Strahlentherapie und Onkologie最新文献

{"title":"[Proton versus photon radiotherapy for patients with oropharyngeal cancer].","authors":"Alexander Rühle, Panagiotis Balermpas, Mechthild Krause, Marlen Haderlein, Sebastian Adeberg, Markus Hecht","doi":"10.1007/s00066-026-02531-2","DOIUrl":"10.1007/s00066-026-02531-2","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"799-801"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730255","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":"Long-term cosmetic outcome after intraoperative radiotherapy boost with low-energy X-rays in breast-conserving therapy: a pooled cohort analysis of the TARGIT-BQR and ROKSM trials.","authors":"Paulina Schimmelfennig, Christiane Reuter, Uta Kraus-Tiefenbacher, Viktoria Brück, Christina Kaiser, Ralf Keymer, Yasser Abo-Madyan, Katharina Fleckenstein, Benjamin Tuschy, Marc Sütterlin, Frederik Wenz, Hans Reichardt, Mathias Fehr, Markus Kuther, Sylvia Büttner, Elena Sperk","doi":"10.1007/s00066-026-02506-3","DOIUrl":"10.1007/s00066-026-02506-3","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates objective long-term cosmetic outcomes in patients with breast cancer after intraoperative radiotherapy applied as a boost (IORT boost) from a pooled international cohort.</p><p><strong>Methods: </strong>A pooled analysis of two prospective studies with IORT boost (low-energy X‑rays, 20 Gy; inclusion criteria: 3.5 cm maximum tumor size and preoperative indication for a boost according to local criteria) during breast-conserving surgery followed by whole-breast radiotherapy (46-50 Gy). The analysis included photos from a subgroup of the prospective phase IV TARGeted Intraoperative radioTherapy (TARGIT) Boost Quality Registry (BQR) study (NCT01440010) with a follow-up of up to 10 years as well as patients from a Swiss study (ROKSM; Spital Thurgau AG; NCT02114086) with a follow-up of 5 years. The pooled analysis included photos from both trials taken at the same timepoints (6 weeks, 6 months, 1 year, 2 years, and 5 years after completion of whole-breast radiotherapy). Cosmetic results were evaluated with the validated BCCT.core software (BCCT.core 2.0, INESC Porto, Portugal) to assess symmetry, color, and scars. A generalized estimating equation (GEE) regression model was used to compare the two cohorts over time.</p><p><strong>Results: </strong>The pooled analysis included 777 cosmetic assessments from 276 patients. Across all follow-ups in the pooled analysis, the majority of cosmetic results were rated as excellent or good (61.9%). Patients from TARGIT-BQR had significantly more excellent or good ratings than patients from ROKSM (p < 0.0001). The proportion of patients receiving \"excellent\" and \"good\" ratings remained higher in TARGIT-BQR than in ROKSM at every timepoint during follow-up. Overall, for up to 10 years, the majority of ratings in the whole cohort were \"excellent\" or \"good.\"</p><p><strong>Conclusion: </strong>In this international pooled analysis, the cosmetic outcome after IORT boost followed by whole-breast irradiation shows a good esthetic long-term outcome. Further studies should explore factors that influence cosmetic outcomes and consider additional treatment-related parameters.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"785-795"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107270","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":"Ethical considerations of prospective data collection for stereotactic arrhythmia radioablation (STAR): an overview from the STOPSTORM.eu consortium.","authors":"Chiara Crico, Oliver Blanck, Marcin Miszczyk, Melanie Grehn, Stefano Mandija, Luis Schiappacasse, Jakub Cvek, Tomasz Jadczyk, Steen Buus Kristiansen, Manuel Algara López, Gaetano Maria De Ferrari, Pieter G Postema, Martin F Fast, Etienne Pruvot, Joost J C Verhoeff, Nicolaus Andratschke, Slawomir Blamek, Marta Perin, Ludovica De Panfilis","doi":"10.1007/s00066-025-02480-2","DOIUrl":"10.1007/s00066-025-02480-2","url":null,"abstract":"<p><strong>Background: </strong>Ventricular tachycardia (VT) is a life-threatening condition, and standard treatments are not suitable for many affected patients. Stereotactic arrhythmia radioablation (STAR) has emerged as a promising experimental last-resort treatment for patients with refractory VT, but it lacks clinical standardization. To address this issue, the STOPSTORM.eu consortium aims to collect data on patients treated with STAR via the development of a multicentric patient registry. The Ethics & Regulations Working Group (ERG) provides support addressing ethical and regulatory challenges.</p><p><strong>Methods: </strong>The ERG conducted a survey to assess how prospective data on STAR are collected at the partner centres and to explore potential ethical concerns. Responses were analysed to evaluate clinical trial approval processes, adherence to STOPSTORM guidelines, and emerging ethical issues.