Radiation oncology journal最新文献

{"title":"Recurrence pattern of glioblastoma treated with intensity-modulated radiation therapy versus three-dimensional conformal radiation therapy.","authors":"So Hwa Mun, Hong Seok Jang, Byung Ok Choi, Shin Woo Kim, Jin-Ho Song","doi":"10.3857/roj.2024.00381","DOIUrl":"10.3857/roj.2024.00381","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate recurrence patterns of and survival outcomes in glioblastoma treated with intensity-modulated radiation therapy (IMRT) versus three-dimensional conformal radiation therapy (3D-CRT).</p><p><strong>Materials and methods: </strong>We retrospectively examined 91 patients with glioblastoma treated with either IMRT (n = 60) or 3D-CRT (n = 31) between January 2013 and December 2019. Magnetic resonance imaging showing tumor recurrence and planning computed tomography scans were fused for analyzing recurrence patterns categorized as in-field, marginal, and out-of-field based on their relation to the initial radiation field.</p><p><strong>Results: </strong>The median overall survival (OS) was 18.9 months, with no significant difference between the groups. The median progression-free survival (PFS) was 9.4 months, with no significant difference between the groups. Patients who underwent gross total resection (GTR) had higher OS and PFS than those who underwent less extensive surgery. Among 78 relapse cases, 67 were of in-field; 5, marginal; and 19, out-of-field recurrence. Among 3D-CRT-treated cases, 24 were of in-field; 1, marginal; and 9, out-of-field recurrence. Among IMRT-treated cases, 43 were of in-field; 4, marginal; and 10, out-of-field recurrence. In partial tumor removal or biopsy cases, out-of-field recurrence was less frequent in the IMRT (16.2%) than in the 3D-CRT (36.3%) group, with marginal significance (p = 0.079).</p><p><strong>Conclusion: </strong>IMRT and 3D-CRT effectively managed glioblastoma with no significant differences in OS and PFS. The survival benefit with GTR underscored the importance of maximal surgical resection. The reduced rate of out-of-field recurrence in IMRT-treated patients with partial resection highlights its potential utility in cases with unfeasible complete tumor removal.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 3","pages":"218-227"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term treatment of metastatic adenoid cystic carcinoma with sequential brachytherapy and stereotactic body radiotherapy.","authors":"Allison Y Zhong, Sangwoo S Kim, Austin Hopper, Greg White, Sayuri Miyauchi, Riley N Jones, Dan Scanderbeg, Loren K Mell, Elizabeth Weihe, Nathalie Boutros, Stephen W Doggett, Andrew B Sharabi","doi":"10.3857/roj.2024.00325","DOIUrl":"10.3857/roj.2024.00325","url":null,"abstract":"<p><p>Adenoid cystic carcinoma is a malignancy that is difficult to treat and often metastasizes to the lung. Systemic chemotherapies are not effective for this tumor type, thus local therapies are frequently used. Here, we report a case demonstrating the use of extensive ablative interventions in controlling the progression of metastatic adenoid cystic carcinoma. A patient with adenoid cystic carcinoma developed numerous metastases to his lungs and liver. Local ablative therapies including interstitial brachytherapy and SBRT were used to treat approximately 80 different metastases over the course of a decade. Over 850 brachytherapy seeds were implanted in this patient, and the tumor control and patient outcome were good. As of the most recent follow-up in March 2024, the patient has survived for approximately 12 years since his diagnosis of adenoid cystic carcinoma. To our knowledge, this case represents the most brachytherapy treatments reported in a single patient. It highlights the utility of interstitial brachytherapy and SBRT in treating extensive lung and liver metastases.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 3","pages":"237-243"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing target and diaphragmatic configuration, and dosimetric benefits using continuous positive airway pressure in stereotactic ablative radiotherapy for lung tumors.","authors":"Jung Bin Park, Joo Ho Lee, Ji Hyun Chang, Jaeman Son, Seho Kwon, Su Yun Choi, Hyun-Woo Shin, Tosol Yu, Hak Jae Kim","doi":"10.3857/roj.2024.00101","DOIUrl":"10.3857/roj.2024.00101","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the impact of facilitating target delineation of continuous positive airway pressure (CPAP) in patients undergoing stereotactic ablative radiation therapy (SABR) for lung tumors by lung expansion and respiratory motion management.