{"title":"Optimizing radiotherapy for anal Cancer: A call for sub-structure-based dose constraints.","authors":"Jie Pang","doi":"10.1016/j.radonc.2025.110937","DOIUrl":"10.1016/j.radonc.2025.110937","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110937"},"PeriodicalIF":4.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120459","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}
Katrine S Storm, Karen Lise G Spindler, Gitte F Persson, Camilla Kronborg, Eva Serup-Hansen
{"title":"Response to \"Optimizing radiotherapy for anal cancer: A call for sub-structure based dose constraints\".","authors":"Katrine S Storm, Karen Lise G Spindler, Gitte F Persson, Camilla Kronborg, Eva Serup-Hansen","doi":"10.1016/j.radonc.2025.110938","DOIUrl":"10.1016/j.radonc.2025.110938","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110938"},"PeriodicalIF":4.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094734","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}
Matthias Guckenberger , Lotte Wilke , Charlotte Billiet , Susanne Rogers , Ciro Franzese , Daniel Schnell , Mateusz Spałek , Daniel M. Aebersold , Hossein Hemmatazad , Thomas Zilli , Judit Boda-Heggemann , Brigitta G. Baumert , Jean-Jacques Stelmes , Franziska Nägler , Philipp Gut , Christian Weiß , Alessio Bruni , Frank Zimmermann , Robert Förster , Jörg Zimmer , Indira Madani
{"title":"Dose-intensified SBRT for vertebral oligometastases: results from a prospective clinical trial","authors":"Matthias Guckenberger , Lotte Wilke , Charlotte Billiet , Susanne Rogers , Ciro Franzese , Daniel Schnell , Mateusz Spałek , Daniel M. Aebersold , Hossein Hemmatazad , Thomas Zilli , Judit Boda-Heggemann , Brigitta G. Baumert , Jean-Jacques Stelmes , Franziska Nägler , Philipp Gut , Christian Weiß , Alessio Bruni , Frank Zimmermann , Robert Förster , Jörg Zimmer , Indira Madani","doi":"10.1016/j.radonc.2025.110940","DOIUrl":"10.1016/j.radonc.2025.110940","url":null,"abstract":"<div><h3>Purpose</h3><div>To prospectively evaluate safety and efficacy of dose-intensified multifraction SBRT using a simultaneous-integrated boost concept for vertebral oligometastases.</div></div><div><h3>Material and Methods</h3><div>Data from 128 patients with 143 vertebral oligometastases (≤5 distant metastases in total) treated with dose-intensified SBRT (48.5 Gy/10 [with epidural involvement] or 40 Gy/5 [without epidural involvement]) in the randomized and non-randomized arms of a phase 3 clinical trial conducted at 18 international centers between 2016 and 2023 were analyzed.</div></div><div><h3>Results</h3><div>The median age of all patients was 68 years; 77 patients (60.2%) had breast and prostate cancer. Of 143 vertebral metastases, 23 (16.1%) and 22 metastases (15.4%) had epidural and paraspinal tumor involvement, respectively. The median follow-up time was 24 months. At 2 years, cumulative incidence of local failure (4 failures) was 5.3%. There were 4 (2.8%) baseline and 8 (5.6%) <em>de novo</em> vertebral compression fractures (VCFs). Two-year OS was 82.2% (95% CI, 74.9–89.6%). There was no grade ≥ 4 adverse events (AE) and the crude rate of grade 3 AEs was 5.5%; no myelopathy or plexopathy was observed. On multivariate analysis, only non-breast or non-prostate cancer (HR, 7.91; 95%, CI 1.79–35.03; 2-sided <em>P</em> = 0.01) were found to be prognostic for adverse OS. No prognostic factors for VCF were identified. Epidural and paraspinal involvement were not found to be prognostic for treatment outcome.</div></div><div><h3>Conclusions</h3><div>Dose-intensified SBRT for vertebral oligometastases is effective and safe, even in high-risk patients with epidural or paraspinal involvement.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"208 ","pages":"Article 110940"},"PeriodicalIF":4.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085758","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}
Jie Zhang , Hailun Pan , Fakai Wang , Lecheng Jia , Jiayi Chen , Fuhua Yan , Yibin Zhang , Yingli Yang
