Strahlentherapie und Onkologie最新文献

{"title":"Initial needle tracking with the first standalone combined infrared camera - CT system for brachytherapy-analysis of tracking accuracy and uncertainties.","authors":"Andre Karius, Lisa Marie Leifeld, Vratislav Strnad, Claudia Schweizer, Rainer Fietkau, Christoph Bert","doi":"10.1007/s00066-024-02253-3","DOIUrl":"10.1007/s00066-024-02253-3","url":null,"abstract":"<p><strong>Purpose: </strong>A prototype infrared camera - cone-beam computed tomography (CBCT) system for tracking in brachytherapy has recently been developed. We evaluated for the first time the corresponding tracking accuracy and uncertainties, and implemented a tracking-based prediction of needles on CBCT scans.</p><p><strong>Methods: </strong>A marker tool rigidly attached to needles was 3D printed. The precision and accuracy of tool tracking was then evaluated for both static and dynamic scenarios. Euclidean distances between the tracked and CBCT-derived markers were assessed as well. To implement needle tracking, ground truth models of the tool attached to 200 mm and 160 mm needles were matched to the tracked positions in order to project the needles into CBCT scans. Deviations between projected and actual needle tips were measured. Finally, we put our results into perspective with simulations of the system's tracking uncertainties.</p><p><strong>Results: </strong>For the stationary scenario and dynamic movements, we achieved tool-tracking precision and accuracy of 0.04 ± 0.06 mm and 0.16 ± 0.18 mm, respectively. The tracked marker positions differed by 0.52 ± 0.18 mm from the positions determined via CBCT. In addition, the predicted needle tips in air deviated from the actual tip positions by only 1.62 ± 0.68 mm (200 mm needle) and 1.49 ± 0.62 mm (160 mm needle). The simulated tracking uncertainties resulted in tip variations of 1.58 ± 0.91 mm and 1.31 ± 0.69 mm for the 200 mm and 160 mm needles, respectively.</p><p><strong>Conclusion: </strong>With the innovative system it was possible to achieve a high tracking and prediction accuracy of marker tool and needles. The system shows high potential for applicator tracking in brachytherapy.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"163-172"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535323","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":"[Longterm outcome of definitive radiotherapy using IMRT vs. 3D-CRT in locally advanced, inoperable non-small cell lung cancer (NSCLC)].","authors":"Karim El-Marouk, Lukas Käsmann","doi":"10.1007/s00066-024-02327-2","DOIUrl":"10.1007/s00066-024-02327-2","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"198-200"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639688","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":"Navigating through recent evidence on locoregional breast cancer radiotherapy: an initiative by the scientific association of Swiss radiation oncology.","authors":"Pelagia G Tsoutsou, Anna-Lena Eberhardt, Günther Gruber, Guido Henke, Wendy Jeannerret-Sozzi, Claudia Linsenmeier, Kristina Lössl, Maria-Carla Valli, Walter P Weber, Kathrin Zaugg, Khalil Zaman, Daniel Zwahlen","doi":"10.1007/s00066-024-02332-5","DOIUrl":"10.1007/s00066-024-02332-5","url":null,"abstract":"<p><strong>Purpose: </strong>Breast cancer (BC) is the most prevalent cancer in women and radiotherapy (RT) is an integral part of its treatment. High-level evidence guides clinical decisions, but given the abundance of guidelines, a need to navigate within the evidence has been identified by the board of the Scientific Association of Swiss Radiation Oncology (SASRO). A pilot project was initiated aiming to create an overview of recent clinically relevant evidence for BC RT, to make it easily available to (radiation) oncologists and radiation oncologists in training.</p><p><strong>Methods: </strong>A panel of 10 radiation oncology experts for BC RT, one expert in BC surgery, and one expert in BC medical oncology critically reviewed the relevant literature. The panel comprehensively represented different geographical regions of Switzerland as well as university, cantonal, and private institutions. We sought to create a consensual overview of the most relevant questions in BC RT today, accompanied by the most recent and relevant available evidence.</p><p><strong>Results: </strong>From January 2023 to January 2024, the panel met four times to review and work on an initial draft. The final draft was reviewed and accepted by all panelists. We hereby publish this work to make it available to international audiences. After publication, the work will be made available to all SASRO members on the SASRO website. This work is to be updated every 2 years.</p><p><strong>Conclusion: </strong>The identified need was addressed with a successful pilot project and will be further expanded upon in other tumor pathologies.