Radiotherapy and Oncology最新文献

{"title":"Elective clinical target volume in early squamous cell anal canal cancer: A systematic review and meta-analysis of the risk of recurrence in untreated upper pelvic and external iliac lymph nodes","authors":"Joanna Socha ,&nbsp;Karol Paciorek ,&nbsp;Krzysztof Bujko","doi":"10.1016/j.radonc.2025.110788","DOIUrl":"10.1016/j.radonc.2025.110788","url":null,"abstract":"<div><h3>Background</h3><div>For squamous-cell carcinoma of the anal canal, most delineation guidelines recommend elective irradiation of the external iliac lymph nodes (LNS) and the upper pelvic LNS (located above the inferior aspect of the sacroiliac joints), regardless of clinical stage. However, neither of these regions is the first-echelon nodal station for anal primaries, and there is no conclusive evidence on the risk of microscopic involvement of these LNS in patients with cT1-2N0 disease. The recommendation to include these regions in the elective CTV for early anal canal cancer is based on historical practice, reflecting lymph node regions in earlier AP-PA fields, rather than conclusive evidence.</div></div><div><h3>Patients and methods</h3><div>A systematic review of the literature and a <em>meta</em>-analysis were performed to determine the rates of regional recurrence in the upper pelvic and external iliac LNS in patients with early anal canal cancer (cT1-2N0) treated with radio(chemo)therapy without elective nodal irradiation (ENI) of these LNS.</div></div><div><h3>Results</h3><div>One prospective and eight retrospective studies were included in the <em>meta</em>-analysis. The pooled weighted rate of regional recurrence in the upper pelvic LNS was 0.9 % (95 % confidence interval [CI]: 0.1–1.8 %) among 495 cT1-2N0 patients treated with ENI not covering these LNS. None of 233 patients treated with ENI not covering external iliac LNS had a recurrence in this region after radio(chemo)therapy.</div></div><div><h3>Conclusion</h3><div>Low risk of regional recurrence in the untreated upper pelvic and external iliac LNS suggests they can be confidently excluded from the elective nodal CTV for patients with early squamous cell anal canal cancer.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110788"},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of bra application in breast cancer radiotherapy: A pilot prospective randomized trial","authors":"Hwa Kyung Byun ,&nbsp;Hojin Kim ,&nbsp;Junyoung Son ,&nbsp;Yongwan Cho ,&nbsp;Yong Jae Kwon ,&nbsp;Dong Wook Kim ,&nbsp;Ho Lee ,&nbsp;Yong Bae Kim","doi":"10.1016/j.radonc.2025.110785","DOIUrl":"10.1016/j.radonc.2025.110785","url":null,"abstract":"<div><h3>Purpose</h3><div>This prospective, randomized clinical trial evaluated the effects of bra-wearing during radiotherapy on breast-shape reproducibility, dosimetry, and treatment toxicities in patients with breast cancer.</div></div><div><h3>Methods</h3><div>Thirty-eight patients with breast cancer who underwent breast-conserving surgery were randomly assigned to bra-wearing or non-wearing groups during radiotherapy. Breast-shape reproducibility was assessed using daily cone-beam computed tomography (CBCT). The primary outcome was breast-shape reproducibility, evaluated by the nipple-to-pectoral muscle distance (ΔNPD) and mean surface distance (MSD), comparing daily CBCT to planning CT. We calculated the mean root-mean-squared error (ε), systematic error (Σ), and random error (σ). Secondary outcomes included dosimetric parameters and acute/subacute toxicities.</div></div><div><h3>Results</h3><div>ΔNPD ε (1.0 mm vs 3.8 mm, P &lt; 0.001), Σ (0.6 mm vs 3.6 mm, P &lt; 0.001), and σ (0.8 mm vs 2.2 mm, P &lt; 0.001) were significantly smaller in the bra-wearing group. For larger breasts (cup sizes C–D), MSD ε was significantly smaller in the bra-wearing group (1.1 mm vs. 2.1 mm, P = 0.006), but not for smaller breasts. The absolute ΔNPD exceeded 3 mm in 0.4 % of CBCT scans in the bra-wearing group and 48.1 % in the non-wearing group (P &lt; 0.001). Absolute MSD exceeded 3 mm in 2.1 % and 10.0 % of scans in the bra-wearing and non-wearing groups, respectively (P &lt; 0.001). No significant differences were observed in lung and heart dosimetric outcomes between groups. Grade 2 or higher toxicities were minimal in both groups.</div></div><div><h3>Conclusion</h3><div>The use of a bra during radiotherapy enhances breast-shape reproducibility, particularly in patients with larger breasts, without increasing treatment toxicities.</div><div>Trial Registration Number: NCT06178861.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110785"},"PeriodicalIF":4.