{"title":"Automated vertebral identification and localization for enhanced radiotherapy patient setup","authors":"Jie Zhang , Hailun Pan , Fakai Wang , Lecheng Jia , Jiayi Chen , Fuhua Yan , Yibin Zhang , Yingli Yang","doi":"10.1016/j.radonc.2025.110939","DOIUrl":"10.1016/j.radonc.2025.110939","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Vertebral bodies are critical landmarks for image-based patient positioning during radiotherapy (RT). However, manual identification of vertebral bodies can be laborious and a source of error, potentially leading to treatment mistakes. This study demonstrated an automated technique for vertebral identification and localization in images with varying quality and field of view (FOV), aiming to streamline the positioning process and minimize the risk of patient misalignment.</div></div><div><h3>Materials and methods</h3><div>This retrospective study employed an nnU-Net-based model for automated vertebral identification and localization. Training was performed on 1,053 datasets (993 public datasets: SpineWeb, Verse19, Verse20, Spine1K; 60 clinical on-board CT scans from Infinity® and TomoTherapy®). Testing included 688 public datasets, 155 clinical on-board CT scans (Ethos®, Infinity®, TomoTherapy®, TrueBeam®, Trilogy®), and 50 clinical planning CTs (Brilliance CT Big-Bore-Oncology®). A strategic four-step post-processing procedure was developed to enhance accuracy, considering the anatomical characteristics of vertebral structures and vertebral abnormalities. Evaluation metrics included identification rates, mean localization errors, and their standard deviations.</div></div><div><h3>Results</h3><div>The method achieved high identification rates of 97.99 % with a mean localization error of 1.64 ± 1.23 mm on public datasets and 99.76 % with a mean error of 1.74 ± 1.36 mm on clinical datasets. Refining traditional 20 mm accuracy thresholds, new section-specific thresholds were established 10 mm for cervical, 15 mm for thoracic, and 19 mm for lumbar vertebrae.</div></div><div><h3>Conclusions</h3><div>This automated approach offers an accurate and widely applicable model for vertebral identification and localization. It has the potential to enhance RT setup workflows and serve as a valuable clinical tool.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"208 ","pages":"Article 110939"},"PeriodicalIF":4.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068212","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}
Daniel Tong , Julie Midroni , Kate Avison , Saif Alnassar , David Chen , Rod Parsa , Orly Yariv , Zhihui Liu , Xiang Y. Ye , Andrew Hope , Philip Wong , Srinivas Raman
{"title":"A systematic review and meta-analysis of the utility of quantitative, imaging-based approaches to predict radiation-induced toxicity in lung cancer patients","authors":"Daniel Tong , Julie Midroni , Kate Avison , Saif Alnassar , David Chen , Rod Parsa , Orly Yariv , Zhihui Liu , Xiang Y. Ye , Andrew Hope , Philip Wong , Srinivas Raman","doi":"10.1016/j.radonc.2025.110935","DOIUrl":"10.1016/j.radonc.2025.110935","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>To conduct a systematic review and <em>meta</em>-analysis of the performance of radiomics, dosiomics and machine learning in generating toxicity prediction in thoracic radiotherapy.</div></div><div><h3>Materials and Methods</h3><div>An electronic database search was conducted and dual-screened by independent authors to identify eligible studies for systematic review and <em>meta</em>-analysis. Data was extracted and study quality was assessed using TRIPOD for machine learning studies, RQS for Radiomics and RoB for dosiomics.</div></div><div><h3>Results</h3><div>10,703 studies were identified, and 5,252 entered screening. 