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"93-105"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792115","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":"Irradiation alters extracellular vesicle microRNA load in the serum of patients with leukaemia.","authors":"Stephanie Hehlgans, Denise Eckert, Daniel Martin, Katalin Lumniczky, Gesine Bug, Claus Rödel, Franz Rödel","doi":"10.1007/s00066-024-02307-6","DOIUrl":"10.1007/s00066-024-02307-6","url":null,"abstract":"<p><strong>Purpose: </strong>Recent data suggest an impact of extracellular vesicles (EVs) and their micro(mi)RNA cargo on cell-cell interactions to contribute to pathophysiology of leukaemia and radiation response. Here, we investigated differential miRNA cargo of EVs from serum derived from patients with leukaemia (n = 11) before and after total body irradiation with 2 × 2 Gy as compared to healthy donors (n = 6).</p><p><strong>Methods: </strong>RNA was isolated from EVs and subjected to next generation sequencing of miRNAs. Analysis of sequencing data was performed with miRDeep29 software and differentially expressed miRNAs were filtered using R package edgeR10,11. Signaling pathways were identified using Kyoto Encyclopedia of Genes and Genomes database (KEGG) pathway analysis.</p><p><strong>Results: </strong>Flow cytometric and Western blot analyses confirmed the presence of characteristic EV markers TSG-101, CD‑9 and CD-81. miRNA sequencing revealed a differential cargo in serum of patients with leukaemia in comparison to healthy donors with 23 significantly upregulated and 16 downregulated miRNAs affecting hedgehog, estrogen, glutathione metabolism and peroxisome proliferator-activated receptor (PPAR) signaling pathways amongst others. Whole body irradiation of patients with leukaemia significantly increased 11 miRNAs, involved in cell cycle regulation and platinum drug resistance, and decreased 15 miRNAs, contributing to apoptosis or cytokine-receptor interactions.</p><p><strong>Conclusion: </strong>As compared to healthy controls and following irradiation, we have identified differentially regulated miRNAs in serum-derived EVs from patients with leukaemia that may serve as possible biomarkers of leukaemic disease and treatment and radiation exposure.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"173-184"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11754379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142354139","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":"Multidisciplinary treatment is necessary in glioblastoma with extracerebral metastases.","authors":"Niklas B Pepper, David R Steike, Heidi Yppärilä-Wolters, Michael Müther, Dorothee Wiewrodt, Hendrik Berssenbrügge, Oliver Grauer, Philipp Lenz, Walter Stummer, Hans T Eich","doi":"10.1007/s00066-024-02359-8","DOIUrl":"https://doi.org/10.1007/s00066-024-02359-8","url":null,"abstract":"<p><strong>Purpose: </strong>While glioblastoma is the most common malignant brain tumor in adults, extracerebral manifestations are very rare in this highly aggressive disease with poor prognosis.</p><p><strong>Methods: </strong>We conducted a systematic literature review in the PubMed database and complemented the data by inclusion of a case treated in our clinic. In this context, we report on a 60-year-old woman with a right frontal glioblastoma, IDH wildtype, MGMT methylated.</p><p><strong>Results: </strong>Six months after initial diagnosis and primary treatment, there was extensive local intracranial progression with additional extension into the subcutaneous and frontotemporal cranial bones. Despite continuation of multimodal treatment, further extracerebral manifestations occurred 11 months after the initial diagnosis, both in the cranial bone as well as metastases in the right parotid gland, cervical lymph nodes, and lungs. While local radiotherapy enabled the cerebral lesions to be controlled, the patient's clinical condition deteriorated rapidly despite simultaneous systemic therapy. The treatment had to be discontinued, and the patient died 5 weeks after confirmation of the multilocal extracerebral manifestations and a total of 12 months after initial diagnosis.</p><p><strong>Conclusion: </strong>Extracerebral manifestations of glioblastoma require close collaboration and joint decision-making with the patient, with an emphasis on palliative strategies.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024788","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":"MR-linac: role of artificial intelligence and automation.","authors":"Serena Psoroulas, Alina Paunoiu, Stefanie Corradini, Juliane Hörner-Rieber, Stephanie Tanadini-Lang","doi":"10.1007/s00066-024-02358-9","DOIUrl":"https://doi.org/10.1007/s00066-024-02358-9","url":null,"abstract":"<p><p>The integration of artificial intelligence (AI) into radiotherapy has advanced significantly during the past 5 years, especially in terms of automating key processes like organ at risk delineation and treatment planning. These innovations have enhanced consistency, accuracy, and efficiency in clinical practice. Magnetic resonance (MR)-guided linear accelerators (MR-linacs) have greatly improved treatment accuracy and real-time plan adaptation, particularly for tumors near radiosensitive organs. Despite these improvements, MR-guided radiotherapy (MRgRT) remains labor intensive and time consuming, highlighting the need for AI to streamline workflows and support rapid decision-making. Synthetic CTs from MR images and automated contouring and treatment planning will reduce manual processes, thus optimizing treatment times and expanding access to MR-linac technology. AI-driven quality assurance will ensure patient safety by predicting machine errors and validating treatment delivery. Advances in intrafractional motion management will increase the accuracy of treatment, and the integration of imaging biomarkers for outcome prediction and early toxicity assessment will enable more precise and effective treatment strategies.