Strahlentherapie und Onkologie最新文献

{"title":"Pentoxifylline and vitamin E for treating radiation-induced fibrosis in breast and head and neck cancer patients.","authors":"M Harpsø, C N Andreassen, B V Offersen","doi":"10.1007/s00066-025-02423-x","DOIUrl":"10.1007/s00066-025-02423-x","url":null,"abstract":"<p><strong>Purpose: </strong>The oncological treatment of breast (BC) and head and neck cancer (H&NC) patients often includes radiotherapy. One serious side effect of this treatment is radiation-induced fibrosis (RIF), for which no established treatment currently exists. Studies have shown a potential effect of pentoxifylline and vitamin E on RIF. In this retrospective analysis, we investigate the effect of pentoxifylline and vitamin E on RIF in a cohort of BC and H&NC patients.</p><p><strong>Methods: </strong>Consecutive BC and H&NC patients referred to the Department of Oncology, Aarhus University Hospital, Denmark, for treatment of severe and discomforting RIF during 2016-2023 were included. After initial evaluation, 61 patients-29 BC and 32 H&NC patients-started treatment with oral pentoxifylline 400 mg and vitamin E (290-350 mg) twice daily. In total, 54 patients-24 BC and 30 H&NC patients-were treated and finally evaluated. The endpoint was patient-reported and/or clinical treatment response.</p><p><strong>Results: </strong>Overall, 18 BC (75%) and 7 H&NC patients (23%) reported subjective improvement following treatment. A clinical treatment response with partial or complete regression of RIF was seen in all patients with subjective effect, except in one BC and one H&NC patient.</p><p><strong>Conclusion: </strong>Pentoxifylline and vitamin E might be an effective treatment for a selected group of patients with RIF. The therapeutic effect was more pronounced in BC patients compared to those with H&NC. Further randomized and blinded studies in larger populations are needed to validate the findings.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"1044-1048"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337013","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":"[Publisher Correction: Improved swallowing function after definitive radiochemotherapy for oropharyngeal and hypopharyngeal cancer by sparing of the pharyngeal constrictor muscles].","authors":"Alexander M Ziebolz","doi":"10.1007/s00066-025-02447-3","DOIUrl":"10.1007/s00066-025-02447-3","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"1121"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969607","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":"Tumor volume change at radiation boost planning to estimate the response to chemoradiotherapy in stage III unresectable NSCLC (TORCH): a multicenter retrospective observational study.","authors":"Simon Trommer, Jörg Andreas Müller, Michael Oertel, Felix Ehret, Siyer Roohani, Hai Minh Ha, Quynh Ngo Ha, Kathrin Hering, Franziska Nägler, Tim Lange, Matthias Mäurer, Thomas Weissmann, Florian Putz, Maike Trommer, Christian Baues, Sophie Dobiasch, Maria Waltenberger, Tomas Skripcak, Dirk Vordermark, Daniel Medenwald","doi":"10.1007/s00066-025-02374-3","DOIUrl":"10.1007/s00066-025-02374-3","url":null,"abstract":"<p><strong>Background: </strong>Progression-free (PFS) and overall survival (OS) in UICC stage III non-small cell lung cancer (NSCLC) after definitive concurrent chemoradiotherapy (CRT) can be increased with consolidating immunotherapy. Recent studies have shown a strong predictive value of gross tumor volume (GTV) changes during CRT on OS. The TORCH trial investigated the prognostic impact of GTV changes during CRT as a predictor for a response to immunotherapy.</p><p><strong>Methods: </strong>This retrospective non-interventional observational multicenter trial included n = 203 patients from 10 German university centers for radiation oncology with confirmed inoperable NSCLC in UICC stage III A-C. Patients had received CRT between 2015 and 2023 as a curative-intent treatment approach. Patient and tumor characteristics were collected anonymously via electronic case report forms. Initial GTVs before CRT (initial planning CT, GTV1) and at 40-50 Gy (re-planning CT for radiation boost, GTV2) were delineated. Absolute and relative GTV changes before/during CRT were correlated with OS to predict the response to CRT with sequential immunotherapy. Hazard ratios (HR) of survival analyses were estimated using adjusted Cox regression models.</p><p><strong>Results: </strong>The mean GTV1 before radiation therapy (RT) was 145.29 ml with the 25th, 50th, and 75th percentiles being 61.36 ml, 145.29 ml, and 204.93 ml, respectively. Before initiation of the radiation boost, the mean GTV2 was 99.58 ml, with the 25th, 50th, and 75th percentiles at 32.93 ml, 70.45 ml, and 126.85 ml. The HR for the impact of GTV1 on survival was 0.99 per ml (95% confidence interval [CI] 0.99-1.00; p = 0.49). For the absolute volume change between GTV1 and GTV2, the HR was 1.004 per ml (95% CI 0.997-1.011; p = 0.26). In a subgroup analysis of patients who were treated with durvalumab, absolute volume changes between GTV1 and GTV2 were associated with longer OS (HR = 0.955 per ml; 95% CI 0.916-0.996; p = 0.03). Overall, durvalumab treatment was positively associated with OS, demonstrating an HR of 0.454 (95% CI 0.209-0.990; p = 0.047).