</p><p><strong>Materials and methods: </strong>We performed a prospective single-institutional trial of patients who were diagnosed with either primary lung cancer or lung metastases and received SABR with a dose of 40 to 60 Gy in 4 fractions. Four-dimensional computed tomography simulations were conducted for each patient: once without CPAP and again with CPAP.</p><p><strong>Results: </strong>Thirty-two patients with 39 tumors were analyzed, after the withdrawal of five patients due to discomfort. For 26 tumors separated from the diaphragm, CPAP significantly increased the superoinferior distance between the tumor and the diaphragm (5.96 cm vs. 8.06 cm; p < 0.001). For 13 tumors located adjacent to the diaphragm, CPAP decreased the overlap of planning target volume (PTV) with the diaphragm significantly (6.32 cm3 vs. 4.09 cm3; p = 0.002). PTV showed a significant reduction with CPAP (25.06 cm3 vs. 22.52 cm3, p = 0.017). In dosimetric analyses, CPAP expanded lung volume by 58.4% with a significant reduction in mean dose and V5 to V40. No more than grade 2 adverse events were reported.</p><p><strong>Conclusion: </strong>This trial demonstrated significant improvement of CPAP in target delineation uncertainties for lung SABR, with dosimetric benefits, a favorable safety profile and tolerability. Further investigation is warranted to explore the role of CPAP as a novel strategy for respiratory motion management.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 3","pages":"200-209"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncological outcomes in patients with residual triple-negative breast cancer after preoperative chemotherapy.","authors":"Hyunki Park, Haeyoung Kim, Won Park, Won Kyung Cho, Nalee Kim, Tae Gyu Kim, Young-Hyuck Im, Jin Seok Ahn, Yeon Hee Park, Ji-Yeon Kim, Seok Jin Nam, Seok Won Kim, Jeong Eon Lee, Jonghan Yu, Byung Joo Chae, Sei Kyung Lee, Jai-Min Ryu","doi":"10.3857/roj.2024.00087","DOIUrl":"10.3857/roj.2024.00087","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the clinical outcomes and prognostic implications of regional nodal irradiation (RNI) after neoadjuvant chemotherapy (NAC) in patients with residual triple-negative breast cancer (TNBC).</p><p><strong>Materials and methods: </strong>We analyzed 152 patients with residual TNBC who underwent breast-conserving surgery after NAC between December 2008 and December 2017. Most patients (n = 133; 87.5%) received taxane-based chemotherapy. Adjuvant radiotherapy (RT) was administered at a total dose of 45-65 Gy in 15-30 fractions to the whole breast, with some patients also receiving RT to regional nodes. Survival was calculated using the Kaplan-Meier method, and prognostic factors influencing survival were analyzed using the Cox proportional-hazards model.</p><p><strong>Results: </strong>During a median follow-up of 66 months (range, 9 to 179 months), the 5-year disease-free survival (DFS) rate was 68.0%. The 5-year locoregional recurrence-free survival, distant metastasis-free survival, and overall survival rates were 83.6%, 72.6%, and 78.7%, respectively. In the univariate analysis, the cN stage, ypT stage, ypN stage, axillary operation type, and RT field were associated with DFS. Multivariate analysis revealed that higher ypT stage (hazard ratio [HR] = 2.0; 95% confidence interval [CI] 1.00-3.82; p = 0.049) and ypN stage (HR = 4.7; 95% CI 1.57-14.24; p = 0.006) were associated with inferior DFS. Among clinically node-positive patients, those who received RT to the breast only had a 5-year DFS of 73.7%, whereas those who received RNI achieved a DFS of 59.6% (p = 0.164). There were no differences between the DFS and RNI.</p><p><strong>Conclusion: </strong>In patients with residual TNBC, higher ypT and ypN stages were associated with poorer outcomes after NAC. RNI did not appear to improve DFS. More intensive treatments incorporating systemic therapy and RT should be considered for these patients.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 3","pages":"210-217"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin-directed radiotherapy for primary cutaneous T-cell lymphomas.","authors":"Ha Un Kim, Yeon Joo Kim, Mi Woo Lee, Woo Jin Lee, Sang-Wook Lee, Youngju Song, Byungchul Cho, Si Yeol Song","doi":"10.3857/roj.2024.00444","DOIUrl":"10.3857/roj.2024.00444","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and toxicities of skin-directed radiotherapy (RT) in primary cutaneous T-cell lymphoma (CTCL).</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 57 CTCL lesions treated with skin-directed RT between January 2000 and December 2022. Lesions were categorized into three distinct groups: early-stage disease treated with local RT, advanced-stage disease treated with local RT, and advanced-stage disease treated with total skin electron beam therapy (TSEBT). Treatment outcomes, including response rates, recurrence patterns, and local progression probability, were assessed for each group.