104 studies including 23,373 patients were eligible for systematic review. Primary toxicity predicted was radiation pneumonitis (81), followed by esophagitis (12) and lymphopenia (4). Fourty-two studies studying radiation pneumonitis were eligible for <em>meta</em>-analysis, with pooled area-under-curve (AUC) of 0.82 (95% CI 0.79–0.85). Studies with machine learning had the best performance, with classical and deep learning models having similar performance. There is a trend towards an improvement of the performance of models with the year of publication. There is variability in study quality among the three study categories and dosiomic studies scored the highest among these. Publication bias was not observed.</div></div><div><h3>Conclusion</h3><div>The majority of existing literature using radiomics, dosiomics and machine learning has focused on radiation pneumonitis prediction. Future research should focus on toxicity prediction of other organs at risk and the adoption of these models into clinical practice.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"208 ","pages":"Article 110935"},"PeriodicalIF":4.9,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018506","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}
Phillip Wall, Wes Tucker, Thomas Mazur, Frank Marshall, Jonathan Pence, Jon Hansen, Michael Prusator, Matthew Schmidt, Nels Knutson
{"title":"Clinical validation of statistical predictive model for patient-specific quality assurance outcomes in stereotactic radiotherapy using secondary Monte Carlo dose calculations.","authors":"Phillip Wall, Wes Tucker, Thomas Mazur, Frank Marshall, Jonathan Pence, Jon Hansen, Michael Prusator, Matthew Schmidt, Nels Knutson","doi":"10.1016/j.radonc.2025.110934","DOIUrl":"https://doi.org/10.1016/j.radonc.2025.110934","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate Monte Carlo (MC) secondary dose verification for predicting ionization chamber (IC)-based patient-specific quality assurance (PSQA) measurements for stereotactic body radiotherapy (SBRT) plans.</p><p><strong>Methods: </strong>IC-based PSQA is a trusted method for verifying accurate delivery of absolute dose calculated by the treatment planning system (TPS). However, these measurements are often time-consuming and challenging to perform precisely, especially for small-volume SBRT targets. To investigate an MC-based method as a viable alternative, a logistic regression model was developed to predict measurement-based PSQA results utilizing 400 retrospectively collected IC PSQA measurements across our system. Each clinically approved plan was recalculated using a commercially available secondary MC-based dose calculation platform (Rad MonteCarlo, Radformation, NY). The dose to a contoured volume corresponding to the active IC volume was recorded. Additionally, measurement setup uncertainty was modeled by placing equivalent volumes +/- 2 mm in each cardinal direction. The TPS-calculated value was compared to the average MC-simulated values for all contours. Receiver Operating Characteristic (ROC) analysis was performed on an additional dataset of 328 prospective PSQA measurements to determine MC-based QA prediction thresholds for indicating when physical measurements can be safely avoided.</p><p><strong>Results: </strong>Of the 400 model plans, the percent differences between IC and TPS doses were [Median: -0.06 %, Range: -19.6 %-4.5 %]. The percent differences between IC and MC doses were [Median: 0.17 %, Range: -21.8 %-5.1 %]. When investigating MC against TPS dose for predicting likely PSQA failures, ROC analysis yielded an AUC of 0.76. Based on threshold analysis of the prospective validation dataset, a difference of 1 % between MC and TPS calculations resulted in zero false negatives, and would safely reduce the number of required IC measurements by 46 %.</p><p><strong>Conclusion: </strong>This study demonstrates feasibility of and a workflow for implementing MC-based secondary dose calculations to reduce the number of physical measurements required for PSQA without compromising safety and quality.</p>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":" ","pages":"110934"},"PeriodicalIF":4.9,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026359","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}