</p><p><strong>Results: </strong>Among the 28 partners, there were 13 interventional clinical trials-ongoing or concluded-across seven countries; centres without ongoing trials enrolled patients under compassionate use. Most trials were single arm, with few exceptions (a randomized trial and dose escalation studies). Most ethics committees approved STAR trials without major objections, but regulatory inconsistencies were observed, resulting in approval denial or delay. Ethical concerns included potential therapeutic misconception among patients, autonomy issues due to the vulnerability of VT patients, and inequities in access to STAR. The heterogeneity in trial designs, endpoints, and follow-up strategies among participating centres posed challenges for data standardization, but using a registry to collect data from multiple local clinical trials offers an innovative approach to overcoming logistical and financial barriers in research on rare diseases.</p><p><strong>Conclusion: </strong>Multicentric non-pharmaceutical trials on STAR may present ethical, regulatory, and organizational challenges. The open registry model facilitates large-scale data collection and supports future protocol standardization. However, greater intercentre collaboration and regulatory harmonization are needed to optimize STAR's integration into clinical practice while upholding ethical standards in patient care and research.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"734-743"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401948","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":"Evidence-based supportive care for patients undergoing radiotherapy: Recommendations from the updated German national S3 guideline for oncological patients.","authors":"Cas Stefaan Dejonckheere, Jürgen Heide, Jiadai Zou, Frank Zimmermann, Leonard Christopher Schmeel, Ulrike Höller, Lukas Käsmann","doi":"10.1007/s00066-026-02532-1","DOIUrl":"10.1007/s00066-026-02532-1","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"708-712"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700242","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":"[Local therapy for metastases in colorectal cancer with multiorgan metastases: no benefit from maximal tumor debulking].","authors":"Jürgen Dunst","doi":"10.1007/s00066-026-02530-3","DOIUrl":"10.1007/s00066-026-02530-3","url":null,"abstract":"","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"796-798"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781692","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":"Interactions and communications in the glioblastoma microenvironment: potential targets for chemo-/radiotherapy.","authors":"Qamar Abuhassan, Hamzeh J Al-Ameer, Subbulakshmi Ganesan, Priya Priyadarshini Nayak, V Ramesh Kumar, Vipasha Sharma, Ashish Singh Chauhan, Nargiza Goyibova","doi":"10.1007/s00066-026-02525-0","DOIUrl":"10.1007/s00066-026-02525-0","url":null,"abstract":"<p><p>Glioblastoma therapy remains constrained by a highly interactive tumor microenvironment (TME) that stimulates invasion, resistance, and immune suppression. The glioblastoma TME comprises malignant astrocytic and stem-like tumor cells, resident microglia, infiltrating immune cells, endothelial cells, and a modified extracellular matrix (ECM) that together establish an immunosuppressive tumor stroma. Communication among these elements proceeds through cytokines, chemokines, growth factors, extracellular vesicles, metabolic exchange, and direct cell-matrix contacts. These interactions modulate DNA damage responses (DDRs); remodel immune responses by immunosuppressive and antitumor immune cells; alter the activity of stromal cells; and change angiogenesis, metastasis, and cell survival pathways-which in turn induce resistance to chemo-/radiotherapy. Chemotherapy and radiotherapy induce acute and chronic changes in the TME, including the recruitment of immunosuppressive cells, upregulation of survival signaling in perivascular niches, vascular remodeling, and hypoxia/metabolism rewiring that diminishes the efficacy of chemo-/radiotherapy. Preclinical and early clinical interventions show that targeting cells and their secretions in the TME can be suggested for reprogramming the glioblastoma TME and the subsequent resistance to chemo-/radiotherapy. The focus of this review is to provide mechanistic evidence linking TME communication networks to chemo-/radiotherapy resistance. Strategies that target these interactions to identify translational pathways for combination therapies are reviewed.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"760-784"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781695","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":"Delta radiomics for predicting early radiation-induced lung injury after thoracic radiotherapy: a retrospective paired-CT study.","authors":"Nuo Zheng, Xiqing Li, Yuyin Le, Xiaolong Lin, Tingxiong Xiao, Haidun Chen, Nila Wang, Libin Liu","doi":"10.1007/s00066-026-02562-9","DOIUrl":"10.1007/s00066-026-02562-9","url":null,"abstract":"<p><strong>Purpose: </strong>Early radiation-induced lung injury remains a clinically relevant complication after thoracic radiotherapy. We compared pretreatment, posttreatment, delta radiomics, and combined models based on paired CT scans for early prediction of lung injury.