Radiation oncology journal最新文献

{"title":"Feasibility and safety study of ultra-hypofractionated neoadjuvant radiotherapy to margins-at-risk in retroperitoneal sarcoma.","authors":"Ru-Xin Wong, Valerie Shi Wen Yang, Clarame Shulyn Chia, Wen Shen Looi, Wen Long Nei, Chin-Ann Johnny Ong","doi":"10.3857/roj.2024.00297","DOIUrl":"https://doi.org/10.3857/roj.2024.00297","url":null,"abstract":"<p><strong>Purpose: </strong>Retroperitoneal sarcomas (RPS) are rare tumors that present unique challenges, often due to late presentation, and the proximity of critical organs makes complete surgical resection challenging. This study aimed to assess the feasibility of neoadjuvant short-course radiotherapy (SCRT) targeting margins-at-risk and to assess its potential impact on outcomes.</p><p><strong>Materials and methods: </strong>This is a single-center, prospective, non-randomized feasibility study. SCRT was administered via image-guided volumetric modulated arc therapy, consisting of 5 fractions of daily radiotherapy followed by immediate surgery. As a starting dose, patients were prescribed 25 Gy in 5 fractions. For the escalation stage, patients were prescribed 30 Gy in 5 fractions. Only the presumed threatened surgical margins were delineated for large tumors.</p><p><strong>Results: </strong>Patients with either primary or recurrent RPS were recruited. Eight patients underwent SCRT but one patient did not have a resection as planned. Seven patients underwent surgical resection, of whom one passed away 3 months postoperative from a cardiac event. After a median follow-up of 20.5 months for the six postoperative survivors, there were no overt long-term toxicities and one patient relapsed out-of-radiotherapy-field.</p><p><strong>Conclusion: </strong>SCRT to RPS with a margin boost followed by immediate surgery is worth investigating. A starting dose of 30 Gy in 5 fractions is recommended for further studies. Longer-term follow-up is necessary.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing clinical target volume margins for multifocal glioblastoma: a multi-institutional analysis of patterns of recurrence and treatment response.","authors":"Francesco Marampon, Giovanni Luca Gravina, Elisa Cinelli, Lucy Zaccaro, Miriam Tomaciello, Nunzia Di Meglio, Francesco Gentili, Alfonso Cerase, Armando Perrella, Mariya Yavorska, Sami Aburas, Luciano Mutti, Maria Antonietta Mazzei, Giuseppe Minniti, Paolo Tini","doi":"10.3857/roj.2024.00059","DOIUrl":"https://doi.org/10.3857/roj.2024.00059","url":null,"abstract":"<p><strong>Purpose: </strong>No guidelines exist to delineate radiation therapy (RT) targets for the treatment of multiple glioblastoma (mGBM). This study analyzes margins around the gross tumor volume (GTV) to create a clinical target volume (CTV), comparing response parameters and modalities of recurrence.</p><p><strong>Material and methods: </strong>One-hundred and three mGBM patients with a CTV margin of 2 cm (GTV + 2.0 cm) or 1 cm (GTV + 1.0 cm) were retrospectively analyzed. All patients received a total dose of 59.4-60 Gy in 1.8-2.0 Gy daily fractions, delivered from 4 to 8 weeks after surgery, concomitantly with temozolomide (75 mg/m2). Overall survival (OS) and progression-free survival (PFS) were calculated from the date of surgery until diagnosis of disease progression performed by magnetic resonance imaging and classified as marginal, in-field, or distant, comparing site of progression with dose distribution in RT plan.</p><p><strong>Results: </strong>OS in mGBM CTV1 group was 11.2 months (95% confidence interval [CI], 10.3-12.1), and 9.2 months in mGBM CTV2 group (95% CI, 9.0-11.3). PFS in mGBM CTV1 group occurred within 8.3 months (95% CI, 7.3-9.3), and 7.3 months in mGBM CTV2 group (95% CI, 6.4-8.1). No difference was observed between the two groups in terms of OS and PFS time distribution. Adjusted to a multivariate Cox risk model, epidermal growth factor receptor amplification resulted a negative prognostic factor for both OS and PFS.</p><p><strong>Conclusion: </strong>In mGBM, the use of a 1 cm CTV expansion seems feasible as it does not significantly affect oncological outcomes and progression outcome.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reinforcing treatment and evaluation workflow of stereotactic ablative body radiotherapy for refractory ventricular tachycardia.","authors":"Hojin Kim, Sangjoon Park, Jihun Kim, Jin Sung Kim, Dong Wook Kim, Nalee Kim, Jae-Sun Uhm, Daehoon Kim, Hui-Nam Pak, Chae-Seon Hong, Hong In Yoon","doi":"10.3857/roj.2024.00262","DOIUrl":"https://doi.org/10.3857/roj.2024.00262","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiac radioablation is a novel, non-invasive treatment for ventricular tachycardia (VT), involving a single fractional stereotactic ablative body radiotherapy (SABR) session with a prescribed dose of 25 Gy. This complex procedure requires a detailed workflow and stringent dose constraints compared to conventional radiation therapy. This study aims to establish a consistent institutional workflow for single-fraction cardiac VT-SABR, emphasizing robust plan evaluation and quality assurance.