</p><p><strong>Conclusion: </strong>Pretreatment GTV and absolute GTV volume changes did not significantly correlate with OS. However, the absolute volume change between the pretreatment and replanning GTV was associated with longer OS in patients treated with durvalumab. Histological subtype, grading, UICC stage, age at onset, pulmonary comorbidities, and smoking status had no significant association with OS. Durvalumab treatment was associated with improved OS.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"1001-1013"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543292","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":"Head and neck squamous cell carcinoma in adults aged 45 or younger-an analysis of two tertiary cancer centres.","authors":"Charlotte Frei, Soeren Schnellhardt, Sabine Semrau, Sarina K Mueller, Manuel Weber, Justus Kaufmann, Rainer Fietkau, Sophia Drabke, Marlen Haderlein","doi":"10.1007/s00066-025-02448-2","DOIUrl":"10.1007/s00066-025-02448-2","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate the outcome, especially disease-free survival (DFS) and recurrence patterns, in patients with a maximum age of 45 years at first diagnosis of head and neck squamous cell carcinoma (HNSCC).</p><p><strong>Methods: </strong>We retrospectively reviewed data from 79 patients with newly diagnosed HNSCC aged 45 or younger without distant metastasis who underwent postoperative or definitive radio(chemo)therapy in either the Department of Radiation Oncology at the University Hospital of Erlangen or the Department of Radiation Oncology at the University Hospital of Mainz between September 2006 and December 2023. The Kaplan-Meier method was used to calculate survival and recurrence rates. In univariate analysis, the log-rank test was used to correlate patient-/tumour- and treatment-related parameters to survival and recurrence rates.</p><p><strong>Results: </strong>The overall survival rate was 79.7% at 2 years and 67.1% at 5 years. The DFS rate was 73.4% at 2 years and 67.1% at 5 years. Cumulatively, 14.6% of patients in the postoperative arm had locoregional recurrences at 2 years and 23.0% at 5 years, while 25.7% of patients in the definitive arm had local recurrences at 2 years and 33.1% at 5 years (p = 0.36). The rate of distant metastasis was 19.2% in the postoperative arm at 2 years and 21.6% at 5 years. In the definitive arm, the distant metastasis rate was 20.7% at 2 years and 28.6% at 5 years (p = 0.49). Disease-free survival was significantly improved in patients who drank little or no alcohol (p = 0.005) and in patients with a low UICC stage (p < 0.001). No differences in DFS were observed for different primary tumour locations or treatment modalities.</p><p><strong>Conclusion: </strong>Locoregional recurrences were the most common site of recurrence, regardless of tumour location and treatment modality. Therefore, future study designs in this patient cohort should potentially investigate intensified treatment approaches.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"1049-1057"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969657","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":"Definitive (chemo)radiotherapy of enteric-type adenocarcinoma of the lung: time to unmask an underrated treatment option?","authors":"Valentina Zagardo, Hector Jose Soto Parra, Gianluca Ferini","doi":"10.1007/s00066-025-02399-8","DOIUrl":"10.1007/s00066-025-02399-8","url":null,"abstract":"<p><strong>Background: </strong>Enteric-type adenocarcinoma of the lung (lung-ETAC) is an exceptionally rare variant of lung adenocarcinoma, often presenting diagnostic challenges due to its histological resemblance to colorectal adenocarcinoma. This rarity has hindered the development of standardized treatment protocols, with most management approaches being empirical. Radiotherapy is used infrequently for lung-ETAC, predominantly reserved for palliative care in metastatic cases. Recent studies, however, suggest that lung-ETAC may have a better prognosis than other lung cancer subtypes, thus raising the need to explore alternative therapeutic strategies, including radiotherapy.</p><p><strong>Case report: </strong>We present the case of a 73-year-old female with stage IIIA lung-ETAC who was treated with curative-intent radiotherapy (60 Gy in 30 fractions) in combination with platinum-based chemotherapy. Despite transient pulmonary complications, the patient exhibited an almost complete response to treatment after 2 months, achieving sustained clinical remission with no further antitumor therapies.</p><p><strong>Conclusion: </strong>This case underscores the potential role of high-dose radiotherapy as a curative treatment for locally advanced lung-ETAC. Given the limited evidence, further research is needed to better define the role of chemoradiotherapy in the management of this rare histological subtype.