Anney Tuo , Dominic H. Moon , Vladimir Avkshtol , Jennifer Lobo Shah , Nhat-Long Pham , David J. Sher
{"title":"Associations between dosimetry and patient-reported outcomes in oropharyngeal cancer: post hoc analysis of elective neck de-escalation trials","authors":"Anney Tuo , Dominic H. Moon , Vladimir Avkshtol , Jennifer Lobo Shah , Nhat-Long Pham , David J. Sher","doi":"10.1016/j.radonc.2025.110933","DOIUrl":"10.1016/j.radonc.2025.110933","url":null,"abstract":"<div><h3>Introduction</h3><div>When using IMRT for oropharyngeal squamous cell carcinoma (OPSCC), the extent to which patient-reported outcomes (PRO) improve at progressively lower dose distributions is unclear. In this study, we evaluated the relationship between PROs and dosimetry in OPSCC patients on two elective neck irradiation (ENI) de-escalation trials.</div></div><div><h3>Methods</h3><div>Eligible patients in this analysis had a diagnosis of OPSCC and were treated on two ENI de-escalation trials. Contoured OARs included oral cavity (OC), floor of mouth (FoM), superior/middle constrictors (SMC), parotid glands (PG), submandibular glands (SMG), and tubarial glands (TG). OAR metrics were dichotomized at the median and in tertiles. The primary endpoints were 3- and 12-month PROs: the overall MD Anderson Dysphagia Inventory (MDADI) and Dry Mouth (DM) and Sticky Saliva (SS) scores from the EORTC HN35.</div></div><div><h3>Results</h3><div>The analysis includes 86 patients. The median mean doses were contralateral (CL, 15.7 Gy) and ipsilateral PG (26.3 Gy), contralateral SMG (35.3 Gy), OC (29.3 Gy), and SMC (47 Gy). OC, SMC and TG were significant predictors of 12-month MDADI, with a dose–response below the lowest tertile. Three-month DM scores were associated with OC doses, CL PG V15 and CL SMG V30, but only FoM and CL SMG V30 were predictors of 12 month DM. Oral cavity, FOM, and SMG doses were associated with 12 month SS outcomes.</div></div><div><h3>Conclusions</h3><div>In a cohort of patients treated with de-escalated IMRT, the critical impact of OC and SMG doses became evident. More work is needed to understand both dosimetric and non-dosimetric predictors of long-term PROs.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"209 ","pages":"Article 110933"},"PeriodicalIF":4.9,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992624","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}
Seongmin Kim , Seung Hyuck Jeon , Yoomin Kim , Nawon Park , In Ah Kim
{"title":"TIGIT blockade increases efficacy of PD-1 blockade combined with radiation therapy in triple-negative breast cancer model","authors":"Seongmin Kim , Seung Hyuck Jeon , Yoomin Kim , Nawon Park , In Ah Kim","doi":"10.1016/j.radonc.2025.110932","DOIUrl":"10.1016/j.radonc.2025.110932","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>T-cell immunoreceptor with Ig and ITIM domains (TIGIT) suppresses functions of CD8<sup>+</sup> T cells, and radiation therapy (RT) induces stimulation of regulatory T cells (Tregs), thereby limiting antitumor efficacy. This study aims to investigate the role of TIGIT in the immunosuppressive tumor environment and evaluate the potential of TIGIT blockade (αTIGIT) to enhance antitumor immune responses.</div></div><div><h3>Methods</h3><div>We analyzed public transcriptomic data to identify the expression patterns of TIGIT on T cells in breast cancer and its prognostic impact. In addition, a murine TNBC model was utilized to evaluate the effects of αPD-1, local RT, and αTIGIT. T cells in tumors, tumor-draining lymph nodes (TdLNs), and the spleen were analyzed to assess the antitumor immune responses upon the treatments.