Cecilia Jiang, Michele Kim, Xiaoyan Han, Monica Chelius, Travis Hoover, Leslie Kersun, Anne F. Reilly, Harper Hubbeling, Elizabeth Cummings, Goldie Kurtz, Christine Hill‐Kayser, John P. Plastaras, Michael J. LaRiviere
BackgroundProton therapy (PT) has potential advantages in pediatric Hodgkin lymphoma (pHL). However, there are limited data on PT, specifically to infradiaphragmatic targets. We report on PT planning details, doses achieved to organs at risk (OARs), and clinical and toxicity outcomes for patients with pHL who received PT to infradiaphragmatic regions.MethodsThis is a retrospective study including patients treated between 2011 and 2022. Demographic and clinical factors were collected, and toxicity was reported using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Dosimetric and clinical factors associated with key outcomes were assessed via Cox regression. Photon plans were generated for all patients, and the paired t‐tests or Wilcoxon signed rank sum tests were used for dosimetric comparisons.ResultsTwenty‐one patients comprising 22 PT courses were included. Median follow‐up was 5.0 years, and mean age was 14.2 years. Median dose was 21 Gray equivalent (GyE) over 14 fractions. Top acute grade 1 (G1) toxicities included fatigue (59%) and anorexia (36%). Rates of acute G2 and G3+ toxicity were 18% and 0%, respectively. After PT, no local or marginal failures occurred. Five percent experienced disease progression, who were all successfully salvaged, and all patients were alive and disease‐free at last follow‐up. No secondary malignancies developed. Compared to photon radiotherapy, PT achieved significantly lower doses to the bowels, stomach, spleen, pancreatic tail, liver, kidneys, and pelvic bones.ConclusionsPT is well‐tolerated and leads to excellent oncologic and toxicity outcomes with long‐term follow‐up. PT confers dosimetric advantages when compared to photons.
{"title":"Outcomes of proton therapy to infradiaphragmatic sites in pediatric patients with Hodgkin lymphoma","authors":"Cecilia Jiang, Michele Kim, Xiaoyan Han, Monica Chelius, Travis Hoover, Leslie Kersun, Anne F. Reilly, Harper Hubbeling, Elizabeth Cummings, Goldie Kurtz, Christine Hill‐Kayser, John P. Plastaras, Michael J. LaRiviere","doi":"10.1002/pbc.31290","DOIUrl":"https://doi.org/10.1002/pbc.31290","url":null,"abstract":"BackgroundProton therapy (PT) has potential advantages in pediatric Hodgkin lymphoma (pHL). However, there are limited data on PT, specifically to infradiaphragmatic targets. We report on PT planning details, doses achieved to organs at risk (OARs), and clinical and toxicity outcomes for patients with pHL who received PT to infradiaphragmatic regions.MethodsThis is a retrospective study including patients treated between 2011 and 2022. Demographic and clinical factors were collected, and toxicity was reported using Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Dosimetric and clinical factors associated with key outcomes were assessed via Cox regression. Photon plans were generated for all patients, and the paired <jats:italic>t</jats:italic>‐tests or Wilcoxon signed rank sum tests were used for dosimetric comparisons.ResultsTwenty‐one patients comprising 22 PT courses were included. Median follow‐up was 5.0 years, and mean age was 14.2 years. Median dose was 21 Gray equivalent (GyE) over 14 fractions. Top acute grade 1 (G1) toxicities included fatigue (59%) and anorexia (36%). Rates of acute G2 and G3+ toxicity were 18% and 0%, respectively. After PT, no local or marginal failures occurred. Five percent experienced disease progression, who were all successfully salvaged, and all patients were alive and disease‐free at last follow‐up. No secondary malignancies developed. Compared to photon radiotherapy, PT achieved significantly lower doses to the bowels, stomach, spleen, pancreatic tail, liver, kidneys, and pelvic bones.ConclusionsPT is well‐tolerated and leads to excellent oncologic and toxicity outcomes with long‐term follow‐up. PT confers dosimetric advantages when compared to photons.","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269449","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}
Ioannis A. Ziogas, Ankush Gosain, Richard D. Schulick, Jonathan P. Roach, Marco Del Chiaro
Pancreaticoduodenectomy with vascular reconstruction is rarely performed in children. We present a 3‐year‐old male with stage IV hepatoblastoma and pre‐treatment extent of disease (PRETEXT) stage III with tumor into the portal vein and superior mesenteric vein (SMV), and with brain and lung metastases status post chemotherapy and stereotactic radiosurgery to left frontal brain lesion. He then underwent deceased donor liver transplant with Roux‐en‐Y hepaticojejunostomy complicated by two recurrences to bilateral lungs treated with wedge resections. His course lastly involved a third hepatoblastoma recurrence to the SMV that was managed with pylorus‐preserving pancreaticoduodenectomy with SMV resection and reconstruction.