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"1014-1017"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812331","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":"28th Annual SASRO Meeting 2024.","authors":"","doi":"10.1007/s00066-025-02421-z","DOIUrl":"10.1007/s00066-025-02421-z","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"1086-1120"},"PeriodicalIF":2.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226781","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":"The role of preoperative stereotactic radiotherapy in the management of resectable brain metastases: A systematic review.","authors":"Sasha Benichou, Nicolas Giraud, Julien Engelhardt, Hélène Cebula, Julian Biau, Georges Noel, Philippe Giraud","doi":"10.1007/s00066-025-02475-z","DOIUrl":"https://doi.org/10.1007/s00066-025-02475-z","url":null,"abstract":"<p><strong>Objectives: </strong>This systematic review assessed the efficacy and safety of preoperative stereotactic radiotherapy (PreopSRT) in the treatment of resectable brain metastases (BM).</p><p><strong>Methods: </strong>A PRISMA systematic review was conducted using Web of Science, Scopus, and PubMed. The search terms included \"(brain or cerebral) and (metastasis or metastases) and (radiotherapy or radiosurgery or radiation) and (neoadjuvant or preoperative).\" Of the 2061 articles identified, 12 studies met the inclusion criteria: patients with resectable BM who received PreopSRT in single or multiple fractions. Literature reviews, protocols, and studies on salvage resections were excluded.</p><p><strong>Results: </strong>Local control at 6 months ranged from 81.8 to 100%, with over 95% control reported in 4 studies, reaching 100% in 3 series. At 12 months, local control ranged from 49.1 to 95%. Data for 24-month local control were available for only 3 studies, ranging from 73 to 97.1%. Multiple fractions appeared to be more effective. PreopSRT showed a rate of leptomeningeal recurrence between 0 and 17% and a rate of radionecrosis from 3.5 to 10.5% at 1 year.</p><p><strong>Conclusion: </strong>This PRISMA review highlights the growing interest in preoperative stereotactic radiotherapy, which appears at least as effective and potentially less toxic than postoperative treatment. Phase III trials are needed to confirm its clinical use.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150851","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":"Stereotactic radiosurgery for cerebral arteriovenous malformations : Evaluation of long-term outcomes in a single institute cohort.","authors":"Luis Mohr, Philipp Lishewski, Markus Schymalla, Kerem Tuna Tas, Edgar Smalec, Rita Engenhart-Cabillic, André Kemmling, Maximilian Schulze, Khaled Elsayad, Fabian Eberle, Christopher Nimsky, Hilke Vorwerk, Klemens Zink, Ahmed Gawish, Sebastian Adeberg","doi":"10.1007/s00066-025-02461-5","DOIUrl":"https://doi.org/10.1007/s00066-025-02461-5","url":null,"abstract":"<p><strong>Objective: </strong>The study we describe focuses on evaluating the effectiveness of linear accelerator (LINAC) stereotactic radiosurgery (SRS) in the treatment of cerebral arteriovenous malformations (AVMs). This treatment option is gaining interest due to the uncertainties associated with combined radiosurgical and endovascular treatments and the significant technological advancements in SRS. The primary goals of the study are to assess rates of obliteration (successful closure of the AVM) and rebleeding (the recurrence of bleeding posttreatment), as well as to identify factors influencing obliteration rates and to document any adverse effects associated with the procedure.</p><p><strong>Materials and methods: </strong>The study retrospectively analyzed data from 134 patients treated with LINAC-based SRS for cerebral AVMs. The patients were categorized based on their prior treatments: 50 had undergone partial embolization, 8 had received a combination of embolization and surgery and 1 patient had a surgical intervention. Furthermore, 75 patients had received no prior treatment. Kaplan-Meier survival analysis and log-rank tests were employed to calculate actuarial obliteration rates and annual cumulative bleeding rates following SRS treatment.</p><p><strong>Results: </strong>The study found that obliteration rates after SRS treatment increased over time, with 5‑year obliteration rates of 85.2% for grades I-II, 76.4% for grade III, and 62.1% for grades IV-V. Annual cumulative bleeding rates post-SRS were 1.5% for the first year and 0.7% for the second year. Interestingly, prior embolization did not affect the obliteration rate. The median time to obliteration was 36 months (range 7-162 months). Obliteration rates were significantly better in Spetzler-Martin (SM) grade I-II (85% at 5 years) compared to grade III-V (68% at 5 years, p = 0.01). Age, sex, and pediatric status had no statistically significant influence on AVM response to SRS. No radiation necrosis was observed in our cohort.