatment of stage IIB-IIIA locally advanced cervical cancer.</p><p><strong>Methods: </strong>Between June 2014 and December 2023, 117 patients with stage IIB-IIIA cervical cancer were treated. Fifty-nine patients were treated with PVRH combined with systemic chemotherapy [45 patients with neoadjuvant chemotherapy (NAC) and adjuvant chemotherapy, 14 patients with adjuvant chemotherapy only)] or with primary concurrent chemoradiotherapy (n = 58).</p><p><strong>Results: </strong>The neoadjuvant chemotherapy, pneumovaginoscopy-assisted radical hysterectomy, and adjuvant chemotherapy (NPA) completion rates were all 100%. The adjuvant radiotherapy avoidance rate was 94.8%. All patients resumed self-urination within 3 months of surgery. The achievement rates of R0 resection were 100% for vagina and 97.8% (1/45 of NAC cases) for parametrium. The adverse events associated with NPA were less severe than those associated with primary concurrent chemoradiotherapy. The patients with complete or partial response by NAC had a prognosis comparable to primary concurrent chemoradiotherapy; however, the patients with stable disease by NAC had a significantly poorer prognosis than primary concurrent chemoradiotherapy. In squamous cell carcinoma, the rate of distant metastasis was numerically lower with NPA group compared to the concurrent chemoradiotherapy group; however, this trend was not observed in the subgroup that showed a poor response to preoperative chemotherapy.</p><p><strong>Conclusions: </strong>Endoscopy-assisted precise RH with perioperative chemotherapy is a feasible multidisciplinary strategy for stage IIB-IIIA cervical cancer, demonstrating high surgical precision and functional preservation. While these results may suggest potential benefits of this treatment, their interpretation requires caution, and patient selection based on the response to preoperative therapy is considered important.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical significance of spread through air spaces according to EGFR mutation status in lung adenocarcinoma.","authors":"Asato Hashinokuchi, Keisuke Kosai, Naoki Haratake, Takatoshi Fujishita, Shinichiro Shimamatsu, Takuro Kometani, Toshiaki Kawabata, Ryo Toyozawa, Kenichi Taguchi, Mototsugu Shimokawa, Masafumi Yamaguchi","doi":"10.1093/jjco/hyag129","DOIUrl":"https://doi.org/10.1093/jjco/hyag129","url":null,"abstract":"<p><strong>Objectives: </strong>Spread through air spaces (STAS) is a poor prognostic pathological feature recently included as a histological factor in the ninth edition of the TNM (tumor, node, and metastasis) classification. However, its clinical significance in lung adenocarcinoma with epidermal growth factor receptor (EGFR) gene mutations remains unclear. Here, we aimed to evaluate the clinical significance of STAS according to EGFR mutation status.</p><p><strong>Methods: </strong>We retrospectively reviewed 347 patients with completely resected pathological stage 0-IIIB lung adenocarcinoma who were evaluated for both STAS and EGFR mutations between 2015 and 2022. We investigated the association between clinicopathological features and STAS and analyzed its prognostic relevance based on EGFR mutation status.</p><p><strong>Results: </strong>STAS and EGFR mutations were present in 85 (24.5%) and 178 (51.3%) patients, respectively. In patients with EGFR-mutated lung adenocarcinoma, STAS was significantly more prevalent in those with exon 19 deletions than those with the L858R mutation (P = .012). STAS was significantly markedly associated with poorer recurrence-free and overall survival in patients both with (P < .001 and P < .001, respectively) and without (P = .003 and P = .023, respectively) EGFR mutations. Multivariable analysis revealed that STAS was an independent prognostic factor for recurrence-free and overall survival in patients with EGFR mutations (P < .001 and P = .020, respectively). However, STAS was not an independent predictor in patients without EGFR mutations.</p><p><strong>Conclusions: </strong>STAS is a key pathological feature of lung adenocarcinoma and holds considerable clinical relevance, particularly in EGFR-mutated lung adenocarcinoma.