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024786","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":"Digital redesign of the radiotherapy course for medical students with a blended learning approach.","authors":"Anne Caroline Knöchelmann, Jan-Niklas Becker, Gerald Stiller, Diana Steinmann, Marianne Behrends","doi":"10.1007/s00066-024-02348-x","DOIUrl":"https://doi.org/10.1007/s00066-024-02348-x","url":null,"abstract":"<p><strong>Purpose: </strong>Due to the need for high-quality teaching, we present a new blended learning concept combining digital modules, interactive seminars, and clinical experience. Furthermore, we evaluated its acceptance among students.</p><p><strong>Methods: </strong>A new concept for teaching was applied to the radiotherapy module and made available via the Hannover Medical School (MHH) learning management system as part of a blended learning concept with educational films, multimedia learning modules, online seminars, and onsite practical training. The evaluation recorded assessments of the requirement profile, design, and opportunities for skills acquisition; evaluation of the seminar and internship; and questions on the overall assessment.</p><p><strong>Results: </strong>The new concept was applied to four passes in the fourth academic year. A total of 152 students completed the radio-oncology learning module, which was evaluated by 46 students. Forty students considered the course duration to be appropriate for the material covered, and most students stated that their prior knowledge had been sufficient. The level of difficulty of the content was rated by the students as somewhat too high. The design of the digital course, the opportunity to acquire skills, the seminar course, and the practical course were mostly rated positively.</p><p><strong>Conclusion: </strong>Through digital redesign, a teaching concept can be implemented that combines self-determined learning, professional exchange with doctors, and clinical practice experience. The concept can be transferred to other areas because it combines theoretical knowledge transfer with synchronous teaching and clinical experience. The results of the evaluation show that the students rated the new concept well.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011763","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":"Analysis of radiation oncology integration within general practitioners' daily patient care: a cross-sectional survey in Germany.","authors":"Sophia M Leiss, Helen X Hou, Steffi Pigorsch, Kai Borm, Jan Peeken, Antonius Schneider, Stephanie Combs, Andreas Dinkel, Denise Bernhardt","doi":"10.1007/s00066-024-02352-1","DOIUrl":"https://doi.org/10.1007/s00066-024-02352-1","url":null,"abstract":"<p><strong>Purpose: </strong>General practitioners (GPs) play a crucial role in providing interdisciplinary care for radiation oncology patients. This study aims to understand the specific needs and challenges faced by general practitioners in Germany when treating oncology patients.</p><p><strong>Methods: </strong>A comprehensive web-based questionnaire with 24 items was disseminated to GPs in Germany via email using survio.com. The survey collected data on demographics, qualifications, clinical experiences, decision-making involvement, and symptom recognition. It specifically examined post-radiotherapy care and the use of specialized palliative homecare networks (SAPV). Statistical analyses were descriptive. The survey was open from July 4 to August 9, 2023.</p><p><strong>Results: </strong>A notable majority of general practitioners displayed confidence in their understanding of cancer-related symptoms, with over half (54.6%) rating their knowledge with 4 out of 5. This level of self-assessed expertise extended to their capacity to address the needs of cancer patients (53.8%), although 67% express a need for further education in specifically radiotherapeutic side effects. Satisfaction with SAPV networks was high, and 72.3% of respondents were actively involved in palliative care, compared to only 45.6% in managing radiation therapy. Notable challenges included inadequate communication with specialists, insufficient staffing, and under-recognition of GPs' roles in oncology care.</p><p><strong>Conclusion: </strong>The study highlights a paradox where GPs show high engagement in palliative care but limited involvement in radiation therapy management due to communication gaps and professional development needs. Addressing these disparities through targeted initiatives and fostering a collaborative care model is essential to amplify the important role of GPs, ensuring more integrated and effective patient care.