Practical Radiation Oncology最新文献

{"title":"Evaluation of the European Society of Medical Oncology-Magnitude of Clinical Benefit Scale Version 1.1 for the Treatment of Extracranial Oligometastatic Non-Small Cell Lung Cancer With Radiosurgery.","authors":"James B Yu, Benjamin W Corn, Summer S Qureshi, Vikram Jairam, Lucy M Yu, Praveen Pendyala, Adeel Riaz, Ronald D Ennis, Eli Sapir","doi":"10.1016/j.prro.2025.07.008","DOIUrl":"10.1016/j.prro.2025.07.008","url":null,"abstract":"<p><strong>Purpose: </strong>The European Society of Medical Oncology (ESMO) magnitude of clinical benefit scale (MCBS) version 1.1 is an evaluation scale that was developed to evaluate the MCBS reported in clinical research studies of cancer treatments. The American Society for Radiation Oncology (ASTRO) and the European Society for Radiotherapy and Oncology (ESTRO) created joint guidelines for the use of local therapy in the management of extracranial oligometastatic non-small cell lung cancer (NSCLC). We applied the ESMO-MCBS v.1.1 to evaluate the clinical benefit reported in studies that informed the ASTRO/ESTRO guidelines.</p><p><strong>Methods and materials: </strong>We applied the ESMO-MCBS v1.1 to the 23 studies identified by the ASTRO/ESTRO taskforce. As well, we evaluated the recently published Consolidative Use of Radiotherapy to Block Oligoprogression study and Stereotactic Radiotherapy for Oligo-Progressive Metastatic Cancer Trial, for a total of 25 studies evaluated. All evaluated studies were graded by at least 3 of the authors. Any discrepancies were subsequently reviewed by the scoring authors.</p><p><strong>Results: </strong>The addition of stereotactic body radiation therapy to all sites of oligometastatic disease in combination with standard-of-care chemotherapy was associated with substantial improvements in survival. These studies resulted in a score of 4 using form 2a (noncurative treatment with overall survival from standard therapy between 12 and 24 months). Of the 10 prospective single-arm studies, 9 received a score of 3 using form 3, due to progression-free survival exceeding 6 months. No studies received a score of 5 (highest clinical benefit).</p><p><strong>Conclusions: </strong>The use of local radiation in the treatment of extracranial oligometastatic NSCLC is associated with a substantial clinical benefit, according to the ESMO-MCBS v1.1. Radiation therapy was comparable to established and groundbreaking targeted therapies such as pembrolizumab in combination with pemetrexed for epidermal growth factor receptor and anaplastic lymphoma kinase-negative NSCLC, and osimertinib for epidermal growth factor receptor-mutated NSCLC. MCBS would be even higher if quality-of-life improvements are found in future trials.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978505","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":"Quantitative Evaluation of AI-based Organ Segmentation Across Multiple Anatomical Sites Using Eight Commercial Software Platforms.","authors":"Lulin Yuan, Quan Chen, Hania Al-Hallaq, Jinzhong Yang, Xiaofeng Yang, Huaizhi Geng, Kujtim Latifi, Bin Cai, Qingrong Jackie Wu, Ying Xiao, Stanley H Benedict, Yi Rong, Jeff Buchsbaum, X Sharon Qi","doi":"10.1016/j.prro.2025.06.012","DOIUrl":"10.1016/j.prro.2025.06.012","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate organs-at-risk (OARs) segmentation variability across eight commercial AI-based segmentation software using independent multi-institutional datasets, and to provide recommendations for clinical practices utilizing AI-segmentation.</p><p><strong>Methods: </strong>160 planning CT image sets from four anatomical sites: head-and-neck, thorax, abdomen and pelvis were retrospectively pooled from three institutions. Contours for 31 OARs generated by the software were compared to clinical contours using multiple accuracy metrics, including: Dice similarity coefficient (DSC), 95 Percentile of Hausdorff distance (HD95), surface DSC, as well as relative added path length (RAPL) as an efficiency metric. A two-factor analysis of variance was used to quantify variability in contouring accuracy across software platforms (inter-software) and patients (inter-patient). Pairwise comparisons were performed to categorize the software into different performance groups, and inter-software variations (ISV) were calculated as the average performance differences between the groups.</p><p><strong>Results: </strong>Significant inter-software and inter-patient contouring accuracy variations (p<0.05) were observed for most OARs. The largest ISV in DSC in each anatomical region were cervical esophagus (0.41), trachea (0.10), spinal cord (0.13) and prostate (0.17). Among the organs evaluated, 7 had mean DSC >0.9 (i.e., heart, liver), 15 had DSC ranging from 0.7 to 0.89 (i.e., parotid, esophagus). The remaining organs (i.e., optic nerves, seminal vesicle) had DSC<0.7. 