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letermovir coadministration and tacrolimus concentration-to-dose ratios before and after intravenous-to-oral conversion in allogeneic hematopoietic stem cell transplant recipients receiving isavuconazole.","authors":"Toshihisa Nakashima, Yoshihiro Inamoto, Ayumu Ito, Takahiro Fukuda, Hironobu Hashimoto","doi":"10.1093/jjco/hyag135","DOIUrl":"https://doi.org/10.1093/jjco/hyag135","url":null,"abstract":"<p><p>Letermovir is used for cytomegalovirus prophylaxis after allogeneic hematopoietic cell transplantation (HCT) and reportedly increases tacrolimus exposure. Isavuconazole, a mold-active triazole antifungal, also inhibits cytochrome P450 3A and may affect tacrolimus pharmacokinetics. This retrospective study evaluated tacrolimus concentration-to-dose (C/D) ratios pre- and post-conversion from continuous intravenous infusion to oral administration in allogeneic HCT recipients receiving isavuconazole. Forty-five patients were stratified according to letermovir coadministration into the isavuconazole-alone group (ISCZ-alone; n = 9) and the isavuconazole with letermovir group (ISCZ + LMV; n = 36). The median C/Dciv ratios were 17.00 and 16.40 (ng/ml)/(mg/day), respectively (P = 0.81); the median C/Dpo ratios were 3.25 and 2.60 (ng/ml)/(mg/day), respectively (P = 0.77); and the median (C/Dpo)/(C/Dciv) ratios were 0.154 and 0.173, respectively (P = 0.72). Sensitivity analyses yielded consistent findings. Letermovir coadministration was not associated with significant differences in tacrolimus C/D ratios pre- or post-conversion to oral administration in allogeneic HCT recipients receiving isavuconazole.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term care needs and service use in terminally ill patients with cancer: a nationwide claims data study.","authors":"Richi Takahashi, Takaaki Konishi, Yoko Nakazawa, Daisuke Fujisawa","doi":"10.1093/jjco/hyag130","DOIUrl":"https://doi.org/10.1093/jjco/hyag130","url":null,"abstract":"<p><strong>Background: </strong>Terminally ill patients with cancer may have difficulty using Japan's public long-term care insurance system because functional decline often occurs rapidly near death. We examined care-need levels, service use, and factors associated with timely service use in this population.</p><p><strong>Methods: </strong>We used anonymized long-term care insurance claims data from January 2018 to August 2025. Patients who died of cancer and whose first observed certification was granted within 1 year before death were included. Certification levels, certification period, and service use were described. Logistic regression examined factors associated with service use within 30 days after first certification.</p><p><strong>Results: </strong>Among 10 491 patients, 17.8% were initially classified as support levels 1 and 2, and 62.0% were first certified within 3 months before death. Overall, 6740 (64.2%) used long-term care services during observation, and 4822 (46.0%) used services within 30 days. Compared with patients certified 6 to ≤ 12 months before death, those certified closer to death had higher odds of service use within 30 days: adjusted odds ratios were 1.63 (95% CI, 1.43-1.84) for ≤ 1 month, 1.23 (1.09-1.40) for 1 to ≤ 3 months, and 1.17 (1.02-1.34) for 3 to ≤6 months. Higher initial care-need levels were also associated with greater service use within 30 days, peaking at care-need level 2 (5.73; 4.78-6.88).</p><p><strong>Conclusions: </strong>Many patients were first certified shortly before death. Certification closer to death was associated with prompt service use, possibly reflecting urgent care coordination. Earlier information provision and timely certification may help patients access long-term care services before death.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De-escalation of perioperative systemic therapy for early breast cancer.","authors":"Makiko Ono, Yasuaki Sagara, Toshiyuki Ishiba, Yukinori Ozaki, Takehiko Sakai, Hideo Shigematsu, Akihiko Shimomura, Kazuki Sudo, Kaori Terata, Yoichi Naito, Kazuki Nozawa, Fumikata Hara, Tomomi Fujisawa, Tadahiko Shien","doi":"10.1093/jjco/hyag131","DOIUrl":"https://doi.org/10.1093/jjco/hyag131","url":null,"abstract":"<p><p>Breast cancer is the most common malignancy among women worldwide, and the number of survivors continues to increase owing to earlier detection and advances in treatment. As long-term survivorship becomes increasingly important, minimizing treatment-related toxicity without compromising oncologic outcomes has become a major goal in the management of early breast cancer. Treatment de-escalation strategies have therefore attracted considerable attention. In HER2-positive disease, several approaches have been explored, including reduction of chemotherapy intensity, shortening the duration of anti-HER2 therapy, chemotherapy-free regimens in selected patients, and response-guided strategies based on pathologic complete response following neoadjuvant therapy. In hormone receptor-positive HER2-negative breast cancer, multigene expression assays have enabled more precise risk