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011758","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":"PET/CT-based target volume definition in involved-site radiotherapy for treatment of early-stage nodal follicular lymphoma.","authors":"Antje Wark, Ji-Young Kim, Elena Mavriopoulou, Christian la Fougère, Thomas Wiegel, Christian W Scholz, Christian Baues, Minglun Li, Thomas Gauler, Stephanie E Combs, Klaus Herfarth","doi":"10.1007/s00066-024-02356-x","DOIUrl":"https://doi.org/10.1007/s00066-024-02356-x","url":null,"abstract":"<p><strong>Purpose: </strong>Recent advancements in imaging, particularly 18F-fluorodeoxyglucose positron-emission tomography-computed tomography (FDG-PET/CT), have improved the detection of involved lymph nodes, thus influencing staging accuracy and potentially treatment outcomes. This study is a post hoc analysis of the GAZAI trial data to evaluate the impact of FDG-PET/CT versus computed tomography (CT) alone on radiation target volumes for involved-site radiotherapy (IS-RT) in early-stage follicular lymphoma (FL).</p><p><strong>Methods: </strong>All patients in the GAZAI trial underwent pretherapeutic FDG-PET/CT examinations, which were subject to central quality control. Lymph nodes with pathological metabolism were assessed for CT morphology. Differential regional involvement and the impact on radiation target volume for IS-RT were compared between PET/CT-based to solely CT-based staging.</p><p><strong>Results: </strong>In 54 patients with PET-positive lymph nodes after initial surgery, 170 involved lymph nodes were identified in total. FDG-PET/CT identified additionally involved lymph nodes not detected by CT in 61% of the patients, leading to a significant change in radiation treatment fields for 30% of the cohort. Only 58% of all involved lymph nodes exhibited pathological CT morphology. The findings were robust across different Deauville score thresholds and CT morphological metrics.</p><p><strong>Conclusion: </strong>The findings confirm the essential role of FDG-PET/CT in accurately defining the radiation volume for treatment of early-stage follicular lymphomas with radiotherapy. These results support the integration of FDG-PET/CT into the standard diagnostic pathway and its inclusion in the service catalogue of statutory health insurance, emphasizing its importance for optimal treatment planning and the potential impact on patient outcomes.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979871","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":"Radiotherapy combined with chemoimmunotherapy improves survival compared to chemoimmunotherapy alone as first-line treatment for oligometastatic esophageal squamous cell carcinoma.","authors":"Xiaoyan Lv, Shuai Wang, Wencheng Zhang, Qingsong Pang, Qiang Lin, Yajing Wu, Zhouguang Hui, Yueping Liu, Yunjie Cheng, Qing Liu, Jun Wang","doi":"10.1007/s00066-024-02347-y","DOIUrl":"https://doi.org/10.1007/s00066-024-02347-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety and efficacy of radiotherapy combined with chemoimmunotherapy (RCIT) versus chemoimmunotherapy (CIT) alone as first-line treatment for oligometastatic esophageal squamous cell carcinoma (OESCC) at initial diagnosis.</p><p><strong>Methods: </strong>We retrospectively evaluated 140 patients newly diagnosed with OESCC who received RCIT or CIT as first-line treatment between June 2018 and December 2021. Among them, 76 patients were in the RCIT cohort and 64 patients in the CIT cohort. Propensity score matching (PSM) was used to simulate random allocation.</p><p><strong>Results: </strong>After 1:1 PSM, 61 well-paired patients were selected. The median follow-up duration was 34.7 months (95%CI: 30.6-38.8 months). After PSM, the median PFS for the RCIT and CIT groups was 10.9 (95%CI: 9.4-12.4) months and 7.3 (95%CI: 6.0-8.7) months, respectively (P = 0.004). The median OS for the RCIT and CIT groups was 22.4 (95%CI: 17.5-27.4) months and 13.4 (95%CI: 10.9-15.9) months, respectively (P = 0.031). There were significant differences in PFS (median PFS: 12.9 vs. 8.6 vs. 7.3 months, P = 0.003) between the group receiving radiotherapy (RT) for all lesions, the group receiving RT for partial lesions, and the CIT group, while OS was on the threshold of significance (median OS: 29.4 vs. 17.3 vs. 13.4 months, P = 0.052). No significant differences in the incidence of grade 3 or higher (G3+) treatment-related adverse events (TRAEs) were observed between the two groups. However, the incidence of G3+ pneumonitis (13.1% vs 1.6%, P = 0.038) were higher in the RCIT group compared to the CIT group.</p><p><strong>Conclusion: </strong>RCIT as first-line treatment for OESCC was safe and efficacious. RCIT improved PFS/OS compared to CIT without increasing the overall high grade toxicity rate. However, the increased incidence of pneumonitis due to RT implementation cannot be disregarded.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979879","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}