儿童很少接受胰十二指肠切除术和血管重建术。我们为您介绍一名 3 岁男性患者，肝母细胞瘤 IV 期，治疗前疾病程度（PRETEXT）III 期，肿瘤进入门静脉和肠系膜上静脉（SMV），化疗后出现脑和肺转移，左额叶脑部病变接受了立体定向放射外科手术。随后，他接受了Roux-en-Y肝空肠吻合术的死亡供体肝脏移植手术，术后并发双肺楔形切除术治疗的两次复发。最后，他的第三次肝母细胞瘤复发至SMV，经保留幽门的胰十二指肠切除术和SMV切除与重建术治疗。
{"title":"Pylorus‐preserving pancreaticoduodenectomy with superior mesenteric vein resection and reconstruction in a child with recurrent hepatoblastoma after liver transplantation","authors":"Ioannis A. Ziogas, Ankush Gosain, Richard D. Schulick, Jonathan P. Roach, Marco Del Chiaro","doi":"10.1002/pbc.31330","DOIUrl":"https://doi.org/10.1002/pbc.31330","url":null,"abstract":"Pancreaticoduodenectomy with vascular reconstruction is rarely performed in children. We present a 3‐year‐old male with stage IV hepatoblastoma and pre‐treatment extent of disease (PRETEXT) stage III with tumor into the portal vein and superior mesenteric vein (SMV), and with brain and lung metastases status post chemotherapy and stereotactic radiosurgery to left frontal brain lesion. He then underwent deceased donor liver transplant with Roux‐en‐Y hepaticojejunostomy complicated by two recurrences to bilateral lungs treated with wedge resections. His course lastly involved a third hepatoblastoma recurrence to the SMV that was managed with pylorus‐preserving pancreaticoduodenectomy with SMV resection and reconstruction.","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142259671","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}
Background/objectivesThe Berlin–Frankfurt–Münster (BFM)‐S classification is a crucial prognostic indicator in children experiencing first‐relapsed acute lymphoblastic leukemia (ALL). Early molecular response to therapy, evaluated by measurable/minimal residual disease (MRD), has a significant impact on the survival of patients with childhood ALL. Applying risk stratification based on the BFM‐S classification and MRD response after induction, the first nationwide prospective multicenter study, ALL‐R08, was conducted in children with first‐relapsed ALL in Japan.MethodsThe ALL‐R08 study comprised two parts: ALL‐R08‐I, an observational study aimed at obtaining an overall picture of outcomes in first‐relapsed childhood ALL, and ALL‐R08‐II, a clinical trial for the non‐T‐ALL S2 risk group. In ALL‐R08‐II, patients with an MRD level of ≥10−3 at the end of induction therapy were assigned to undergo allogeneic hematopoietic stem cell transplantation (allo‐HCT), whereas those with an MRD level less than 10−3 and isolated extramedullary relapse continued to receive chemotherapy.ResultsIn total, 163 patients were enrolled in the ALL‐R08 study, and 82 and 81 patients were enrolled in the ALL‐R08‐I and the ALL‐R08‐II, respectively. In ALL‐R08‐I, the probability of 3‐year event‐free survival (EFS) for patients with S1, S2, S3, S4, and post‐HCT groups was 83% ± 15%, 37% ± 11%, 28% ± 8%, 14% ± 7%, and 0%, respectively. In the ALL‐R08‐II trial, 3‐year EFS in patients with post‐induction MRD less than 10−3 and ≥10−3 was 70% ± 9% (n = 27) and 68% ± 8% (n = 31) (p = .591), respectively.ConclusionsALL‐REZ BFM‐type treatment is equally effective for children with first‐relapsed ALL treated according to the Japanese frontline protocols and for children with first‐relapsed ALL treated according to the BFM‐type frontline protocols.
