Cancer Radiotherapie最新文献

{"title":"Intelligence artificielle en oncologie radiothérapie : réinventer la formation et préserver l’esprit critique","authors":"Lucien Lahmi ,&nbsp;Jean-Emmanuel Bibault ,&nbsp;Yannis Constantinides ,&nbsp;Joseph Azria ,&nbsp;Véronique Cheval ,&nbsp;Catherine Dejean ,&nbsp;Catherine Durdux ,&nbsp;Angélique Ducteil ,&nbsp;Alexandre Escande ,&nbsp;Cédric Gesbert ,&nbsp;Thibaud Haaser ,&nbsp;Gabriel Kobeissi ,&nbsp;Claire Lemanski ,&nbsp;Moshe Nataf ,&nbsp;Charles Raynaud ,&nbsp;Sébastien Thureau ,&nbsp;Jean-Léon Lagrange ,&nbsp;Florence Huguet ,&nbsp;Commission éthique de la Société française de radiothérapie oncologique (SFRO)","doi":"10.1016/j.canrad.2025.104673","DOIUrl":"10.1016/j.canrad.2025.104673","url":null,"abstract":"<div><div>The growing integration of artificial intelligence is profoundly transforming radiation oncology, particularly through the automation of tasks such as target volume delineation. While artificial intelligence holds the promise of enhancing treatment efficiency and accuracy, it also raises significant ethical and educational concerns: How can we preserve core clinical skills? How can we transmit expertise that is now less frequently practiced? How can we ensure truly informed patient consent in the face of automated systems? And finally, how should we use the time freed up by automation? To address these challenges, medical training must increasingly incorporate critical thinking and algorithmic literacy. The caregiver–patient relationship must remain central, with medical decisions remaining under human responsibility. Artificial intelligence should thus remain a tool in the hands of physicians, not a substitute for clinical judgment. Ethical reflection must accompany every step of artificial intelligence implementation, ensuring its integration is thoughtful, responsible, and human-centred.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104673"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oligometastatic head and neck cancer: Navigating patient trajectories and broader implications","authors":"Juliette Thariat ,&nbsp;Jihane Lehyanti ,&nbsp;Pierre Boisselier ,&nbsp;Anouchka Modesto ,&nbsp;Sébastien Thureau ,&nbsp;Yoann Pointreau ,&nbsp;Xu-Shan Sun","doi":"10.1016/j.canrad.2025.104675","DOIUrl":"10.1016/j.canrad.2025.104675","url":null,"abstract":"<div><div>Oligometastatic head and neck squamous cell carcinoma is a distinct clinical state inadequately addressed in current metastatic disease trials. This narrative review is based on historical literature and recently published data of the Omet trial. The Gortec 2014-04 Omet phase II randomized trial investigated whether genuine metachronous oligometastases in head and neck squamous cell carcinoma, characterized by a limited number (up to three) of lesions not induced by prior systemic therapy, may benefit from a “de-escalation strategy” using curative-intent stereotactic ablative radiotherapy alone rather than strategies relying on systemic treatments upfront. Randomized phase II-III trials are scarce on head and neck squamous cell carcinoma. In the Omet trial, survival at 1 year exceeded 85 % in both arms. Progression-free survival was, as anticipated, slightly longer in the group chemotherapy and stereotactic ablative radiotherapy (10 months versus 7.5 months) but without deleterious impact upon metastatic relapse. Stereotactic ablative radiotherapy alone showed significantly lower grade 3–4 toxicity (8.8 % versus 60 %). Quality of life declined less with stereotactic ablative radiotherapy alone. Poor prognostic factors included male sex and multiple metastases. Major protocol deviations correlated with worse outcomes. Stereotactic ablative radiotherapy offers a viable, less toxic alternative to systemic therapy for genuine oligometastatic head and neck squamous cell carcinoma, warranting refined patient selection and further research. Despite its role as a new standard-of-care, the role of immunotherapy remains uncertain in the oligometastatic setting and requires specific studies in oligometastatic head and neck squamous cell carcinoma to challenge this new option.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104675"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The QuADRANT project: Enhancing quality and safety in radiological procedures through clinical audit","authors":"Gianfranco Brusadin ,&nbsp;Adrian P. Brady ,&nbsp;Monika Hierath ,&nbsp;David C. Howlett","doi":"10.1016/j.canrad.2025.104689","DOIUrl":"10.1016/j.canrad.2025.104689","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;The project entitled “Quality Improvement Through Clinical Audit in Diagnostic (Including Interventional) Radiology, Radiotherapy and Nuclear Medicine (Including Therapies)” (QuADRANT) was conceived to thoroughly assess the state of clinical audit implementation across Europe, regarding the medical application of ionizing radiation. The central aim was to elevate the quality and safety standards in radiological procedures. This initiative arose from the understanding that consistent and rigorous clinical audit is fundamental for enhancing patient outcomes and adhering to safety regulations in cancer treatment using radiation. The project aimed to address the observed variations in how clinical audit was being applied across Europe.