Supportive Care in Cancer最新文献

{"title":"Photobiomodulation for the treatment and prevention of chemotherapy- and/or radiotherapy-induced oral mucositis in cancer patients: a systematic review and meta-analysis of randomized clinical trials published in the last six years.","authors":"Rojas G, Escalante-Parra R, Duarte A, Terán-Ángel G, Moreno-Garces P, Silveira Fm, Sanchez-Ramirez C","doi":"10.1007/s00520-026-10729-4","DOIUrl":"https://doi.org/10.1007/s00520-026-10729-4","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically evaluate and update the evidence about photobiomodulation therapy (PBMT) as a therapy for the prevention and/or treatment of oral mucositis (OM) induced by antineoplastic therapies.</p><p><strong>Methods: </strong>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic literature search was conducted across PubMed, Web of Science, Scopus, and Embase as the primary databases. Additional searches were performed in the Virtual Health Library (VHL) and LILACS through the BIREME platform, as well as in Redalyc and the Wiley Online Library, covering the period from 2020 to 2026. Only randomized clinical trials published within the last six years investigating PBMT as a preventive or therapeutic intervention for oral mucositis (OM) in cancer patients receiving chemotherapy and/or radiotherapy were included.</p><p><strong>Results: </strong>Seven studies comprising 329 patients were included. PBMT proved to be highly effective in the management of OM (RR 0.50, 95% CI 0.35-0.73). Moderate heterogeneity was observed across studies (I² = 40%). PBMT protocols varied, with laser wavelengths ranging from 635 to 980 nm, most commonly 660 nm for intraoral (IO) application. Application sites included IO and/or extraoral (EO) approaches, with IO application times ranging from 3 to 20 s. OM was consistently assessed using World Health Organization (WHO) criteria across all studies. The included trials demonstrated a low risk of bias and publication bias.</p><p><strong>Conclusion: </strong>Evidence from recent randomized clinical trials confirms that PBMT is highly effective for the management of oral mucositis, reducing its incidence and severity, improving quality of life and treatment adherence, and potentially lowering healthcare costs during cancer therapy.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"34 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843101","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":"Serum neurofilament light chain (sNFL) as a predictive biomarker for Chemotherapy-induced peripheral neurotoxicity (CIPN): consideration of current evidence, validation steps, and barriers to CIPN biomarker implementation in clinical practice-a narrative review.","authors":"Paola Alberti, Sara Faithfull, Andreas A Argyriou, David Balayssac, Daniel L Hertz, Maryam Lustberg, Susanna B Park, Tiffany Li, Mary Tanay, Terri Jabaley, Lise Worthen-Chaudhari, Ellen M L Smith","doi":"10.1007/s00520-026-10690-2","DOIUrl":"10.1007/s00520-026-10690-2","url":null,"abstract":"<p><strong>Purpose: </strong>Several anticancer drugs can cause chemotherapy-induced peripheral neurotoxicity (CIPN) in approximately 70% of patients; of these, 30% continue to have chronic symptoms hampering quality of life. As more people live with and beyond cancer therapy, it is becoming increasingly important for clinicians to assess those at higher risk of CIPN and provide care for managing CIPN severity. Biomarkers could be appropriate in this regard. However, an initial step towards biomarker-informed care is to advance scientific knowledge regarding the potential of current biomarkers such as neurofilament light chain (NfL). Here, outcomes of a CIPN biomarker workshop and discussions among clinical and scientific experts held during the MASCC 2024 annual conference are reported. The aims of this work are to (1) identify knowledge gaps regarding the potential for serum NfL (sNfL) as a predictive CIPN biomarker, (2) provide guidance for future biomarker research, and (3) explore whether sNfL is ready for use in clinical practice.</p><p><strong>Methods: </strong>Consensus of the experts was gained using a Normative Group Technique. A two-stage iterative approach was used: Stage 1 involved a literature review and an in-person workshop; Stage 2 involved a virtual zoom event to confirm understanding and priorities following the workshop.</p><p><strong>Results: </strong>Eleven studies identified that increases in serum NfL after receiving 2-3 chemotherapy doses are associated with CIPN severity post treatment. Despite preliminary evidence suggesting positive correlations among sNfL and CIPN objective and subjective measures, wide variation in sNfL levels, the prescribed neurotoxic chemotherapy agent, dose and schedule, and symptom assessment time points make it difficult to use sNfL as a predictor of CIPN severity.</p><p><strong>Conclusions: </strong>While there is potential for sNfL to be a useful biomarker, larger scale research exploring the predictive value is needed before sNfL can be used to inform clinical decision-making. Identifying links with validated clinical assessments could be utilized to enhance biomarker accuracy and to address the multiple pathological mechanisms of neurotoxicity that occur from the differing chemotherapies. Moreover, workshop participants identified significant barriers to biomarker implementation (e.g. costs, long processing time, and unknown cut off points).