</p><p><strong>Conclusion: </strong>This study contributes to the body of evidence supporting the effectiveness of SRS in treating cerebral AVMs and provides valuable insights into factors affecting treatment outcomes. The findings suggest that patients can expect a high chance of successful obliteration of the AVM with minimal adverse effects, making SRS a compelling option for those affected by this condition.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150847","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":"The impact of vitreous humor: a new perspective on radiation-induced cataractogenesis.","authors":"Ecem Yigit, Irem Koc, Gozde Yazici, Ekim Gumeler, Aysenur Elmali, Alper Kahvecioglu, Fazli Yagiz Yedekci, Samiye Yabanoglu Ciftci, Meltem Karatas, Aysima Sezer, Hayyam Kiratli, Mustafa Cengiz","doi":"10.1007/s00066-025-02468-y","DOIUrl":"https://doi.org/10.1007/s00066-025-02468-y","url":null,"abstract":"<p><strong>Purpose: </strong>The precise mechanisms underlying radiation-induced cataractogenesis remain incompletely understood. Increased oxidative stress is known to play a central role in cataract pathogenesis. The vitreous humor contributes to maintaining the hypoxic environment of the lens by regulating oxygen pressure and containing antioxidants. This study aims to explore the effect of radiation-induced changes in the vitreous humor on lens health, with a particular focus on its cataractogenic potential.</p><p><strong>Methods: </strong>In this experimental study, 12 New Zealand rabbits were utilized. A single 20-Gy dose of radiation was administered to the left eye's vitreous humor with a lens-sparing technique, while the right eye served as a control. Monthly ophthalmological evaluations were conducted over a 3-month period. At the end of the follow-up, orbital magnetic resonance imaging (MRI) was performed. Vitreous humor samples were analyzed using spectrophotometric methods to determine total oxidant and antioxidant levels.</p><p><strong>Results: </strong>Cataract formation was observed in two of the eight irradiated eyes (25%). The MRI analysis revealed a significant reduction in signal intensity within the left eye's aqueous humor in non-contrast sequences (p = 0.03), while an increase in signal intensity was observed in late post-contrast sequences (p = 0.04). Spectrophotometric analysis indicated that total oxidant levels (p = 0.04) and the oxidative stress index (p = 0.04) were significantly lower in the treatment group.</p><p><strong>Conclusion: </strong>These findings suggest that radiation-induced changes in the vitreous humor and posterior ocular structures may influence the anterior chamber, contributing to the development of radiation-induced cataracts.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131981","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":"Locally advanced breast cancer: primary ultra-hypofractionated radiotherapy for inoperable or frail patients.","authors":"Anne Caroline Knöchelmann, Roland Merten, Hans Christiansen, Elna Kuehnle, Daniela Meinecke","doi":"10.1007/s00066-025-02445-5","DOIUrl":"https://doi.org/10.1007/s00066-025-02445-5","url":null,"abstract":"<p><strong>Purpose: </strong>Locally advanced breast cancer in frail and inoperable patients often causes tumor-associated pain, bleeding, or discharge. These patients may not be suitable for therapeutic options like surgery or potentially toxic systemic treatment. Local radiotherapy with little impact on treatment time may be beneficial in this patient subgroup. We evaluated an ultra-hypofractionated definitive irradiation concept in five fractions (5 × 5 Gy with a simultaneous integrated boost of 5 × 6 Gy) for these patients, focusing on tolerability and clinical outcome.</p><p><strong>Methods: </strong>A total of 29 patients were retrospectively sampled. They were treated by irradiation to the breast with 25 Gy in five fractions with a simultaneous integrated boost (SIB) of 6 Gy per fraction. Tumor response and clinical outcome were evaluated by clinical examination.</p><p><strong>Results: </strong>In total, 27 patients with a median age of 82 years were assessed. Median follow-up was 7.4 months. All patients completed radiotherapy with 25 Gy in five fractions with a simultaneous integrated boost of 30 Gy (6 Gy per fraction) without any high-grade toxicity (≥ grade 2). Within the first 90 days after irradiation, 15 patients (56%) exhibited a clinical response and 12 showed stable disease. Only 7 patients reported low-grade acute dermatotoxicity grade 1 (CTCAE) within the first 90 days, and only one experienced toxicity later (fibrosis grade 1, LENT-SOMA).</p><p><strong>Conclusion: </strong>Radiotherapy in five consecutive daily fractions is sufficient. The studied regimen proved to be a safe, effective palliative treatment in inoperable and frail patients not suitable for surgery or toxic systemic therapy.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125965","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}