</div></div><div><h3>Results</h3><div>The analysis revealed that <em>TIGIT</em> is predominantly expressed on T cells within breast cancer, and the expression of <em>TIGIT</em> was associated with poor outcomes in TNBC patients. In the murine model, the combination of αPD-1 and RT increased TIGIT<sup>+</sup>CD226<sup>+</sup>CD8<sup>+</sup> TILs, which are crucial for the efficacy of αTIGIT. Adding αTIGIT to αPD-1 and RT (αPD-1/RT) resulted in a synergistic antitumor effect, which was accompanied by increased infiltration of CD8<sup>+</sup> TILs in both irradiated and nonirradiated tumors by the triple combination therapy compared to αPD-1/RT. The triple combination therapy also resulted in a less exhausted phenotype among CD8<sup>+</sup> TILs and increased the proliferation of splenic CD8<sup>+</sup> T cells. Moreover, αTIGIT significantly reduced Tregs in tumors, TdLNs, and the spleen when combined with αPD-1/RT.</div></div><div><h3>Conclusion</h3><div>αTIGIT exhibits synergistic effects when added to αPD-1/RT by increasing the infiltration and activation of CD8<sup>+</sup> TILs while reducing Tregs. The study suggests that αTIGIT could be an effective strategy to enhance the antitumor efficacy of αPD-1 and RT in TNBC.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"208 ","pages":"Article 110932"},"PeriodicalIF":4.9,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043535","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}
Lieselotte Lauwens , Marvin F. Ribeiro , Catharina M.L. Zegers , Morton Høyer , Claire Alapetite , Malin Blomstrand , Valentin Calugaru , Dario Di Perri , Alberto Iannalfi , Carola Lütgendorf-Caucig , Frank Paulsen , Alida A. Postma , Alejandra Méndèz Romero , Beate Timmermann , Esther G.C. Troost , Hiska L. van der Weide , Gillian A. Whitfield , Semi Harrabi , Maarten Lambrecht , Daniëlle B.P. Eekers
{"title":"Systematic review of MRI alterations in the brain following proton and photon radiation therapy: Towards a uniform European Particle Therapy Network (EPTN) definition","authors":"Lieselotte Lauwens , Marvin F. Ribeiro , Catharina M.L. Zegers , Morton Høyer , Claire Alapetite , Malin Blomstrand , Valentin Calugaru , Dario Di Perri , Alberto Iannalfi , Carola Lütgendorf-Caucig , Frank Paulsen , Alida A. Postma , Alejandra Méndèz Romero , Beate Timmermann , Esther G.C. Troost , Hiska L. van der Weide , Gillian A. Whitfield , Semi Harrabi , Maarten Lambrecht , Daniëlle B.P. Eekers","doi":"10.1016/j.radonc.2025.110936","DOIUrl":"10.1016/j.radonc.2025.110936","url":null,"abstract":"<div><div>Magnetic resonance imaging (MRI) often demonstrates alterations following cranial radiotherapy (RT), which may result in clinical symptoms and diagnostic uncertainty, and thus potentially impact treatment decisions. The potential differences in MRI alterations after proton and photon RT, has raised concerns regarding the relative biological effectiveness of proton therapy. To provide an overview of MRI alterations in the brain post-RT and to explore differences between photon and proton RT, a systematic review adhering to the PRISMA guidelines was conducted, focusing on the assessment methods and definitions across studies. A systematic search of three electronic databases was performed using the concepts ‘normo-fractionated radiotherapy ‘, ‘MRI alterations’ and ‘brain, skull base or head and neck tumours in adult and paediatric populations’. Data extraction and quality assessment was performed on articles meeting the predefined criteria by two independent reviewers. Out of 5887 screened studies, 94 met the inclusion criteria. These studies were categorized based on confinement of the MRI alterations to temporal lobe, brainstem, or across the entire brain. Additional subclassification was performed based on MRI sequences evaluated or by the nature of the alterations, with pseudoprogression generally reserved for glioma patients. While many papers exist on MRI alterations in the brain after RT, this review highlights significant inconsistencies in the terminology and definitions, limiting the comparability of findings across studies. Our results highlight the need for and facilitate the development of a standardized framework for describing MRI alterations after RT.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"208 ","pages":"Article 110936"},"PeriodicalIF":4.9,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948709","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}