{"title":"Outcomes in children with first‐relapsed acute lymphoblastic leukemia in Japan: Results from JCCG Study JPLSG‐ALL‐R08","authors":"Junko Yamanaka, Chitose Ogawa, Ayumu Arakawa, Takao Deguchi, Toshinori Hori, Nobutaka Kiyokawa, Hideaki Ueki, Masanori Nishi, Shinji Mochizuki, Takuro Nishikawa, Tadashi Kumamoto, Ritsuo Nishiuchi, Atsushi Kikuta, Shohei Yamamoto, Katsuyoshi Koh, Daisuke Hasegawa, Atsushi Ogawa, Kenichiro Watanabe, Atsushi Sato, Akiko M. Saito, Tomoyuki Watanabe, Atsushi Manabe, Keizo Horibe, Hiroaki Goto, Hidemi Toyoda","doi":"10.1002/pbc.31319","DOIUrl":"https://doi.org/10.1002/pbc.31319","url":null,"abstract":"Background/objectivesThe Berlin–Frankfurt–Münster (BFM)‐S classification is a crucial prognostic indicator in children experiencing first‐relapsed acute lymphoblastic leukemia (ALL). Early molecular response to therapy, evaluated by measurable/minimal residual disease (MRD), has a significant impact on the survival of patients with childhood ALL. Applying risk stratification based on the BFM‐S classification and MRD response after induction, the first nationwide prospective multicenter study, ALL‐R08, was conducted in children with first‐relapsed ALL in Japan.MethodsThe ALL‐R08 study comprised two parts: ALL‐R08‐I, an observational study aimed at obtaining an overall picture of outcomes in first‐relapsed childhood ALL, and ALL‐R08‐II, a clinical trial for the non‐T‐ALL S2 risk group. In ALL‐R08‐II, patients with an MRD level of ≥10<jats:sup>−3</jats:sup> at the end of induction therapy were assigned to undergo allogeneic hematopoietic stem cell transplantation (allo‐HCT), whereas those with an MRD level less than 10<jats:sup>−3</jats:sup> and isolated extramedullary relapse continued to receive chemotherapy.ResultsIn total, 163 patients were enrolled in the ALL‐R08 study, and 82 and 81 patients were enrolled in the ALL‐R08‐I and the ALL‐R08‐II, respectively. In ALL‐R08‐I, the probability of 3‐year event‐free survival (EFS) for patients with S1, S2, S3, S4, and post‐HCT groups was 83% ± 15%, 37% ± 11%, 28% ± 8%, 14% ± 7%, and 0%, respectively. In the ALL‐R08‐II trial, 3‐year EFS in patients with post‐induction MRD less than 10<jats:sup>−3</jats:sup> and ≥10<jats:sup>−3</jats:sup> was 70% ± 9% (<jats:italic>n</jats:italic> = 27) and 68% ± 8% (<jats:italic>n</jats:italic> = 31) (<jats:italic>p</jats:italic> = .591), respectively.ConclusionsALL‐REZ BFM‐type treatment is equally effective for children with first‐relapsed ALL treated according to the Japanese frontline protocols and for children with first‐relapsed ALL treated according to the BFM‐type frontline protocols.","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142259670","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}
Matteo Amicucci, Eugenia Trigoso, Maria Grazia Nori, Sara Colomer‐Lahiguera, Elena Rostagno, Valentina Biagioli, Vincenza Sansone, Andrea Zibaldo, Andrea Mastria, Moreno Crotti Partel, Marta Canesi, Andreea Cristina Schiopu, Immacolata Dall'Oglio
The aim of this scoping review is to describe the role, education, policies/regulation, skills and competencies required for advanced practice in paediatric haematology‐oncology nursing in Europe, highlighting the differences in development between the different European countries. A scoping review was conducted following the methodological framework of guidelines by Arksey and O'Malley and the recommendations for advancing the methodology by Levac et al. We searched MEDLINE/PubMed, EMBASE, CINAHL, Cochrane Library, Scopus, grey literature, webpages, reference lists and performed a manual search, without any restrictions on language or time. The intersection between databases, grey literature and evidence documents traced from the sites of the most authoritative European organisations in the field made it possible to identify the regulatory and training differences between the various countries that were examined. This scoping review highlights how advanced knowledge and competences are used in the care of paediatric haematology‐oncology patients, which are strictly necessary for implementing quality care. At present these competences are not recognised in policies and regulation in most of the countries that were examined. It is desirable that all EU member states work to implement a radical change and allow these more competent figures to assist patients in the best possible way.