</p><p><strong>Materials and methods: </strong>The study developed a consistent institutional workflow for VT-SABR, including computed tomography (CT) simulation, target volume definition, treatment planning, robust plan evaluation, quality assurance, and image-guided strategy. The workflow was implemented for two patients with cardiac arrhythmia. Accurate target volume definition using planning CT images and electronic anatomical mapping was critical. A four-dimensional (4D) cone-beam CT (CBCT) and breath-hold electrocardiographic gated CT images reliably detected target motion.</p><p><strong>Results: </strong>The resulting plans exhibited a conformity index greater than 0.7 and a gradient index around G4.0. Dose constraints for the planning target volume (PTV) aimed for 95% or higher PTV dose coverage, with a maximum dose of 200% or lower. However, one case did not meet the PTV dose coverage due to the proximity of the PTV to gastrointestinal organs. Plans adhered to dose constraints for organs at risk near the heart, but meeting constraints for specific cardiac sub-structures was challenging and dependent on PTV location.</p><p><strong>Conclusion: </strong>The plans demonstrated robustness against respiratory motion and patient positional uncertainty through a robust evaluation function. The 4D and intra-fractional CBCT were effective in verifying target motion and setup stability.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"319-329"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left atrial myxoma metastasizing to the brain: a case report and review of literature.","authors":"Anna Basu, Natalie Grindrod, A Rashid Dar, Andrew Leung, Matt Cecchini, Michael Lock","doi":"10.3857/roj.2024.00395","DOIUrl":"https://doi.org/10.3857/roj.2024.00395","url":null,"abstract":"<p><p>Cardiac myxomas, the most common primary cardiac tumors, are believed to originate from multipotent mesenchymal cells. Approximately 75% of myxomas occur within the left atrium, increasing the risk of systemic thromboembolic events. While typically benign, atrial myxomas can rarely metastasize to the brain, with fewer than 60 cases reported. We present a case of a 56-year-old woman with a history of left atrial myxoma who developed headaches, right arm weakness, and blurry vision three months post-cardiac surgery. Imaging showed multiple hemorrhagic brain lesions, and she was treated with whole brain radiotherapy (20 Gy/5 fractions). Four years later, she remains stable with no new lesions and has fully regained function. Currently, there is no standard management for cardiac myxoma metastases. This case highlights the potential role of radiotherapy in managing brain metastases from left atrial myxomas, suggesting a possible treatment strategy based on this case and a review of the literature.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"330-334"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation therapy volumes after primary systemic therapy in breast cancer patients: an international EUBREAST survey.","authors":"Maria Luisa Gasparri, Orit Kaidar-Person, Oreste Davide Gentilini, Jana de Boniface, Thorsten Kuehn, Philip Poortmans","doi":"10.3857/roj.2024.00248","DOIUrl":"https://doi.org/10.3857/roj.2024.00248","url":null,"abstract":"<p><strong>Purpose: </strong>After primary systemic therapy (PST), agreement on the extent of locoregional therapy is lacking in breast cancer patients who convert from a node-positive to a node-negative status. The aim of this survey was to investigate radiation therapy approaches after PST according to different axillary surgical strategies and disease responses.</p><p><strong>Materials and methods: </strong>The European Breast Cancer Research Association of Surgical Trialists developed a web-based survey containing 39 questions on locoregional management based on clinical scenarios in initially node positive breast cancer patients undergoing PST. Twelve international breast cancer societies distributed the link to breast surgeons and radiation oncologists.