</p><p><strong>Methods: </strong>This retrospective study included 82 patients with paired CT scans acquired before and after thoracic radiotherapy. The cohort was divided into a training set (n = 57) and an independent test set (n = 25). The endpoint was grade 1 or higher radiation-induced lung injury within 3 months after radiotherapy according to Common Terminology Criteria for Adverse Events Version 5.0 (CTCAE V5.0). Delta radiomics features were defined as posttreatment minus pretreatment values. Five signatures were constructed: clinical, pre, post, delta, and combined. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration analysis, DeLong testing, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Only nodal (N) classification remained significant in multivariable analysis (OR 1.189, 95% CI 1.044-1.354, P = 0.030). In the test cohort, the post signature outperformed the pre signature (AUC 0.844 vs. 0.681). The delta signature achieved the best performance among the radiomics-only models, with a test AUC of 0.882, accuracy of 0.840, sensitivity of 0.889, and specificity of 0.812. The combined signature achieved the highest overall test AUC at 0.889, but the gain over the delta model was limited.</p><p><strong>Conclusion: </strong>Posttreatment and delta radiomics outperformed pretreatment radiomics for predicting early radiation-induced lung injury after thoracic radiotherapy. The temporal imaging change captured by paired CT may provide the most informative signal for early risk stratification.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318997","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":"Cardiac substructure dosimetry in thoracic radiotherapy: moving beyond mean heart dose and toward precision cardiac risk mitigation.","authors":"Ahmed Sohaib, Mohamed T Amin, Mohamed Alhefny","doi":"10.1007/s00066-026-02561-w","DOIUrl":"https://doi.org/10.1007/s00066-026-02561-w","url":null,"abstract":"<p><strong>Background: </strong>Radiation-induced heart disease (RIHD) remains a clinically significant consequence of thoracic radiotherapy (RT). Historically, the mean heart dose (MHD) has served as the primary metric for cardiac risk estimation. However, accumulating evidence demonstrates that MHD inadequately captures the heterogeneous dose distribution across functionally distinct cardiac substructures and poorly predicts specific cardiovascular endpoints.</p><p><strong>Objective: </strong>This narrative review synthesizes recent evidence (2013-2025) on the transition from whole-heart dosimetry to substructure-level dose-volume analysis in thoracic RT, encompassing dose-response relationships for specific cardiac substructures, advances in artificial intelligence (AI)-driven auto-segmentation, modern cardiac-sparing delivery techniques, biomarker-guided surveillance, pharmacologic cardioprotection, and normal tissue complication probability (NTCP) modeling.</p><p><strong>Methods: </strong>A structured literature search was conducted across PubMed, Scopus, and Web of Science databases (January 2013-March 2025) using predefined search terms. Studies reporting cardiac substructure dose-response relationships, auto-segmentation performance, cardiac-sparing techniques, biomarkers, pharmacologic interventions, and NTCP models were included.</p><p><strong>Results: </strong>Substructure-specific dose metrics-particularly dose to the left anterior descending artery (LAD), heart base, left ventricle (LV), and cardiac conduction system-predict coronary events, arrhythmias, and overall survival with substantially greater accuracy than MHD. Deep learning auto-segmentation now achieves ≥ 94% clinical acceptability for cardiac chambers, enabling routine substructure-based planning. Deep inspiration breath hold (DIBH) reduces heart and LAD doses by 36-42%, and proton beam therapy (PBT) offers superior cardiac sparing across all tumor sites, though randomized cardiac outcome data remain pending. Statins demonstrate a compelling retrospective cardioprotective signal (up to 66% reduction in major adverse cardiac events), but prospective validation is lacking. The 2022 European Society of Cardiology (ESC) cardio-oncology guidelines and the 2024 American Radium Society (ARS) appropriate use criteria provide the current clinical framework.</p><p><strong>Conclusion: </strong>The paradigm shift from MHD to substructure-level cardiac dosimetry represents a transformative advance in thoracic RT. Integration of AI-driven segmentation, advanced delivery techniques, biomarker surveillance, and pharmacologic cardioprotection into routine clinical workflows is essential for precision cardiac risk mitigation in irradiated patients.