</p><p><strong>Results: </strong>Mycosis fungoides (MF) constituted 90.9% of the advanced-stage pathologies, while CD4+ primary cutaneous small/medium T-cell lymphoproliferative disorder was common in the early stage lesions (55%). Median RT doses were 30.6 Gy, 27 Gy, and 32 Gy for the local RT with early stage, the local RT with advanced stage, and TSEBT with advanced stage, respectively. The complete response rates were high across the groups: 95.5%, 70.8%, and 90.9%, respectively. Seven local recurrences (29.2%) occurred in the local RT group with advanced stage, while seven patients (63.6%) in the TSEBT group experienced local failure. All recurrences were observed in lesions and patients with MF. Acute toxicities were mainly grade 1 or 2, with no grade 3 or higher events. No significant association between RT dose and local progression rates in MF lesions was found.</p><p><strong>Conclusion: </strong>Skin-directed RT in CTCL is effective for local control and well-tolerated with less toxicity.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 3","pages":"228-236"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11467483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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 3. Genitourinary and gynecological cancers","authors":"Gyu Sang Yoo, Soo-Yoon Sung, J. Song, Byoung Hyuck Kim, Y. Kwak, Kyung Su Kim, H. K. Byun, Y. Kim, Yeon Joo Kim","doi":"10.3857/roj.2023.01046","DOIUrl":"https://doi.org/10.3857/roj.2023.01046","url":null,"abstract":"or palliative treat-Hypofractionated radiotherapy (","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141668653","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":"Lattice radiotherapy in inflammatory breast cancer: report of a first case treated with curative aim.","authors":"Silvana Parisi, Miriam Sciacca, Paola Critelli, Giacomo Ferrantelli, Federico Chillari, Valeria Venuti, Claudio Napoli, Issa Shteiwi, Carmelo Siragusa, Anna Brogna, Antonio Pontoriero, Gianluca Ferini, Anna Santacaterina, Stefano Pergolizzi","doi":"10.3857/roj.2024.00038","DOIUrl":"10.3857/roj.2024.00038","url":null,"abstract":"<p><p>Inflammatory breast cancer (IBC) is a rare, aggressive form of breast cancer characterized by poor prognosis. The treatment requires a multidisciplinary approach, with neoadjuvant chemotherapy, surgery, and radiation therapy (RT). Particularly, high doses of conventional RT have been historically delivered in the adjuvant setting after chemotherapy and mastectomy or as radical treatment in patients ineligible for surgery. Here, we report the case of a 49-year-old woman patient with IBC unsuitable for surgery and treated with a combination of lattice RT and fractionated external beam RT concurrent with trastuzumab, with a curative aim. One year after RT, the patient showed a complete response and tolerable toxicities. This is the first reported case of a not-operable IBC patient treated with this particular kind of RT.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 2","pages":"160-165"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating psychological anxiety in patients receiving radiation therapy using smartwatch.","authors":"Sangwoon Jeong, Chanil Jeon, Dongyeon Lee, Won Park, Hongryull Pyo, Youngyih Han","doi":"10.3857/roj.2023.01067","DOIUrl":"10.3857/roj.2023.01067","url":null,"abstract":"<p><strong>Purpose: </strong>Patients undergoing radiation therapy (RT) often experience psychological anxiety that manifests as muscle contraction. Our study explored psychological anxiety in these patients by using biological signals recorded using a smartwatch.</p><p><strong>Materials and methods: </strong>Informed consent was obtained from participating patients prior to the initiation of RT. The patients wore a smartwatch from the waiting room until the conclusion of the treatment. The smartwatch acquired data related to heart rate features (average, minimum, and maximum) and stress score features (average, minimum, and maximum). On the first day of treatment, we analyzed the participants' heart rates and stress scores before and during the treatment. The acquired data were categorized according to sex and age. For patients with more than three days of data, we observed trends in heart rate during treatment relative to heart rate before treatment (HRtb) over the course of treatment. Statistical analyses were performed using the Wilcoxon signed-rank test and paired t-test.</p><p><strong>Results: </strong>Twenty-nine individuals participated in the study, of which 17 had more than 3 days of data. During treatment, all patients exhibited elevated heart rates and stress scores, particularly those in the younger groups. The HRtb levels decreased as treatment progresses.