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical experience with free-breathing expiration-gated 10MV FFF VMAT stereotactic lung radiotherapy","authors":"Isabel F. Remmerts de Vries ,&nbsp;Max Dahele ,&nbsp;Tezontl S. Rosario ,&nbsp;Ben J. Slotman ,&nbsp;Wilko F.A.R. Verbakel","doi":"10.1016/j.radonc.2025.110783","DOIUrl":"10.1016/j.radonc.2025.110783","url":null,"abstract":"<div><h3>Background</h3><div>Free-breathing expiration-gating (EG) is a non-invasive technique used to manage respiratory-induced tumor motion. This study explores the effectiveness of EG stereotactic body radiotherapy (SBRT) for lung tumors using 10MV FFF VMAT.</div></div><div><h3>Methods and Materials</h3><div>The study included 41 patients (50 targets) treated with EG lung SBRT between September 2019 and February 2023. Patients underwent free-breathing uncoached 10-phase 4DCT for planning, with the choice for EG based on e.g. tumor motion, critical organ dose, expected target visibility on free-breathing CBCT, taking into account suitability of the breathing pattern. The gating window was typically set at phases 30–70 % of the breathing cycle. Treatment planning utilized VMAT with 10MV FFF, and tumor motion was monitored using EG-CBCT ± near real-time markerless kV imaging. Treatment times for the different parts of treatment, tumor stability and clinical outcomes were evaluated. Dosimetric outcomes were compared between EG and free-breathing plans for a subset of 10 patients.</div></div><div><h3>Results</h3><div>EG SBRT substantially reduced longitudinal tumor motion and internal target volume (ITV) by 77 % and 42 % respectively. There was a mean decrease of 21/24 % in V5/V20Gy for the ipsilateral lung. Motion monitoring during treatment for 20 targets showed that intrafraction tumor motion remained within 2 mm for most patients, ensuring accurate dose delivery. 86 % of fractions were completed within 25 min. No local recurrences were observed during a median follow-up of 13 months.</div></div><div><h3>Conclusion</h3><div>Free-breathing EG SBRT is a feasible, effective, and practical approach for lung cancer treatment, offering significant reductions in tumor motion and lung doses while maintaining high treatment accuracy and acceptable treatment times.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110783"},"PeriodicalIF":4.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pioneering BNCT: Refining strategies for complex cutaneous malignancies","authors":"Xiaowei Zhang","doi":"10.1016/j.radonc.2025.110786","DOIUrl":"10.1016/j.radonc.2025.110786","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110786"},"PeriodicalIF":4.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the significance of peak dose in normal tissue toxicity in spatially fractionated radiotherapy: The case of proton minibeam radiation therapy","authors":"Yolanda Prezado ,&nbsp;Charlotte Lamirault ,&nbsp;Thibaut Larcher ,&nbsp;Cristele Gilbert ,&nbsp;Julie Espenon ,&nbsp;A. Patriarca ,&nbsp;L. de Marzi ,&nbsp;Angela Corvino ,&nbsp;Ramon Ortiz ,&nbsp;Marjorie Juchaux","doi":"10.1016/j.radonc.2025.110769","DOIUrl":"10.1016/j.radonc.2025.110769","url":null,"abstract":"<div><h3>Purpose</h3><div>Spatially fractionated radiotherapy is an unconventional radiotherapy approach able to widen the therapeutic window for difficult-to-treat cases today. To unlock its full potential, accurate knowledge of the relationship between the different dosimetry and geometry parameters and the biological response is still needed. When the same beam width is used, the valley dose has been assumed to be the main parameter influencing normal tissue sparing, with peak doses having little relevance. However, a recent retrospective evaluation of preclinical data suggests peak dose plays a major role in the normal tissue sparing of minibeam radiation therapy (MBRT). The goal of this study was to experimentally validate for the first time the significance of the peak dose for normal tissue sparing in proton MBRT.</div></div><div><h3>Materials and methods</h3><div>We irradiated the brains of naive rats with two different configurations of pMBRT, resulting in the same valley and average doses but different peak doses. Behavioural tests and histopathological evaluations were carried out.</div></div><div><h3>Results</h3><div>At the same valley dose, a higher peak dose (high peak-to-valley dose ratio (PVDR), larger centre-to-centre (ctc) distance) is more detrimental than a lower peak dose (low PVDR, narrower catch). In the first case, the animals exhibited some hyperactivity in locomotor and exploration activity as well as memory alterations. In addition, the highest peak dose led to a significantly higher cumulative lesion score in the histopathology evaluations than the lowest peak dose.