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Material and methods&lt;/h3&gt;&lt;div&gt;The QuADRANT project employed a comprehensive methodology to gather data. This included an extensive review of existing literature, European regulations, and international guidelines pertinent to clinical audit in radiological procedures. National surveys were conducted, reaching out to representatives from European Union member states and other selected countries to collect information on national frameworks, methodologies, existing barriers, and facilitating factors. In-depth case studies, involving site visits and interviews with various stakeholders such as healthcare professionals and policymakers, provided deeper insights. Expert consultations with specialists in medical physics, radiation oncology, and quality assurance further enriched the data. Workshops were also held to engage national stakeholders in discussions about legal requirements, benefits, and good practices of clinical audit. The collected data was systematically analysed to identify key trends, common challenges, successful strategies, and areas ripe for improvement, leading to the formulation of evidence-based recommendations.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The project observed significant variations in the adoption and maturity of clinical audit programs across European countries, even within individual nations. While some countries demonstrated well-established practices, particularly concerning dosimetry audits in radiotherapy, a widespread and comprehensive clinical audit program covering all radiological procedures was often lacking. Data collection for audit purposes was frequently inconsistent, with common deviations from standard practice noted in patient data registration, diagnosis, treatment details, and the recording of adverse events. Many countries reported limited financial and human resources allocated to clinical audit. A general lack of awareness among healthcare professionals regarding the specific requirements and benefits of clinical audit was also identified. Organizational culture sometimes presented resistance to systematic quality improvement initiatives. Challenges were noted in data quality and the burden associated with manual data entry ","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104689"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery for all patients with T1N0 non-small cell lung cancer?","authors":"Claudia Pouypoudat ,&nbsp;Sébastien Thureau ,&nbsp;Nicolas Giraud ,&nbsp;Yaniss Belaroussi ,&nbsp;Étienne Martin","doi":"10.1016/j.canrad.2025.104683","DOIUrl":"10.1016/j.canrad.2025.104683","url":null,"abstract":"<div><div>T1N0 non-small cell lung cancers account for about 20 % of all lung cancer cases and are defined as tumours up to 3<!--> <!-->cm without nodal or distant metastasis. The incidence of early-stage diagnoses is increasing, largely driven by the implementation of low dose computed tomography screening programs. Surgery has long been considered the standard of care for these tumours, offering excellent oncologic outcomes and allowing essential pathological staging. However, surgery may be indicated or poorly tolerated in certain populations, particularly elderly or medically inoperable patients. Stereotactic body radiotherapy has emerged as a non-invasive alternative with high local control rates and reduced early morbidity. This raises a critical question: should all patients with early-stage non-small cell lung cancer be managed surgically, or is there a role for treatment individualization? Current evidence highlights the need of balancing curative intent with treatment-related risks. Several clinical trials are currently evaluating stereotactic body radiotherapy in operable patients, aiming to identify subsets that may derive benefit from a non-surgical approach. This review advocates for a personalized, patient-centred treatment strategy, integrating tumour characteristics, operability, comorbidities, and patient preference.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104683"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommandations de l’Association francophone pour les soins oncologiques de support et de la Société française de radiothérapie oncologique relatives aux effets secondaires respiratoires radio-induits","authors":"Olivier Cravéreau ,&nbsp;Vincent Bourbonne ,&nbsp;Loïg Vaugier ,&nbsp;François Lucia ,&nbsp;Florence Le Tinier ,&nbsp;Jacques Cadranel ,&nbsp;Boris Duchemann ,&nbsp;Paul Habert ,&nbsp;Nicolas Martz ,&nbsp;William Gehin ,&nbsp;Marie Bruand ,&nbsp;Anaïs Stefani ,&nbsp;Johann Marcel ,&nbsp;Ida Trampetti ,&nbsp;Christelle Clément-Duchêne ,&nbsp;Delphine Lerouge ,&nbsp;Adrien Laville ,&nbsp;Kim Cao ,&nbsp;Nicolas Pourel ,&nbsp;Audrey Zaccariotto ,&nbsp;Jean-Christophe Faivre","doi":"10.1016/j.canrad.2025.104687","DOIUrl":"10.1016/j.canrad.2025.104687","url":null,"abstract":"<div><h3>Purpose</h3><div>Radiation-induced lung injury is relatively uncommon but disabling, and a dose-limiting factor in thoracic radiotherapy. This complication is mainly encountered following radiotherapy for lung cancers. We provide recommendations for good clinical practice, defining the prevention and management of radiation-induced lung injury.