{"title":"Role, education, policies and competencies for advanced practice in paediatric haematology‐oncology nursing in Europe: A scoping review","authors":"Matteo Amicucci, Eugenia Trigoso, Maria Grazia Nori, Sara Colomer‐Lahiguera, Elena Rostagno, Valentina Biagioli, Vincenza Sansone, Andrea Zibaldo, Andrea Mastria, Moreno Crotti Partel, Marta Canesi, Andreea Cristina Schiopu, Immacolata Dall'Oglio","doi":"10.1002/pbc.31325","DOIUrl":"https://doi.org/10.1002/pbc.31325","url":null,"abstract":"The aim of this scoping review is to describe the role, education, policies/regulation, skills and competencies required for advanced practice in paediatric haematology‐oncology nursing in Europe, highlighting the differences in development between the different European countries. A scoping review was conducted following the methodological framework of guidelines by Arksey and O'Malley and the recommendations for advancing the methodology by Levac et al. We searched MEDLINE/PubMed, EMBASE, CINAHL, Cochrane Library, Scopus, grey literature, webpages, reference lists and performed a manual search, without any restrictions on language or time. The intersection between databases, grey literature and evidence documents traced from the sites of the most authoritative European organisations in the field made it possible to identify the regulatory and training differences between the various countries that were examined. This scoping review highlights how advanced knowledge and competences are used in the care of paediatric haematology‐oncology patients, which are strictly necessary for implementing quality care. At present these competences are not recognised in policies and regulation in most of the countries that were examined. It is desirable that all EU member states work to implement a radical change and allow these more competent figures to assist patients in the best possible way.","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142259713","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}
Yu Furui, Shoji Saito, Yuta Maruyama, Eri Okura, Koichi Hirabayashi, Miyuki Tanaka, Yozo Nakazawa
{"title":"Successful ibrutinib treatment for pulmonary involvement in a post‐transplant patient with inherited bone marrow failure syndrome and very short telomeres","authors":"Yu Furui, Shoji Saito, Yuta Maruyama, Eri Okura, Koichi Hirabayashi, Miyuki Tanaka, Yozo Nakazawa","doi":"10.1002/pbc.31314","DOIUrl":"https://doi.org/10.1002/pbc.31314","url":null,"abstract":"","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142204718","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}
Sarah G. Mitchell, Emily Christison‐Lagay, Jennie Aldrink, Michael R. Sargen, Theodore W. Laetsch, Mary Austin, Melinda Jen, Robyn Gartrell, Arivarasan Karunamurthy, John M. Kirkwood, Alberto S. Pappo, Brittani K. N. Seynnaeve
{"title":"Feasibility of a prospective pediatric melanocytic tumor clinical trial: A report of multidisciplinary clinician survey data from the Children's Oncology Group Rare Tumor Committee","authors":"Sarah G. Mitchell, Emily Christison‐Lagay, Jennie Aldrink, Michael R. Sargen, Theodore W. Laetsch, Mary Austin, Melinda Jen, Robyn Gartrell, Arivarasan Karunamurthy, John M. Kirkwood, Alberto S. Pappo, Brittani K. N. Seynnaeve","doi":"10.1002/pbc.31312","DOIUrl":"https://doi.org/10.1002/pbc.31312","url":null,"abstract":"","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142204717","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}
Sheila Judge Santacroce, Melissa P. Beauchemin, Wendy Pelletier, Joanna M. Robles, Jenny Ruiz, Lindsay J. Blazin, Paula Aristizabal, Manuela Orjuela-Grimm, Anurekha G. Hall, Justine Kahn, Cassie Kline, Alix E. Seif, Maria C. Velez, Lena E. Winestone
Background
Increasing representation in clinical trials is a priority for the National Cancer Institute and Children's Oncology Group (COG). Our survey of COG-affiliated institutions revealed that many sites have insufficient processes and resources to enroll children whose parents use languages other than English (LOE). We describe reported barriers and facilitators to enrolling children in clinical trials when parents use LOE and propose opportunities for improvement.
