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The impact of HIV infection on women receiving radiation for cervical cancer 艾滋病毒感染对接受宫颈癌放射治疗的妇女的影响
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2015-07-03 DOI: 10.1080/20742835.2015.1083697
M. Mangena, L. Snyman, G. Dreyer, S. Bassa, P. Becker
Abstract Background: The objective of the study was to compare patient characteristics, treatment toxicity and interruptions, and survival in human immunodeficiency virus (HIV)-positive and HIV-negative cervical cancer patients receiving radiation as primary or adjuvant treatment. Method: Demographics, clinical and tumour characteristics, and the outcomes of 51 HIV-positive and 47-HIV negative consecutive cervical cancer patients were assessed and compared, including co-morbidities, performance status, treatment type and toxicities, and survival. Results: HIV-positive women were 13 years younger (p < 0.001), more often had anaemia (p 0.021) and needed pretreatment blood transfusion (p 0.037) more often than HIV-negative women. Performance status, kidney function, International Federation of Gynecology and Obstetrics stage, histology types and treatment intent and planning did not differ between the two groups. Treatment interruptions (p 0.004), transfusion during treatment (p 0.012), treatment toxicities (p 0.040) and average deficit (p 0.021) occurred significantly more in HIV-positive patients. Survival was significantly worse in HIV-positive women (p 0.029) and was associated with insufficient radiation (p < 0.001) and treatment interruptions (p 0.051). Conclusion: In spite of being younger, the pretreatment correction of anaemia and the prescription of sufficient radiation dosages, HIV-infected cervical cancer patients experienced poorer survival. Treatment interruption and incomplete radiation contributed to poor outcomes.
背景:本研究的目的是比较人类免疫缺陷病毒(HIV)阳性和HIV阴性宫颈癌患者接受放射作为主要或辅助治疗的患者特征、治疗毒性和治疗中断以及生存率。方法:对51例hiv阳性和47例hiv阴性连续宫颈癌患者的人口统计学、临床和肿瘤特征及转归进行评估和比较,包括合并症、表现状况、治疗类型和毒副作用、生存期。结果:hiv阳性妇女比hiv阴性妇女年轻13岁(p < 0.001),更常发生贫血(p 0.021),更常需要预处理输血(p 0.037)。两组患者的运动状态、肾功能、国际妇产联合会分期、组织学分型、治疗意图和治疗计划均无差异。治疗中断(p 0.004)、治疗期间输血(p 0.012)、治疗毒性(p 0.040)和平均缺陷(p 0.021)在hiv阳性患者中显著增加。hiv阳性妇女的生存率明显较差(p 0.029),并且与放疗不足(p < 0.001)和治疗中断(p 0.051)有关。结论:hiv感染的宫颈癌患者尽管年龄较轻,贫血的预处理纠正和足够的放射剂量处方,但生存率较低。治疗中断和不完全放疗导致预后不良。
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引用次数: 11
Transvaginal colour Doppler ultrasound in predicting response to chemoradiation in patients with carcinoma of the cervix 经阴道彩色多普勒超声预测宫颈癌患者对放化疗的反应
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2015-07-03 DOI: 10.1080/20742835.2015.1083722
M. Mangla, D. Singla
Abstract Background: The objective of the study was to evaluate the potential role of transvaginal colour Doppler ultrasound (TVCDUS) in predicting response to chemoradiotherapy in patients with locally advanced cervical cancer. Method: TVCDUS was used in 56 patients with histologically proven cervical carcinoma (stage IIA–IIIB) before the start of chemoradiation, and after one and three months of therapy. Resistive index (RI) and pulsatality index (PI) were calculated using TVCDUS. Tumour response to chemotherapy was determined. Complete response was when no residual tumour was found, partial response if the tumour volume decreased by more than 50%, and no response when there was no appreciable change in the size of tumour, or the tumour volume decreased to less than 50% of the original volume. Results: A statistically significant increase in RI and PI was demonstrated with TVCDUS following treatment in patients who had a complete and partial response to chemoradiation, compared to those who had no response. Conclusion: TVCDUS is useful in predicting clinical response to concurrent chemoradiation in patients with locally advanced cervical cancer. Thus, it is recommended during the pretreatment evaluation and follow-up.