</div></div><div><h3>Methods</h3><div>Members of the Association francophone pour les soins oncologiques de support (Afsos; French-speaking association for oncology care and support) and the Société française de radiothérapie oncologique (SFRO, French society for radiation oncology) set up a multidisciplinary working and review group to draft these recommendations for 2023 to 2024, based on a systematic review of the literature.</div></div><div><h3>Results</h3><div>Radiation-induced lung injury comprises several forms, mainly resulting from acute toxicity (radiation pneumonitis) and chronic toxicity (radiation fibrosis). Specific forms can be identified, such as organising pneumonia (formerly bronchiolitis obliterans organizing pneumonia) and radiation recall pneumonia. The risk factors are numerous and include dosimetric risk factors, patient-related factors and tumour-related factors. New challenges include the specific complications of stereotactic radiotherapy, the combination of recent specific oncological treatments including tyrosine kinase inhibitors and immunotherapy, and the association with certain pathologies such as interstitial lung disease.</div></div><div><h3>Conclusion</h3><div>The profile of radiation-induced lung injury is evolving with new radiotherapy techniques and innovative systemic oncology treatments. Rapid detection and management of these side-effects are essential for good patient care.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104687"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic education for patients with prostate cancer: Feasibility, implementation, and preliminary outcomes","authors":"Thérèse Valy-Foti ,&nbsp;Elvire Martin-Mervoyer ,&nbsp;Josselin Sebille ,&nbsp;Sophie Allain ,&nbsp;Stéphane Supiot ,&nbsp;Virginie Berger ,&nbsp;Valentine Guimas","doi":"10.1016/j.canrad.2025.104708","DOIUrl":"10.1016/j.canrad.2025.104708","url":null,"abstract":"<div><h3>Purpose</h3><div>Since 2007, therapeutic patient education has been recognized as essential in complementing medical care, particularly for chronic diseases like prostate cancer. To address its underdevelopment in oncology, we have developed a therapeutic patient education programme at our institution specifically for patients with prostate cancer. The aim of this article is to describe the process of developing and implementing this programme and to present a first evaluation at 2 years.</div></div><div><h3>Material and methods</h3><div>This study describes the development of a therapeutic patient education programme for patients with prostate cancer at our institution, detailing the steps taken – including needs assessment, staff training, programme declaration, and structuring of educational stages – followed by a comprehensive evaluation of its implementation. The 2-year assessment analysed patient registries, questionnaires, and educator feedback to evaluate the program's effectiveness and impact on patient care.</div></div><div><h3>Results</h3><div>The development of our therapeutic patient education programme for patients with prostate cancer, which involved assessing patient needs, training multidisciplinary staff, designing targeted workshops, and obtaining authorization from the French regional health agency. Over 24 months, the programme successfully engaged 249 patients in five different workshops, with high satisfaction rates, fostered team collaboration, and highlighted challenges such as logistical constraints and patient participation barriers.</div></div><div><h3>Conclusion</h3><div>Although our therapeutic education programme showed high patient satisfaction and exceeded enrolment expectations, future steps include expanding programme visibility, developing digital options, addressing geographic barriers, and conducting controlled studies to evaluate its impact on self-efficacy and symptom management. Therapeutic patient education in oncology addresses the complex needs of patients with chronic prostate cancer by improving quality of life through multidisciplinary collaboration and dedicated efforts, while also enhancing team cohesion.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104708"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptive radiotherapy, promises and pitfalls","authors":"Ariane Lapierre ,&nbsp;Pierre Blanchard","doi":"10.1016/j.canrad.2025.104677","DOIUrl":"10.1016/j.canrad.2025.104677","url":null,"abstract":"<div><div>Adaptive radiotherapy is a technique that adapts the radiotherapy to the changes of the patient's anatomy and tumour volume by using repeated images acquired during the treatment course. Adaptive radiotherapy aims to optimize the dose distribution, ensure that the tumour remains in the treatment volume and spare the organs at risk. Adaptive radiotherapy can be applied at three timescales: between fractions (offline), immediately before a fraction (online) or real-time (online, during a fraction). Over the last decade, manufacturers have developed linear accelerators dedicated to online adaptive radiotherapy, based on either computed tomography or magnetic resonance imaging. These systems allow for treatment plan adaptation according to deformable, registration-based segmentation and physicist-driven plan optimization. This has led to a rapid rise of this technique on a larger scale, although robust data on its benefits remains scarce. Adaptive radiotherapy has demonstrated dosimetric benefits, such as improved lesion coverage and sparing of organs at risk, in various tumour sites. However, the clinical benefit, in terms of toxicity reduction or improved tumour control, remains to be demonstrated in many disease sites. Furthermore, the implementation of adaptive radiotherapy requires careful planning, increased time, logistics and security, which represents an extra burden and impacts the cost-efficiency of the approach.