</p><p><strong>Results: </strong>Responses from 349 breast specialists were recorded, 72 of whom (20.6%) were radiation oncologists from 17 countries. Nodal status at diagnosis informed the decision for postoperative regional nodal irradiation (RNI) for 44/72 (61.1%) responders. RNI in node positive patients having undergone axillary lymph node dissection (ALND) is delivered in selected cases by 30/72 (41.7%) responders and systemically recommended by 26/72 (36.1%) responders. In case of macrometastases found on ALND, 43/72 (59.7%) responders always deliver RNI. In case of micrometastases in the sentinel lymph node(s) or targeted lymph node(s), 45/72 (62.5%) responders prefer RNI to completion ALND. A majority of responders (59.7%) determine the target volume for RNI according to European Society for Radiotherapy and Oncology guidelines. Significant heterogeneity was observed regarding nodal basins and volumes of interest for dose coverage by RNI.</p><p><strong>Conclusions: </strong>There is significant heterogeneity in radiation-therapy delivered to the axilla after PST. A more standardized approach engaging both radiation oncologists and breast surgeons will help to optimize the harm-benefit equilibrium of axillary surgery and RNI.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"308-318"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral radiation therapy for well-lateralized tonsillar cancer with multiple ipsilateral neck nodes: should we encourage patients take risks and pursue quality of life or not?","authors":"Sung Ho Moon","doi":"10.3857/roj.2024.00731","DOIUrl":"https://doi.org/10.3857/roj.2024.00731","url":null,"abstract":"","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"245-246"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphopenia is an adverse prognostic factor in rectal adenocarcinoma patients receiving long-course chemoradiotherapy.","authors":"Ioannis M Koukourakis, Ioannis Georgakopoulos, Dimitra Desse, Dina Tiniakos, Vassilios Kouloulias, Anna Zygogianni","doi":"10.3857/roj.2024.00052","DOIUrl":"https://doi.org/10.3857/roj.2024.00052","url":null,"abstract":"<p><strong>Purpose: </strong>Neoadjuvant radiotherapy (RT) or chemoradiotherapy (CRT) is the standard treatment for locally advanced rectal adenocarcinoma. The recent emerging data on preoperative immunotherapy as an effective therapeutic modality for mismatch repair deficient rectal carcinomas suggests that the immune system plays a significant role in tumor eradication. Although RT has been shown to stimulate anti-tumor immunity, it also leads to substantial lymphopenia, hindering the effect of immune response.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 33 rectal adenocarcinoma patients who underwent CRT in our department, aiming to identify the effects of CRT on the peripheral blood lymphocyte counts (LC) and the potential impact of CRT-induced lymphopenia on tumor response and prognosis of patients.</p><p><strong>Results: </strong>A statistically significant decrease in the LC of patients was observed after CRT (median values of 2,184/μL and 517/μL before and after treatment, respectively; p < 0.001). While no correlation between ypT-stage, ypN status, and LC was found, poor tumor regression grade was significantly associated with lower LC (p = 0.036). Moreover, lymphopenia was associated with poorer distant metastasis-free survival (p = 0.003). Distant metastases were documented in 0% of patients with post-CRT LC above 518/μL vs. 44.5% of patients with lower LC values.</p><p><strong>Conclusion: </strong>Although further investigation is demanded, given the limited number of patients analyzed in the study, lymphopenia emerges as a significant adverse event that rectal adenocarcinoma patients face during treatment with neoadjuvant CRT, with subsequent implications on tumor response and prognosis. Protection of the immune system during CRT emerges as an important target for clinical research.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"263-272"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based clinical recommendations for hypofractionated radiotherapy: exploring efficacy and safety - Part 4: Liver and locally recurrent rectal cancer.","authors":"Hwa Kyung Byun, Gyu Sang Yoo, Soo-Yoon Sung, Jin-Ho Song, Byoung Hyuck Kim, Yoo-Kang Kwak, Yeon Joo Kim, Yeon-Sil Kim, Kyung Su Kim","doi":"10.3857/roj.2024.00108","DOIUrl":"https://doi.org/10.3857/roj.2024.00108","url":null,"abstract":"<p><p>In this paper, we review the use of hypofractionated radiotherapy for gastrointestinal malignancies, focusing on primary and metastatic liver cancer, and recurrent rectal cancer. Technological advancements in radiotherapy have facilitated the direct delivery of high-dose radiation to tumors, while limiting normal tissue exposure, supporting the use of hypofractionation. Hypofractionated radiotherapy is particularly effective for primary and metastatic liver cancer where high-dose irradiation is crucial to achieve effective local control. For recurrent rectal cancer, the use of stereotactic body radiotherapy offers a promising approach for re-irradiation, balancing efficacy and safety in patients who have been administered previous pelvic radiotherapy and in whom salvage surgery is not applicable. Nevertheless, the potential for radiation-induced liver disease and gastrointestinal complications presents challenges when applying hypofractionation to gastrointestinal organs. Given the lack of universal consensus on hypofractionation regimens and the dose constraints for primary and metastatic liver cancer, as well as for recurrent rectal cancer, this review aims to facilitate clinical decision-making by pointing to potential regimens and dose constraints, underpinned by a comprehensive review of existing clinical studies and guidelines.