</div></div><div><h3>Conclusions</h3><div>While our study does not exclude the relevant role of the valley dose in tissue sparing, it does highlight the importance of peak doses, contradicting previous assumptions. Our results agree with the conclusion of a recent retrospective evaluation of preclinical studies in micro and minibeam radiation therapy.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110769"},"PeriodicalIF":4.9,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel approaches to fiducial-guided SBRT for ultra-central thoracic oligometastases","authors":"Jiao Yu,&nbsp;Xin Chen","doi":"10.1016/j.radonc.2025.110776","DOIUrl":"10.1016/j.radonc.2025.110776","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110776"},"PeriodicalIF":4.9,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk-adapted stereotactic body radiation therapy for the treatment of large (>3 cm) primary lung cancer with or without histologic confirmation: A propensity score matched and weighted analysis","authors":"Hong-Yu Zeng ,&nbsp;Yan-Jin Li ,&nbsp;Chao-Zhi Ji ,&nbsp;Huan-Huan Wang ,&nbsp;Xin-Ru Yu ,&nbsp;Yuan He ,&nbsp;Hui Bai ,&nbsp;Bo-Yu Zheng ,&nbsp;Yuan-Yuan Yan ,&nbsp;Ji-Wen Xu ,&nbsp;Nicholas G Zaorsky ,&nbsp;Jin-Ming Shi ,&nbsp;Yang Dong ,&nbsp;Xu-Yao Yu ,&nbsp;Jing-Sheng Wang ,&nbsp;Yong-Chun Song ,&nbsp;Zhi-Yong Yuan ,&nbsp;Ying Chen ,&nbsp;Mao-Bin Meng","doi":"10.1016/j.radonc.2025.110781","DOIUrl":"10.1016/j.radonc.2025.110781","url":null,"abstract":"<div><h3>Purpose</h3><div>Stereotactic body radiation therapy (SBRT) is a promising therapeutic approach for inoperable, small (≤3 cm) primary lung cancer. However, the efficacy and safety of risk-adapted SBRT for treating large (&gt;3 cm) primary lung cancer remains inadequately characterized.</div></div><div><h3>Patients and Methods</h3><div>Patients with large (&gt;3 cm) primary lung cancer, diagnosed either clinically or histologically, were recruited between November 1, 2010 and December 31, 2022. Risk-adapted SBRT was administered in fractions (median, 5) for a total dose of 60 Gy (range, 45–63 Gy). The primary endpoint was overall survival (OS), and secondary endpoints included progression-free survival (PFS), local failure (LF), regional failure (RF), distant metastasis (DM), cancer-specific mortality (CSM), and toxicity. Differences in baseline characteristics were balanced via propensity score matching (PSM) with the logistic regression model, as well as 1:1 ratio matching and inverse probability of treatment weighting (IPTW). The Cox proportional hazards model was used for univariate and multivariate analyses aimed at identifying prognostic factors influencing OS and PFS.</div></div><div><h3>Results</h3><div>The 126 enrolled patients included 61 cases (48.4 %) diagnosed clinically and 65 cases (51.6 %) diagnosed pathologically. Following PSM and IPTW, no differences were found between patients diagnosed clinically versus pathologically in OS, PFS, tumor failure, and CSM. Univariate and multivariate analyses identified a Charlson comorbidity index ≥5 as an adverse prognostic factor for OS and PFS. One patient (0.8 %) in the pathologically diagnosed group developed grade 5 pneumonitis 2 months after undergoing SBRT.</div></div><div><h3>Conclusions</h3><div>Risk-adapted SBRT may be an optimal treatment for appropriately selected patients with a large (&gt;3 cm) primary lung cancer lacking histologic confirmation.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110781"},"PeriodicalIF":4.9,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing multiple MRI sequences in deep learning-based synthetic CT generation for MR-only radiation therapy of head and neck cancers","authors":"Jacob Antunes ,&nbsp;Tony Young ,&nbsp;Dane Pittock ,&nbsp;Paul Jacobs ,&nbsp;Aaron Nelson ,&nbsp;Jon Piper ,&nbsp;Shrikant Deshpande","doi":"10.1016/j.radonc.2025.110782","DOIUrl":"10.1016/j.radonc.2025.110782","url":null,"abstract":"<div><h3>Purpose</h3><div>This study investigated the effect of multiple magnetic resonance (MR) sequences on the quality of deep-learning-based synthetic computed tomography (sCT) generation in the head and neck region.</div></div><div><h3>Materials and methods</h3><div>12 MR series (T1pre-, T1post-contrast, T2 each with 4 Dixon images) were collected from 26 patients with head and neck cancers. 