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104677"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BQUATRO audits in radiotherapy: Crossperspectives between auditors and audited departments","authors":"Aude Vaandering ,&nbsp;Séverine Cucchiaro","doi":"10.1016/j.canrad.2025.104679","DOIUrl":"10.1016/j.canrad.2025.104679","url":null,"abstract":"<div><div>Since 2011, the Belgian College of Physicians for Radiation Oncology has implemented a national program of peer-reviewed clinical audits in radiotherapy departments, aiming to enhance quality practices, safety culture, and promote professional experience sharing. This article summarizes the theoretical and practical aspects of this peer audit process providing cross-perspectives of auditors and audited departments. National audits have been carried out using the BQUATRO methodology and framework whereby radiotherapy departments are audited every 5 to 6 years. The audit is carried out by a multidisciplinary team of clinically active radiotherapy professionals. Peer reviewed clinical audits have been carried out in Belgium since 2010 resulting in all radiotherapy departments having been audited at least twice<em>.</em> Audits have helped reinforce team engagement, highlight often-underestimated strengths, and structure continuous improvement initiatives. Auditors have also developed crossfunctional expertise and a better understanding of organizational challenges. The BQUATRO peer-reviewed clinical audit differs from traditional regulatory approaches by its collaborative and constructive posture. It promotes organizational learning and practice alignment among Belgian radiotherapy departments. The peer-reviewed clinical audit process is a strategic lever for improving quality of care in Belgian radiotherapy. Its sustainability and expansion to other countries represent key improvement opportunities for radiotherapy centres.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104679"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144704151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypofractionated radiotherapy of central nervous system tumours: Current thoughts in 2025","authors":"Agathe Margulies ,&nbsp;Anaïs Stefani ,&nbsp;Delphine Antoni","doi":"10.1016/j.canrad.2025.104680","DOIUrl":"10.1016/j.canrad.2025.104680","url":null,"abstract":"<div><div>The use of hypofractionated radiotherapy for central nervous system tumours is expanding, particularly due to the increase in reirradiation situations. This article reports a reflection on its use for neurological tumours through five questions illustrated by non-exhaustive clinical examples. Why? We explored the rationale of hypofractionation and its benefits. For whom? We reviewed the different recommendations on indications including patients and tumours which would benefit more of hypofractionation. How? Treatment planning must be careful and adapted to this specific technique, especially in reirradiation cases, and when systemic therapies are involved. When? Timing is the essence, it can be used exclusively, combined with systemic treatment, prior to or after surgery… Why not? Hypofractionation is not suitable for all central nervous system tumours, it may even be contraindicated in some cases.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104680"},"PeriodicalIF":1.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144712977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complementary therapies: What are we talking about?","authors":"Stéphanie Träger","doi":"10.1016/j.canrad.2025.104707","DOIUrl":"10.1016/j.canrad.2025.104707","url":null,"abstract":"<div><div>Complementary therapies are used by cancer patients at every stage of treatment. Denying this reality would mean denying our patients’ quest for well-being and autonomy. It would also mean ignoring the satisfaction they derive from them. There is a need for clarification on the definitions of the terms used, as well as on regulations and practitioner training. Developing clinical studies of good methodological quality that are adapted to practice is essential to providing scientific proof of efficacy and safety (qualitative and quantitative evaluations). Integrating complementary therapies with supportive care is a fundamental interdisciplinary approach to integrative oncology. This integration must be considered at all levels – institutionally, within the framework of the service project, and in the patient's care pathway – in order to optimize quality of care and overall management.</div></div>","PeriodicalId":9504,"journal":{"name":"Cancer Radiotherapie","volume":"29 5","pages":"Article 104707"},"PeriodicalIF":1.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}