</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"34 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843146","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":"Critique on \"Restrictive versus standard hyperhydration during high-dose cyclophosphamide for hematopoietic stem cell transplantation: a retrospective cohort study\".","authors":"Zubaida Bibi, Kausar Ali","doi":"10.1007/s00520-026-10770-3","DOIUrl":"https://doi.org/10.1007/s00520-026-10770-3","url":null,"abstract":"","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"34 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843118","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":"Impact of novel systemic cancer therapies on osseointegration and dental implant outcomes: a systematic review.","authors":"Gunjan Chouksey, Kritika Singhal, Neha Arya, Arpana Parihar, Amit Agrawal","doi":"10.1007/s00520-026-10731-w","DOIUrl":"https://doi.org/10.1007/s00520-026-10731-w","url":null,"abstract":"<p><strong>Purpose: </strong>Advances in systemic cancer therapies such as immune checkpoint inhibitors (ICIs), tyrosine kinase inhibitors (TKIs), and anti-angiogenic agents have markedly improved survival in patients with solid and hematologic malignancies. As survivorship increases, oral rehabilitation with dental implants is increasingly sought to restore quality of life. However, these therapies may adversely affect bone healing, angiogenesis, and immune regulation, raising concerns regarding implant-related complications. This systematic review aimed to evaluate reported dental implant outcomes and complications in patients receiving novel systemic cancer therapies, emphasizing the implications for supportive oncology.</p><p><strong>Methods: </strong>This review was conducted according to PRISMA 2020 guidelines and registered in PROSPERO (CRD420251142681). PubMed/MEDLINE, Scopus, ScienceDirect, and the Cochrane Library were searched for English-language clinical reports describing dental implant outcomes in patients treated with ICIs, TKIs, or anti-angiogenic agents. Study selection, data extraction, and quality appraisal using the Joanna Briggs Institute checklist for case reports were performed independently by two reviewers.</p><p><strong>Results: </strong>Seven case reports (2017-2024) were included, representing Level IV evidence. Two cases involving TKIs reported successful osseointegration and long-term survival. In contrast, five cases described adverse outcomes including early failure and MRONJ predominantly associated with anti-angiogenic agents, either alone or in combination with ICIs and antiresorptive agents. These complications often resulted in significant functional morbidity and the need for invasive surgical intervention.</p><p><strong>Conclusion: </strong>Based on limited case report evidence, anti-angiogenic therapies were more frequently observed in cases with adverse outcomes, including implant-related MRONJ and failure, while TKIs were associated with favorable outcomes in limited cases. The role of ICIs remains unclear due to sparse data, particularly regarding monotherapy effects. Given the preliminary nature of current evidence derived from case reports, prospective studies with appropriate control groups are urgently needed to establish evidence-based guidelines.</p><p><strong>Prospero number and date of registration: </strong>CRD420251142681; 08/09/2025.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"34 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843103","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":"Influence of socioeconomic status on physical and psychological wellbeing during the cancer care continuum: a longitudinal and logistic regression analysis of cancer patients in New Delhi, India.","authors":"Ishaan Rahman, Mevhibe Hocaoglu","doi":"10.1007/s00520-026-10734-7","DOIUrl":"10.1007/s00520-026-10734-7","url":null,"abstract":"<p><p>This study examined the influence of socioeconomic status (SES) on physical, psychological, and wellbeing symptom burden among palliative cancer patients in New Delhi, India, to identify manifestations of inequity across the cancer care continuum. A secondary analysis of a prospective cohort dataset of 240 cancer patients receiving palliative care was conducted. Participants completed a baseline survey (T1); 120 were followed up after 1 month (T2). Symptom burden was measured using Likert scales for physical, psychological, and wellbeing outcomes. Chi-square tests assessed associations between SES and symptom severity. Ordinal logistic regressions examined the predictive effects of education, income, and slum residence, adjusting for age, sex, and cancer stage. Low education and financial insecurity were associated with higher symptom burden. At T1, patients with no formal education reported more severe weakness than those with tertiary education (OR = 2.84, 95% CI 1.25-6.42, p = 0.012). Not coping on income was associated with greater weakness (OR = 2.67, 95% CI 1.48-4.82, p = 0.001) and depression (OR = 1.94, 95% CI 1.10-3.40, p = 0.021). At T2, this was also associated with more pain (OR = 2.44, 95% CI 1.02-5.81, p = 0.044) and feeling less informed (OR = 2.58, 95% CI 1.03-6.44, p = 0.043). Slum residence was associated with higher odds of depression (OR = 0.25, 95% CI 0.09-0.70, p = 0.008). SES strongly shaped symptom burden, with low-income, less-educated, and slum-resident patients disproportionately affected. Findings highlight the need for cancer care strategies integrating financial protection, patient education, and mental health services to mitigate inequities in LMICs.