stratification and have allowed omission of adjuvant chemotherapy in patients with biologically low-risk tumors. In addition, the neoadjuvant setting provides an opportunity to evaluate treatment response using biomarkers such as Ki67, which may help identify patients who can safely avoid chemotherapy. Ongoing clinical trials are further evaluating response-guided treatment strategies, particularly in premenopausal patients. Furthermore, circulating tumor DNA has recently emerged as a promising biomarker for detecting minimal residual disease and monitoring treatment response. Integration of molecular biomarkers with response-adapted strategies may further refine risk stratification and support personalized treatment approaches. This review summarizes current evidence and ongoing studies on treatment de-escalation across breast cancer subtypes.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of severe postoperative complications on oncologic outcomes after curative resection for stage I-III colorectal cancer: a multicenter study.","authors":"Shintaro Hashimoto, Tetsuro Tominaga, Keisuke Noda, Toshio Shiraishi, Hiroki Katayama, Shoko Tei, Taiji Hida, Kazuki Motoyama, Shoto Yamazaki, Takashi Ohnoda, Hiroshi Maruta, Yuma Takamura, Rika Ono, Nobuhito Ogata, Makoto Hisanaga, Mitsutoshi Ishii, Masaaki Moriyama, Hidetoshi Fukuoka, Kazuo To, Kaido Oishi, Takashi Nonaka, Keitaro Matsumoto","doi":"10.1093/jjco/hyag126","DOIUrl":"https://doi.org/10.1093/jjco/hyag126","url":null,"abstract":"<p><strong>Background: </strong>Severe postoperative complications (Clavien-Dindo [CD] grade ≥ 3) may compromise long-term oncologic outcomes after colorectal cancer (CRC) surgery, but their impact across all pathological stages remains unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed 1990 patients who underwent curative resection for pStage I-III CRC at six hospitals (2016-2021). Multivariable Cox proportional hazards models were used to evaluate recurrence-free survival (RFS), overall survival (OS), cancer-specific survival (CSS), and time to recurrence (TTR). Stratified analyses were performed by pathological stage and complication type (intra-abdominal infectious complications [IAI] vs. non-IAI), and a 30-day landmark analysis was conducted.</p><p><strong>Results: </strong>CD ≥3 complications occurred in 128 patients (6.4%). On multivariable analysis, CD ≥3 complications were independent adverse prognostic factors for RFS (hazard ratio [HR] 1.84, P < .001), OS (HR 2.52, P < .001), and CSS (HR 2.04, P = .024), but not for TTR (HR 1.22, P = .451). Stage-stratified analyses showed significant associations with worse RFS and OS in pStage II-III, with trends in pStage I. CSS was significantly worse in pStage III (HR 3.06, P < .001). TTR showed no significant association with CD ≥3 complications in any pStage. IAI complications were independently associated with worse CSS (HR 2.21, P = .039), whereas non-IAI complications were not. These adverse effects persisted after 30-day landmark analysis.</p><p><strong>Conclusions: </strong>CD ≥3 complications independently worsen RFS, OS, and CSS but do not significantly affect TTR after curative resection for pStage I-III CRC. IAI complications are particularly associated with worse cancer-specific mortality. This discordance suggests that severe complications may not primarily accelerate recurrence itself, but may instead impair survival after recurrence, highlighting possible mechanisms beyond direct recurrence acceleration.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extramedullary multiple myeloma simulating lymphoproliferative disease on multimodality imaging.","authors":"Paloma Salvador-Sáenz, Pablo A Álvarez-Reyes, Juan J Gómez-Herrera, Waleska Salcedo-Mercado","doi":"10.1093/jjco/hyag127","DOIUrl":"https://doi.org/10.1093/jjco/hyag127","url":null,"abstract":"<p><p>A 77-year-old male with monoclonal gammopathy of undertermined significance presented with multiple bulky extraosseous soft-tissue masses on imaging tests, mimicking radiological features of lymphoma. Ultimately, a diagnosis of multifocal extraosseous multiple myeloma was established, highlighting the need for comprehensive clinical and diagnostic correlation to ensure appropriate management.