Procedures
We sent a 20-item survey to COG-affiliated institutions. Five items allowed respondents to expand on replies to questions about (a) local institutional review board (IRB) requirements regarding translation of consent documents, (b) contributors to provider discomfort consenting parents who use LOE, (c) available language services and resources, and (d) barriers to enrolling children whose parents use LOE or offer ideas about approaches to improvements. Two pairs of researchers independently coded free-text responses and compared results for concordance.
Results
A total of 139 (N = 230; 60%) institutions returned the survey. Respondents were mainly physician principal investigators (n = 79/139; 57%) at the United States sites (n = 118/139; 85%) serving less than 100 newly diagnosed children per year (n = 99/139, 71%). They described challenges at multiple levels. Proposed approaches to improvements included centralized provision of translated materials and video educational materials in various languages, and collaborating with IRBs on regulatory processes that protect families and facilitate equitable clinical trial access.
Conclusions
Clinical trial consortia, such as COG, face challenges in enrolling representative samples. Further research is required to design and implement multilevel interventions to ensure equitable access for all, regardless of language used, and mitigate disparate research participation.
{"title":"Multilevel challenges to equitable inclusion of children in trials when parents use languages other than English: A qualitative report from Children's Oncology Group's Diversity and Health Disparities Committee Language Equity Working Group","authors":"Sheila Judge Santacroce, Melissa P. Beauchemin, Wendy Pelletier, Joanna M. Robles, Jenny Ruiz, Lindsay J. Blazin, Paula Aristizabal, Manuela Orjuela-Grimm, Anurekha G. Hall, Justine Kahn, Cassie Kline, Alix E. Seif, Maria C. Velez, Lena E. Winestone","doi":"10.1002/pbc.31321","DOIUrl":"10.1002/pbc.31321","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Increasing representation in clinical trials is a priority for the National Cancer Institute and Children's Oncology Group (COG). Our survey of COG-affiliated institutions revealed that many sites have insufficient processes and resources to enroll children whose parents use languages other than English (LOE). We describe reported barriers and facilitators to enrolling children in clinical trials when parents use LOE and propose opportunities for improvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Procedures</h3>\u0000 \u0000 <p>We sent a 20-item survey to COG-affiliated institutions. Five items allowed respondents to expand on replies to questions about (a) local institutional review board (IRB) requirements regarding translation of consent documents, (b) contributors to provider discomfort consenting parents who use LOE, (c) available language services and resources, and (d) barriers to enrolling children whose parents use LOE or offer ideas about approaches to improvements. Two pairs of researchers independently coded free-text responses and compared results for concordance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 139 (<i>N</i> = 230; 60%) institutions returned the survey. Respondents were mainly physician principal investigators (<i>n</i> = 79/139; 57%) at the United States sites (<i>n</i> = 118/139; 85%) serving less than 100 newly diagnosed children per year (<i>n</i> = 99/139, 71%). They described challenges at multiple levels. Proposed approaches to improvements included centralized provision of translated materials and video educational materials in various languages, and collaborating with IRBs on regulatory processes that protect families and facilitate equitable clinical trial access.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clinical trial consortia, such as COG, face challenges in enrolling representative samples. Further research is required to design and implement multilevel interventions to ensure equitable access for all, regardless of language used, and mitigate disparate research participation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":19822,"journal":{"name":"Pediatric Blood & Cancer","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140755","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}
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