16 of the 31 organs (52%) had RAPL less than 0.1.</p><p><strong>Conclusion: </strong>Our results reveal significant inter-software and inter-patient variability in the performance of AI-segmentation software. These findings highlight the need of thorough software commissioning, testing, and quality assurance across disease sites, patient-specific anatomies and image acquisition protocols.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978495","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":"Liver metastases treated with MRI-guided SBRT: Outcomes of tolerability, acute toxicity and quality of life from the MOMENTUM study.","authors":"Md J E Peltenburg, R Westley, L A Daamen, R Tissier, K L Aitken, U Bernchou, S Boeke, P M Braam, A Hosni, M P W Intven, T Janssen, J-J Sonke, M W Straza, W A Hall, M E Nowee","doi":"10.1016/j.prro.2025.07.006","DOIUrl":"https://doi.org/10.1016/j.prro.2025.07.006","url":null,"abstract":"<p><strong>Purpose/objective(s): </strong>Stereotactic body radiation therapy (SBRT) is a local treatment option for liver metastases. The introduction of Magnetic Resonance Imaging (MRI)-guided SBRT has paved the way for optimal treatment outcomes by improved tumor visualization, daily plan adaptation and margin reduction. The purpose of this study is to review tolerability of MRI-guided liver SBRT and to present early toxicity and quality of life (QoL) outcomes from a prospective multicenter registry.</p><p><strong>Materials/methods: </strong>All patients enrolled in MOMENTUM study (NCT04075305) who were treated for liver metastases between April 2019-April 2023 on a 1.5T MR-Linac were included. Descriptive statistics were used to present tolerability of treatment, acute toxicity (CTCAEv5.0) and QoL (QLQ-C30 and EQ-5D-5L) at baseline and three months after treatment.</p><p><strong>Results: </strong>135 patients (median age 67 years, range 31-93) were treated in seven institutes across four countries. The most common primary tumor origins were colorectal-(50%) and lung cancer(12%). Prescribed total SBRT doses ranged from 20.0-67.5 Gy, delivered in 2-12 fractions of 7-22.5 Gy per fraction (median BED 180Gy (range 59.5-540Gy). 97% of patients (n=131) completed their treatment and there were no interruptions due to poor tolerability. Up to three months, fourteen grade three toxicities were reported in twelve patients(10.6%), with only one(0.9%) recorded as radiotherapy related (gastritis). No grade≥4 toxicities were reported. 62 and 63 patients completed the QLQ-C30 and EQ-5D-5L questionnaires at both time points respectively. These showed a worsening of 5-10 points at three months for role functioning, nausea, fatigue, constipation and pain.</p><p><strong>Conclusion: </strong>In this prospective cohort, 97% of treatments were well tolerated and completed successfully with only one acute grade three radiotherapy-related toxicity and no grade≥4 toxicity reported. QoL outcomes showed clinically relevant worsening (defined as ≥5points) in five domains, which is comparable to CT-guided SBRT. Overall, outcomes showed that MRI-guided SBRT is well-tolerated and a safe treatment for patients with liver metastases.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978481","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":"Radiation-Induced Acute Lung Pneumonitis After Pencil-Beam Scanning Proton Treatment for Breast Cancer: Correlation With Dose-Volume Parameters and Optimization Objectives to Reduce Lung Toxicities.","authors":"Jiyeon Park, Julie A Bradley, Nancy P Mendenhall, Raymond B Mailhot Vega, Teena Burchianti, Yawei Zhang, Hardev Grewal, Mohammad Saki, Twyla Willoughby, Perry B Johnson, Mark Artz","doi":"10.1016/j.prro.2025.07.005","DOIUrl":"10.1016/j.prro.2025.07.005","url":null,"abstract":"<p><p>Proton treatment using pencil-beam scanning (PBS) for patients with breast cancer offers advantages in achieving a conformal dose distribution while also reducing the cardiac dose. However, when employing 2 anterior fields to mitigate the effects of respiratory motion on dose delivery, managing the ipsilateral lung doses becomes critical due to the high linear-energy transfer (LET) at the distal end of the beams. Although the incidence of radiation pneumonitis (RP) after breast radiation therapy is relatively low, it is essential to address the cases that develop RP following proton treatment to minimize lung toxicity. We conducted a retrospective case study analyzing follow-up computed tomography images taken at 1 week, 1.5 months, and 4.5 months after the onset of the patient's pneumonitis symptoms to correlate them with proton