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atezolizumab vs durvalumab for extensive-stage small cell lung cancer in Japan: a real-world comparative analysis of costs and clinical outcomes.","authors":"Katsuya Hirano, Akito Hata, Yuta Yamanaka, Toshiyuki Sumi, Motohiro Tamiya, Yuki Sato, Yuko Oya, Kosuke Hamai, Nobuyuki Katakami, Katsuhiko Iwasaki, Tatsuhiro Uenishi, Kinya Kokubo, Ataru Igarashi","doi":"10.1093/jjco/hyag128","DOIUrl":"https://doi.org/10.1093/jjco/hyag128","url":null,"abstract":"<p><strong>Background: </strong>Platinum-etoposide combined with a PD-L1 inhibitor (atezolizumab or durvalumab) is the standard first-line treatment for extensive-stage small cell lung cancer (ES-SCLC). Although phase 3 trials have demonstrated similar efficacy, no direct comparison exists, and differences in treatment cost and resource utilization may influence clinical decision-making.</p><p><strong>Methods: </strong>In this multicenter retrospective study, real-world data from eight Japanese institutions were analyzed. Patients with ES-SCLC treated with platinum-etoposide plus atezolizumab or durvalumab between August 2018 and December 2022 were included. Individual-level medical costs were calculated from health insurance claims linked to electronic medical records. After propensity score matching and exclusion of cisplatin-treated patients, 128 patients were analyzed. The primary outcome was mean monthly medical cost during immunotherapy. Secondary outcomes included overall survival (OS), immune-related adverse events (irAEs), and prognostic factors.</p><p><strong>Results: </strong>Among 128 patients (mean age, 74 years; 85% male), mean monthly medical cost was significantly lower with atezolizumab than durvalumab (¥1 003 922 [$7183] vs ¥1 596 511 [$11 422]; P < .001). Median OS was comparable (13.9 months [95% CI, 11.7-17.5] vs 14.8 months [95% CI, 10.5-not reached]; P = .92). Grade ≥2 irAEs (11% vs 31%; P = .009) and interstitial lung disease (3% vs 20%; P = .004) were less frequent with atezolizumab. Poor performance status was associated with worse OS, whereas treatment type was not.</p><p><strong>Conclusions: </strong>Atezolizumab was associated with lower medical costs and similar survival outcomes compared with durvalumab in ES-SCLC, suggesting its use as a clinically comparable option with lower associated costs in Japanese real-world practice.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Characterization of distant metastases in salivary gland cancer patients undergoing upfront surgery followed by postoperative radiation therapy: a multicenter analysis.","authors":"","doi":"10.1093/jjco/hyag136","DOIUrl":"https://doi.org/10.1093/jjco/hyag136","url":null,"abstract":"","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PCU-to-home transition sequences and final place of death in advanced cancer: a prospective Japanese cohort study of a regional electronic communication platform.","authors":"Shinya Kajiura, Nozomu Murakami, Ryuji Hayashi","doi":"10.1093/jjco/hyag122","DOIUrl":"https://doi.org/10.1093/jjco/hyag122","url":null,"abstract":"<p><strong>Background: </strong>Transition from a palliative care unit (PCU) to home is clinically important in advanced cancer, but the sequence from planned or attempted transition through discharge realization and final place of death is insufficiently described. Electronic communication platforms may provide process markers of regional coordination.</p><p><strong>Methods: </strong>We conducted a single-center prospective observational cohort study of consecutive patients with advanced cancer from 2018 to 2023. Patients were included when PCU-to-home transition was planned or attempted and they were registered in a regional electronic home palliative care communication platform derived from a paper-based pathway. We descriptively examined transition sequences, final place of death, non-home death subcategories, cumulative notebook count, and notebook entries per 7 home-care days.</p><p><strong>Results: </strong>Among 209 planned or attempted transitions, 199 (95.2%) achieved actual home discharge and 10 (4.8%) remained unrealized. In the full cohort, home death occurred in 122 patients (58.4%) and non-home death in 87 (41.6%); 77 of 87 non-home deaths occurred in a PCU/palliative care unit. Among actual home-discharge patients, home death occurred in 122/199 (61.3%) and non-home death in 77/199 (38.7%). Median cumulative notebook counts were 23 [13-44] and 20 [10-40], respectively (descriptive P = 0.326). Median entries per 7 home-care days were 7.54 [2.62-19.76] and 5.13 [1.79-9.58] (descriptive P = 0.012).</p><p><strong>Conclusions: </strong>Most planned or attempted transitions achieved actual home discharge, but final place of death diverged thereafter. Notebook count and rate were descriptive communication-process markers that may help characterize and review multidisciplinary coordination across the ongoing regional transition process after PCU discharge.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}