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"34 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843058","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":"Large fiber contribution to symptoms in chemotherapy-induced peripheral neuropathy in cancer survivors.","authors":"Jon D Levine, Bruce A Cooper, Gary Abrams, Carolyn Harris, Steven M Paul, Yvette P Conley, Marilyn J Hammer, Christine Miaskowski","doi":"10.1007/s00520-026-10736-5","DOIUrl":"https://doi.org/10.1007/s00520-026-10736-5","url":null,"abstract":"<p><strong>Purpose: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) is associated with a large amount of interindividual variability in signs and symptoms. The purposes were to use latent profile analysis to identify subgroups of survivors with distinct lower extremity (LE) loss-of-function CIPN profiles; evaluate for differences in demographic, clinical, and pain characteristics between the profiles and characteristics associated with membership in the more severe profile; and examine relationships between the profiles and measures of large fiber loss and C-tactile fiber function.</p><p><strong>Methods: </strong>LE loss-of-function CIPN profiles were created using measures of worst pain, loss of light touch sensation, loss of cold sensation, loss of pain sensation, vibration threshold, and two balance measures.</p><p><strong>Results: </strong>Of the 405 survivors evaluated, two distinct profiles were identified: less severe loss of LE function (76.5%) and more severe loss of LE function (23.5%). Risk factors for membership in the more severe profile included being older, male, and having lower functional status. In terms of the loss of large fiber function, survivors in the more severe class had four more sites on average that lost light touch sensation; their vibration thresholds were 1.5 times higher; and their ratings of numbness were significantly higher. For C-tactile fiber function, significant between-group differences were found in survivors' ratings of the severity of sensitive skin and unpleasantness.</p><p><strong>Conclusions: </strong>Findings suggest that distinct \"CIPN phenotypes\" can be identified in cancer survivors. Detailed phenotyping and molecular characterization of various CIPN phenotypes will lead to the development and testing of targeted and personalized interventions.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"34 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843138","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":"Post-diagnosis unemployment and access to work-related health benefits in survivors of brain cancer compared to other cancers.","authors":"John Dempsey, Alexandra Balshi, Adam Jiadi, Harish Babu","doi":"10.1007/s00520-026-10740-9","DOIUrl":"https://doi.org/10.1007/s00520-026-10740-9","url":null,"abstract":"<p><strong>Purpose: </strong>Brain cancer diagnoses often disrupt patient function, well-being, and financial stability, but population-level economic outcomes remain underexplored. Our aim was to determine if survivors of brain cancer face greater odds of post-diagnosis unemployment and lower odds of working full-time, benefit-providing jobs following diagnosis compared to survivors of other cancers.</p><p><strong>Methods: </strong>We analyzed pooled 2019-2023 National Health Interview Survey data of adults who reported a cancer diagnosis ≥ 1 year prior to survey completion. Weighted logistic regressions evaluated the association between cancer type and post-diagnosis unemployment and work-related health benefits, adjusting for age, disability (physical, sensory, and cognitive), and social drivers of health.</p><p><strong>Results: </strong>The cohort represented 22.9 million US adult survivors of cancer, including 198,961 with brain cancer. People with a diagnosis of brain cancer faced higher odds of post-diagnosis unemployment compared to other cancer types, adjusting for age, disability, and social drivers of health (OR 2.54, 95% CI 1.12, 5.77). In addition, employed survivors of brain cancer were less likely to work full-time (OR 0.26, 95% CI 0.09, 0.74) or have jobs offering health insurance (OR 0.37, 95% CI 0.15, 0.96) or paid sick leave (OR 0.40, 95% CI 0.17, 0.96).</p><p><strong>Conclusion: </strong>These findings reveal markedly higher socioeconomic vulnerability for survivors of brain cancer compared to those with other cancer types.