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309513","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":"Successful palliative hypofractionated radiotherapy with superficial hyperthermia for heavily pretreated cutaneous breast cancer lesions.","authors":"D M V de Vries-Huizing, A Holtmaat, M W Kolff, J Crezee","doi":"10.1007/s00066-026-02536-x","DOIUrl":"https://doi.org/10.1007/s00066-026-02536-x","url":null,"abstract":"<p><strong>Background: </strong>Hypofractionated radiotherapy has been successfully shown to reduce pain and skin lesion bleeding. In previously irradiated areas, the effect of hypofractionated radiotherapy (weekly 4 Gy radiotherapy to a total dose of 20 Gy) can be enhanced by hyperthermia: increasing temperatures in target areas up to 43 °C. Superficial hyperthermia in combination with radiotherapy is a proven and widely applied treatment for recurrent breast cancer and malignant melanoma. Literature on the use of radiotherapy to cause hemostasis of the skin is available; however, the role of hyperthermia in combination with radiotherapy for this indication is not yet described.</p><p><strong>Short communication: </strong>We present a 72-year old woman with a history of breast cancer with painful and bleeding cutaneous metastases in the right upper arm and right breast which had a large impact on her quality of life. The metastases progressed under T‑deruxtecan treatment, and she was referred for re-irradiation to control the bleeding skin. Hyperthermia was added as a tumor-selective radiosensitizer to the radiotherapy fractions to enhance irradiation. The main treatment goal was to reduce bleeding and itching of the cutaneous lesions. The patient was treated once a week with hyperthermia immediately followed by 4 Gy radiotherapy fractions for 5 consecutive weeks. Bleeding was already decreased during the treatment series and the skin healed within 4 weeks after therapy.</p><p><strong>Conclusion: </strong>Treatment with 5 × 4 Gy radiotherapy combined with hyperthermia sessions was a successful palliative therapy for bleeding cutaneous metastases. The treatment schedule was well-tolerated and the skin fully recovered within 1 month.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296235","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":"Significant aggravation of pre-existing myalgic encephalomyelitis/chronic fatigue syndrome following proton beam therapy for sphenoid wing meningioma: case report.","authors":"Christian Fischer, Annekatrin Seidlitz, Mechthild Krause","doi":"10.1007/s00066-026-02553-w","DOIUrl":"https://doi.org/10.1007/s00066-026-02553-w","url":null,"abstract":"<p><strong>Background: </strong>Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating multisystem disorder characterized by profound fatigue, post-exertional malaise (PEM), immune dysregulation, and mitochondrial dysfunction. While radiation exposure has been linked to fatigue syndromes with overlapping pathophysiology, no previous reports have described the effects of therapeutic radiation, including proton beam radiotherapy (PBRT), in patients with ME/CFS.</p><p><strong>Case presentation: </strong>We report the case of a 46-year-old woman with a pre-existing, clinically confirmed diagnosis of ME/CFS (Bell score 60, ECOG 1), who underwent postoperative PBRT (50.4 Gy in 28 fractions) for a recurrent left sphenoid wing meningioma (CNS WHO grade 1). The tumor had been surgically resected but showed residual disease with early postoperative progression and close proximity to the left optic nerve, prompting the indication for adjuvant radiotherapy. The patient initially tolerated treatment well, with only mild acute worsening of pre-existing fatigue and transient corticosteroid-responsive symptoms. However, within weeks of completing radiotherapy, she developed progressive and severe worsening of fatigue, myalgia, vertigo, and hypersensitivity to sensory stimuli as well as cognitive decline. Over several months, she became completely bedridden (Bell score 0, ECOG 4) with persistent ME/CFS aggravation unresponsive to supportive measures persisting until the last known contact 20 months after radiation. Follow-up imaging showed stable postoperative findings without tumor progression or new structural brain lesions.</p><p><strong>Discussion: </strong>This case illustrates a profound and irreversible deterioration of ME/CFS following PBRT, suggesting that radiation-induced mitochondrial dysfunction, oxidative stress, and chronic inflammatory activation may critically worsen pre-existing metabolic fragility. Despite the theoretical advantages of proton radiotherapy in reducing normal tissue exposure, its protective effects may be insufficient in patients with baseline mitochondrial malfunction.</p><p><strong>Conclusion: </strong>This is, to our knowledge, the first reported case of severe and sustained ME/CFS exacerbation after radiotherapy. The case emphasizes the urgent need for risk stratification, tailored consent processes, and research in the field of radiotherapy tolerance in ME/CFS patients, as conventional expectations regarding side effects may not predict outcomes in this vulnerable population.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228571","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}