doses. The patient's PBS treatment was prescribed at a dose of 50 Gy with an additional 10 Gy boost, using a relative biological effectiveness (RBE) of 1.1, delivered in 2 Gy daily fractions. Our histogram analysis revealed noticeable increases in Hounsfield units at a dose of 40 Gy (RBE = 1.1), underscoring a potential dose-volume parameter that could help minimize the occurrence of RP. Furthermore, the lung volume associated with the RP was encompassed with an iso-LET level greater than 5.0 keV/μm, with a proton dose exceeding 40 Gy (RBE = 1.1). In examining the LET-dependent RBE-weighted dose using the McNamara model in the original treatment plan, we found the volumes receiving more than 50 Gy (V_50Gy) and 40 Gy (V_40Gy) were 110 cc and 267 cc, respectively. By incorporating dose objectives of V_50Gy and V_40Gy to limit the ipsilateral lung volume into PBS plans, the volumes were successfully reduced to 0 cc and 3 cc, while maintaining target dose coverage and robustness. Optimizing a breast PBS plan (RBE = 1.1) using objectives that addressed both the V_50Gy and V_40Gy to minimize lung exposure was shown to be clinically feasible and should be considered as a strategy to reduce lung toxicity when treating breast cancer with PBS proton therapy.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978463","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":"Current Status of Proton Craniospinal Irradiation for Solid Tumor Leptomeningeal Disease.","authors":"Omer Gal, Jonathan T Yang, Rupesh Kotecha","doi":"10.1016/j.prro.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.prro.2025.06.010","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769306","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":"Celiac Plexus Radiosurgery for the Management of Pancreatic Cancer Pain: Key Tips and Considerations.","authors":"Aisling M Glynn, Teo Stanescu, Joanna Javor, Laura A Dawson, Yaacov R Lawrence, Michael Yan","doi":"10.1016/j.prro.2025.07.004","DOIUrl":"10.1016/j.prro.2025.07.004","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755112","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":"Volumetric Changes and Acute Toxicity With ⁶⁸Ga Prostate-Specific Membrane Antigen Versus ¹⁸F-Fluciclovine Positron Emission Tomography/Computer Tomography Guided Postprostatectomy Radiation: Final Analysis of a Randomized Trial.","authors":"Vishal R Dhere, David M Schuster, Subir Goyal, Eduard Schreibmann, Nikhil T Sebastian, Sagar A Patel, Sheela Hanasoge, Joseph W Shelton, Pretesh R Patel, Bruce W Hershatter, Olayinka A Abiodun-Ojo, Ismaheel O Lawal, Ashesh B Jani","doi":"10.1016/j.prro.2025.07.003","DOIUrl":"10.1016/j.prro.2025.07.003","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated changes in radiation therapy target volume and acute toxicity using ⁶⁸Ga-prostate specific membrane antigen (PSMA) versus ¹⁸F-fluciclovine positron emission tomography (PET)/computed tomography in postprostatectomy patients with biochemical recurrence. We hypothesized that both fluciclovine and PSMA-guided radiation therapy would (1) significantly change pre-PET radiation therapy volumes and (2) show similar toxicity.</p><p><strong>Methods and materials: </strong>We performed an institutional review board-approved, randomized trial comparing fluciclovine (Arm 1) and PSMA (Arm 2)-guided postprostatectomy radiation therapy in patients with detectable prostate-specific antigen after prostatectomy. Treatment volumes were rigidly defined based on PET, and simultaneous integrated boosts to PET uptake in the prostate bed (70.2-76.0 Gy) or pelvis (54.0-56.0 Gy) were allowed. Clinical target volumes (CTVs) included: prostate bed (CTV_PB); pelvic lymph nodes (CTV_PLV); and volumetric constraints for bladder(-CTV) and rectum. Acute genitourinary and gastrointestinal (GI) toxicity (per Common Terminology Criteria for Adverse Events v5.0) was assessed <90 days from treatment.</p><p><strong>Results: </strong>In total, 140 patients were enrolled with 70 randomized to each arm; 11 Arm 1 and 10 Arm 2 patients did not receive radiation on study and were excluded. Fluciclovine and PSMA incorporation increased both CTV_PB and CTV_PLV (P < .01). More fluciclovine patients received prostate bed boosts (45 of 59 patients vs 26 of 60 patients; P < .01), but there was no difference in proportion receiving pelvic nodal boosts (10 of 15 patients vs 9of 16 patients, fluciclovine vs PSMA; P = .97). Dose constraints were met for most patients. Rates of grade 2 genitourinary (17.0% vs 6.7%, fluciclovine vs PSMA; P = .15) and GI (5.1% vs 1.7%, fluciclovine vs PSMA; P = .47) toxicity were low, with no grade 3+ events. Higher rectal and bladder dose metrics correlated with GI toxicity (P < .05), but use of simultaneous integrated boosts was not associated with acute toxicity.