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"34 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843136","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 potential of bee products in clinical trials focused on the side effects of radiotherapy and chemotherapy used for cancer treatment.","authors":"Shaden A M Khalifa, Aida A Abd El-Wahed, Aamer Saeed, Maria Daglia, Haged H El-Seedi, Zhengxuan Wang, Hussein Sabit, Hongcheng Zhang, Zhiming Guo, Paolo Coghi, Hesham R El-Seedi","doi":"10.1007/s00520-026-10707-w","DOIUrl":"https://doi.org/10.1007/s00520-026-10707-w","url":null,"abstract":"<p><strong>Purpose: </strong>Cancer is a major global issue threatening the whole world, especially developing countries. Treatment of cancer using chemotherapy and radiotherapy has several consequences that negatively affect the quality of life of cancer patients.</p><p><strong>Methods: </strong>Bee products have numerous pharmacological effects and clinical impacts due to their extraordinary chemical composition. The objective of the current work is to shed light on preclinical studies and clinical trials of bee products, particularly propolis, honey, and royal jelly, with special emphasis on their role in reducing the complications of chemotherapy and radiotherapy by employing a variety of databases. The search used specific keywords, including \"bee products\", \"propolis\", \"honey\", \"royal jelly\", \"cancer\", \"clinical trials\", \"radiotherapy\", and \"chemotherapy\". Only peer-reviewed randomized controlled trials (RCTs) and published research papers were included.</p><p><strong>Results: </strong>According to the literature review, bee-generated propolis, honey, and royal jelly have been used in animal models to reduce the adverse effects of radiotherapy and chemotherapy. Depending on the kind of cancer, different dosages and treatment times were used for certain bee products. Bee products are used in various forms, such as crude, in capsules, mouthwashes, tablets, and oils. Propolis, royal jelly, and honey are used at dosages up to 400 mg, 1 g, and 50 g, respectively. Clinical trials have further confirmed their efficacy in cancer treatment, either as standalone therapies or as supplements to conventional treatments.</p><p><strong>Conclusion: </strong>It is crucial to investigate the active mechanisms of these products further and to include them in additional clinical trials as potential cancer treatments.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"34 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842729","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":"Expanding perspectives on informed decision-making in pancreatic cancer.","authors":"Galip Can Uyar, Enes Yeşilbaş, Kadriye Başkurt, Orhun Akdoğan, Osman Sütcüoğlu","doi":"10.1007/s00520-026-10762-3","DOIUrl":"https://doi.org/10.1007/s00520-026-10762-3","url":null,"abstract":"","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"34 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843061","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":"Spirituality and religiosity in cancer care: A targeted review of the NCCN distress thermometer and implications for holistic screening.","authors":"Jessica Benfer, Tendai Chihuri, Bellinda L King-Kallimanis, Karen Tripp","doi":"10.1007/s00520-026-10750-7","DOIUrl":"https://doi.org/10.1007/s00520-026-10750-7","url":null,"abstract":"<p><strong>Purpose: </strong>Spiritual and religious concerns are an integral yet often overlooked component of distress in cancer care. The National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) includes a \"spiritual/religious concerns\" item on its Problem List, but little is known about how this item is used or how it informs clinical care.</p><p><strong>Methods: </strong>This targeted review examined how spiritual distress is identified and addressed using the DT in oncology settings. A PubMed search yielded 44 articles; six met inclusion criteria. Most studies were cross-sectional, conducted outside the United States, and varied widely in design, populations, and measurement tools.</p><p><strong>Results: </strong>Findings suggest that spiritual/religious concerns are endorsed by a meaningful subset of patients-especially during active treatment or at critical points such as diagnosis or recurrence-and often coincide with high distress scores. However, prevalence rates varied significantly (5%-60%), and few studies evaluated whether positive screens led to referrals or meaningful spiritual support. Only two studies used validated measures of spiritual well-being alongside the DT, and some findings-such as unexpectedly strong correlations between spiritual well-being and anxiety/depression-warrant further investigation.</p><p><strong>Conclusion: </strong>Despite its inclusion in a widely used screening tool, the spiritual/religious concerns item remains underutilized and poorly understood. This review identifies major gaps in understanding when and how spiritual concerns arise, what influences their reporting, and how needs are addressed in practice. In the United States, where the DT is routinely collected, these gaps present a clear opportunity for targeted research and implementation efforts to improve holistic, values-aligned cancer care through better spiritual support integration.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"34 6","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843048","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}