14 unique deep-learning models using the U-Net framework were trained using multiple MRs as inputs to generate sCTs. Mean absolute error (MAE), Dice Similarity Coefficient (DSC), as well as Gamma pass rates were used to compare sCTs to the actual CT across the different multi-channel MR-sCT models.</div></div><div><h3>Results</h3><div>Using all available MR series yielded sCTs with the lowest pixel-wise error (MAE = 80.5 ± 9.9 HU), but increasing channels also increased artificial tissue which led to poorer auto-contouring and lower dosimetric accuracy. Models with T2 protocols generally resulted in poorer quality sCTs. Pre-contrast T1 with all Dixon images was the best multi-channel MR-sCT model, consistently ranking high for all sCT quality measurements (average DSC across all structures = 80.0 % ± 13.6 %, global Gamma Pass Rate = 97.9 % ± 1.7 % at 2 %/2mm dose criterion and 20 % of max dose threshold).</div></div><div><h3>Conclusions</h3><div>Deep-learning networks using all Dixon images from a pre-contrast T1 sequence as multi-channel inputs produced the most clinically viable sCTs. Our proposed method may enable MR-only radiotherapy planning in a clinical setting for head and neck cancers.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110782"},"PeriodicalIF":4.9,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiotherapy quality assurance for the PEACE 1 trial: An individual case review analysis","authors":"Najlaa Alyamani ,&nbsp;Enrico Clementel ,&nbsp;Paul Sargos ,&nbsp;Pierre Blanchard ,&nbsp;Stephane Supiot ,&nbsp;Philippe Ronchin ,&nbsp;Pascal Pommier ,&nbsp;Thomas Duberge ,&nbsp;Marlon Silva ,&nbsp;Yasser Hammoud ,&nbsp;Ali Hasbini ,&nbsp;Jonathan Khalifa ,&nbsp;Khemara Gnep ,&nbsp;Christopher Scrase ,&nbsp;Jordi Saez ,&nbsp;Laure Vieillevigne ,&nbsp;Melissa Christiaens ,&nbsp;Thomas Zilli ,&nbsp;Hélène Ribault ,&nbsp;Alberto Bossi ,&nbsp;Nicolaus Andratschke","doi":"10.1016/j.radonc.2025.110780","DOIUrl":"10.1016/j.radonc.2025.110780","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiotherapy quality assurance (RTQA) is essential for ensuring adherence to trial protocols. This paper summarizes the individual case review (ICR) results from the PEACE-1 trial, a phase-III study investigates standard of care (androgen deprivation therapy with or without docetaxel) with or without local radiotherapy; and with or without abiraterone acetate plus prednisone in patients with metastatic hormone-sensitive prostate cancer (mHSPC).</div></div><div><h3>Materials and methods</h3><div>Participating institutions submitted radiotherapy (RT) plans for central review, assessing protocol compliance in target volume and organs at risk (OARs) delineation, as well as dose specifications. ICRs were conducted either retrospectively (r-ICRs), after starting RT, or prospectively (p-ICRs), before RT initiation. Case reviews were categorized as acceptable per protocol, acceptable variation, or unacceptable variation based on delineation and dose and plan parameters.</div></div><div><h3>Results</h3><div>Out of 585 patients in the RT arms, 527 (90%) had r-ICRs, primarily using intensity-modulated radiotherapy (IMRT). Delineation review approved 417 (87%) r-ICRs and 44 (92%) p-ICRs. The main reasons for unacceptable delineation were erroneous clinical target volume (CTV) delineation. In dose and plan reviews, 399 (96%) r-ICRs cases and 46 (96%) p-ICRs were approved, with unacceptable cases primarily due to PTV dose distribution issues.</div></div><div><h3>Conclusion</h3><div>RTQA is crucial in prostate cancer trials, primarily for proper target volume delineation. It is recommended to omit r-ICRs due to resource demands and lack of impact on RTQA outcomes, using limited p-ICRs with early feedback for site deviations and reserving full p-ICRs for trails with new techniques or dose regimens.</div><div>ClinicalTrials.gov: NCT01957436.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"206 ","pages":"Article 110780"},"PeriodicalIF":4.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current advances in automation in radiotherapy","authors":"Jasper Nijkamp,&nbsp;Barbara Knäusl,&nbsp;Marianne Aznar,&nbsp;Dietmar Georg,&nbsp;Daniela Thorwarth,&nbsp;David Thwaites,&nbsp;Ludvig P. Muren,&nbsp;Uulke A. van der Heide","doi":"10.1016/j.radonc.2025.110779","DOIUrl":"10.1016/j.radonc.2025.110779","url":null,"abstract":"","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"205 ","pages":"Article 110779"},"PeriodicalIF":4.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383223","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}