</p><p><strong>Conclusions: </strong>Although both PSMA and fluciclovine use modestly increased target volumes, significantly more fluciclovine patients received prostate bed boosts. Planning directives were met for most patients, and acute toxicity was mild in both Arms. Analysis of biochemical control, late toxicity, and patient-reported outcomes are forthcoming.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755113","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":"A Case of Hydrogel Spacer Intravasation of the Internal Iliac Vein and Associated Thrombus Formation During Preparation for Prostate Cancer External Beam Radiation Therapy.","authors":"Jacob Eckstein, Mina S Makary, Spero R Cataland, Rebekah Young, Russel Palm, Dayssy A Diaz Pardo, Therese Andraos, Doug Martin, Shang Jui Wang","doi":"10.1016/j.prro.2025.07.001","DOIUrl":"10.1016/j.prro.2025.07.001","url":null,"abstract":"<p><p>Use of rectal spacer gel has been associated with decreased risk of radiation therapy (RT)-related rectal toxicity in clinical trials and has been increasingly adopted. Optimal management of spacer-related toxicities, such as rectal wall and vascular infiltration, remains poorly defined. To address this gap, we present a case of extensive hydrogel intravasation of the periprostatic venous plexus with development of associated bland thrombus extending to the level of the common iliac vein. The patient was evaluated for placement of an inferior vena cava (IVC) filter and anticoagulation by a multidisciplinary team. After undergoing 6 months of anticoagulation without IVC filter placement, both the hydrogel and the associated thrombus resolved asymptomatically. We review the timeline of these events, their associated symptomatology, our rationale in management of this clinical scenario, and propose a treatment paradigm.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638680","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 Body Radiation Therapy for the Treatment of Adrenal Metastases - A Case-Based Radiosurgery Society Practice Guide and Review.","authors":"Felix Ehret, Daniel K Ebner, Tugce Kutuk, Aria Shakeri, Sabi Shrestha, Karin A Skalina, Fatemeh Fekrmandi, Simon S Lo, John L Gore, Rupesh Kotecha, Percy Lee, Ben J Slotman, Christoph Fürweger, Alexander Muacevic, Shankar Siva, Krishna Reddy","doi":"10.1016/j.prro.2025.06.011","DOIUrl":"10.1016/j.prro.2025.06.011","url":null,"abstract":"<p><strong>Purpose: </strong>Adrenal metastases are frequently diagnosed in patients with common solid tumors. Surgical adrenalectomy has historically been used for their management. However, stereotactic body radiation therapy (SBRT) has emerged as a safe and effective alternative. Careful treatment planning is essential, considering multiple factors such as tumor size and location, motion management, dose and fractionation, and proximity to adjacent organs at risk. This case-based practice guide and review provides an overview of SBRT for the management of adrenal tumors, with a particular focus on adrenal metastases.</p><p><strong>Methods and materials: </strong>Three clinical scenarios were selected to illustrate the use of SBRT in managing adrenal tumors. These include a small right-sided metastasis treated with single-fraction, fiducial-based SBRT, a large left-sided metastasis treated with fractionated SBRT under magnetic resonance imaging guidance, and a case of bilateral metastases, which emphasizes the potential risk of adrenal insufficiency. We also address the limited evidence available regarding the management of primary adrenal gland tumors with SBRT.</p><p><strong>Results: </strong>SBRT is an effective treatment modality for most adrenal tumors, demonstrating a favorable safety profile. Thoughtful treatment planning and an understanding of potential pitfalls, limitations, and risks are essential to ensure the appropriate use of SBRT.</p><p><strong>Conclusions: </strong>This case-based guide and review provides a comprehensive overview of SBRT for treating adrenal tumors, specifically metastases. We present and discuss clinical cases and relevant literature, highlighting key considerations specific to adrenal SBRT.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638694","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":"Postoperative Stereotactic Radiosurgery for Resected Brain Metastases: Targeting of the Surgical Tract.","authors":"Charlotte I Rivers, Michael D Mix, Kyle Wang, William Godwin, Istvan Takacs, Bhisham Chera","doi":"10.1016/j.prro.2025.02.012","DOIUrl":"https://doi.org/10.1016/j.prro.2025.02.012","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602243","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}