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"247-256"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of neoadjuvant chemoradiotherapy in T4 rectal cancer patients: a real-world single institution experience.","authors":"Reza Ghalehtaki, Kasra Kolahdouzan, Guglielmo Niccolò Piozzi, Saeid Rezaei, Zoha Shaka, Nima Mousavi Darzikolaee, Reyhaneh Bayani, Behnam Behboudi, Mahdi Aghili, Felipe Couñago, Azadeh Sharifian, Farzaneh Bagheri, Reza Nazari, Naeim Nabian, Mohammad Babaei, Mohsen Ahmadi Tafti, Mohammadsadegh Fazeli, Farshid Farhan","doi":"10.3857/roj.2024.00136","DOIUrl":"https://doi.org/10.3857/roj.2024.00136","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment outcomes of locally advanced rectal cancer have improved significantly in recent decades. This retrospective study aimed to assess the efficacy of neoadjuvant chemoradiotherapy (nCRT) followed by surgery in patients with T4 rectal cancer and the different outcomes between T4a and T4b patients.</p><p><strong>Materials and methods: </strong>A total of 60 clinically T4 rectal cancer patients who underwent nCRT were included in the analysis. Patient characteristics, treatment regimens, down-staging rates, pathological response, and overall survival (OS) were evaluated.</p><p><strong>Results: </strong>Both T4a and T4b patients experienced down-staging following nCRT (36.6% and 6.2% respectively; p = 0.021). T4a patients exhibited a higher rate of pathological complete response (pCR) than T4b patients (13.3% in T4a vs. 0% in T4b; p = 0.122). After a median follow-up of 36 months, the OS and recurrence-free survival (RFS) of T4a patients were significantly higher compared to T4b patients (hazard ratio [HR] = 2.52, 95% confidence interval [CI] 1.05-6.05, p = 0.038 for OS; HR = 2.32, 95% CI 1.09-4.92, p = 0.025 for RFS).</p><p><strong>Conclusion: </strong>This study provides valuable insights into the effectiveness of nCRT in T4 rectal cancer patients. Although down-staging was observed in both T4a and T4b subgroups, achieving a pCR remains a challenge, particularly in T4b patients. Further research is needed to optimize treatment strategies and enhance pCR rates in T4 rectal cancer patients to improve oncologic outcomes.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"273-280"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first Korean carbon-ion radiation therapy facility: current status of the Heavy-ion Therapy Center at the Yonsei Cancer Center.","authors":"Min Cheol Han, Seo Hee Choi, Chae-Seon Hong, Yong Bae Kim, Woong Sub Koom, Jin Sung Kim, Jaeho Cho, Chan Woo Wee, Changhwan Kim, Jong Won Park, Soorim Han, Heejeong Lee, Hong In Yoon, Ik Jae Lee, Ki Chang Keum","doi":"10.3857/roj.2024.00206","DOIUrl":"https://doi.org/10.3857/roj.2024.00206","url":null,"abstract":"<p><strong>Purpose: </strong>This report offers a detailed examination of the inception and current state of the Heavy-ion Therapy Center (HITC) at the Yonsei Cancer Center (YCC), setting it apart as the world's first center equipped with a fixed beam and two superconducting gantries for carbon-ion radiation therapy (CIRT).</p><p><strong>Materials and methods: </strong>Preparations for CIRT at YCC began in 2013; accordingly, this center has completed a decade of meticulous planning and culminating since the operational commencement of the HITC in April 2023.</p><p><strong>Results: </strong>This report elaborates on the clinical preparation for adopting CIRT in Korea. It includes an extensive description of HITC's facility layout at YCC, which comprises the accelerator and treatment rooms. Furthermore, this report delineates the clinical workflow, criteria for CIRT application, and the rigorous quality assurance processes implemented at YCC. It highlights YCC's sophisticated radiation therapy infrastructure, collaborative initiatives, and the efficacious treatment of >200 prostate cancer cases utilizing CIRT.</p><p><strong>Conclusion: </strong>This manuscript concludes by discussing the prospective influence of CIRT on the medical domain within Korea, spotlighting YCC's pioneering contribution and forecasting the widespread integration of this groundbreaking technology.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 4","pages":"295-307"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}