</p><p><strong>Conclusion: </strong>Patients undergoing RT experience notable psychological anxiety, which tends to diminish as the treatment progresses. Early stage interventions are crucial to alleviate patient anxiety during RT.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 2","pages":"148-153"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of histology on the outcome of sinonasal carcinomas treated with radiotherapy: a single institution experience.","authors":"Ali Kazemian, Borna Farazmand, Maryam Taherioun, Mahdie Razmkhah, Mohammad Shirkhoda, Amirmohsen Jalaeefar, Ata Garajei, Mehrdad Jafari, Farrokh Heidari, Mahdi Aghili, Reza Ghalehtaki","doi":"10.3857/roj.2022.00514","DOIUrl":"10.3857/roj.2022.00514","url":null,"abstract":"<p><strong>Purpose: </strong>Sinonasal malignancies are a rare group of head and neck cancers. We aimed to report the oncological outcomes based on histological types in patients who underwent radiotherapy.</p><p><strong>Materials and methods: </strong>In this single-institution study, we retrospectively retrieved and analyzed data of patients with sinonasal carcinomas who underwent radiotherapy during 2011-2016 as part of their treatment. The 3-year rate of local, regional, and distant recurrences, and overall survival were evaluated according to the histological type.</p><p><strong>Results: </strong>A total of 28 patients were evaluated in this study, the majority of whom were male (60%). Squamous cell carcinoma (SCC), adenoid cystic carcinoma (ACC), and adenocarcinoma (ADC) were found in 15 patients (53.5%), 8 (28.5%), and 5 (18%), respectively. The highest rates of local and regional recurrences were observed in ACC and SCC, respectively. Distant recurrences were numerically more common in ADC. The 3-year OS was 48%, 50%, and 73% in SCC, ADC, and ACC, respectively.</p><p><strong>Conclusion: </strong>Different histopathologies of sinonasal cancer seem to have different patterns of failure, and this may be considered in the treatment approach.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 2","pages":"116-123"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypofractionated radiation therapy combined with androgen deprivation therapy for clinically node-positive prostate cancer.","authors":"Tae Hoon Lee, Hongryull Pyo, Gyu Sang Yoo, Seong Soo Jeon, Seong Il Seo, Byong Chang Jeong, Hwang Gyun Jeon, Hyun Hwan Sung, Minyong Kang, Wan Song, Jae Hoon Chung, Bong Kyung Bae, Won Park","doi":"10.3857/roj.2024.00080","DOIUrl":"10.3857/roj.2024.00080","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to analyze the treatment outcomes of combined definitive radiation therapy (RT) and androgen deprivation therapy (ADT) for clinically node-positive prostate cancer.</p><p><strong>Materials and methods: </strong>Medical records of 60 patients with clinically suspected metastatic lymph nodes on radiological examination were retrospectively analyzed. Eight patients (13.3%) were suspected to have metastatic common iliac or para-aortic lymph nodes. All patients underwent definitive RT with a dose fractionation of 70 Gy in 28 fractions. ADT was initiated 2-3 months before RT and continued for at least 2 years. Biochemical failure rate (BFR), clinical failure rate (CFR), overall survival (OS), and prostate cancer-specific survival (PCSS) were calculated, and genitourinary and gastrointestinal adverse events were recorded.</p><p><strong>Results: </strong>The median follow-up period was 5.47 years. The 5-year BFR, CFR, OS, and PCSS rates were 19.1%, 11.3%, 89.0%, and 98.2%, respectively. The median duration of ADT was 2.30 years. BFR and CFR increased after 3 years, and 11 out of 14 biochemical failures occurred after the cessation of ADT. Grade 2 and beyond late genitourinary and gastrointestinal toxicity rates were 5.0% and 13.3%, respectively. However, only two grade 3 adverse events were reported, and no grade 4-5 adverse events were reported. Patients with non-regional lymph node metastases did not have worse BFR, CFR, or adverse event rates.</p><p><strong>Conclusion: </strong>This study reported the efficacy and tolerable toxicity of hypofractionated definitive RT combined with ADT for clinically node-positive prostate cancer. Additionally, selected patients with adjacent non-regional lymph node metastases might be able to undergo definitive RT combined with ADT.</p>","PeriodicalId":94184,"journal":{"name":"Radiation oncology journal","volume":"42 2","pages":"139-147"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11215505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}