摘要背景:本研究的目的是评估经阴道彩色多普勒超声(TVCDUS)在预测局部晚期宫颈癌患者放化疗反应中的潜在作用。方法:对56例经组织学证实的宫颈癌(IIA-IIIB期)患者在放化疗开始前、治疗1个月和3个月后应用TVCDUS。利用TVCDUS计算电阻指数(RI)和脉搏指数(PI)。测定肿瘤对化疗的反应。完全缓解是指未发现残留肿瘤;部分缓解是指肿瘤体积缩小50%以上;肿瘤大小无明显变化或肿瘤体积缩小至原体积的50%以下时无缓解。结果:与无反应的患者相比,对放化疗有完全和部分反应的患者在接受TVCDUS治疗后,RI和PI有统计学意义上的显著增加。结论:TVCDUS可用于预测局部晚期宫颈癌患者同步放化疗的临床反应。因此,建议在预处理评估和随访时使用。
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引用次数: 3
Cobalt-60 is a logical, economical and comparable alternative to Ir-192: analysis and institutional experience from western India 钴-60是一种合理的、经济的、可与Ir-192相媲美的替代品:来自印度西部的分析和制度经验
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2015-07-03 DOI: 10.1080/20742835.2015.1083720
Upendra Nandwana, N. Rathore, Sunnia Gupta, A. Shukla, Satish Kumar, Kiran Intodia, Poonam Chand Bana, A. Jain
Abstract Objectives: The objective of the study was to examine the dosimetry of intracavitary radiotherapy (ICRT) in carcinoma of the cervix using cobalt-60 (Co-60) as source of ICRT, and as an alternative to iridium-192 (Ir-192). Design: This was a retrospective study. Subjects and setting: The study was on 80 ICRT patients attending the radiotherapy department at Maharana Bhupal Government Hospital, Udaipur, India. Outcome measures: The dosimetry of ICRT was studied retrospectively in 80 related applications. The dose to point A, 60 Gy isodose reference volume, and bladder and rectum maximum and mean doses were defined. Results: It was found that dosimetry with Co-60 as a brachytherapy source was consistent with the International Commission on Radiation Units (ICRU 38) recommendations. Conclusion: Co-60 is a logical alternative to Ir-192 in low socio-economic settings when repeated changing of the source is not an option.
摘要目的:本研究的目的是研究使用钴-60 (Co-60)作为ICRT源并替代铱-192 (Ir-192)的宫颈癌腔内放疗(ICRT)的剂量学。设计:这是一项回顾性研究。研究对象和环境:研究对象为印度乌代普尔Maharana Bhupal政府医院放疗部的80名ICRT患者。结果测量:回顾性研究了80个相关应用的ICRT剂量学。定义了到达A点的剂量、60 Gy等剂量参考体积、膀胱和直肠的最大剂量和平均剂量。结果:发现以Co-60作为近距离放射治疗源的剂量测定符合国际放射单位委员会(ICRU 38)的建议。结论:在低社会经济环境中,当重复改变来源不是一个选择时,Co-60是Ir-192的合乎逻辑的替代品。
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引用次数: 3
Adjuvant treatment, tumour recurrence and the survival rate of uterine serous carcinomas: a single-institution review of 62 women 辅助治疗、肿瘤复发和子宫浆液性癌的生存率:62名妇女的单机构回顾
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2015-01-02 DOI: 10.1080/20742835.2015.1030891
F. Pol, D. Allen, R. Bekkers, P. Grant, S. Hyde
Abstract Objectives: The aim of this study was to assess our department’s management of uterine serous carcinoma (USC) and to determine the correlation of the recurrence and survival rates of stage I-IV patients with different adjuvant treatment modalities. Design: A retrospective, single-institution, observational cohort study was performed. Subjects and setting: The study participants were women diagnosed with stage I-IV USC between 1996 and 2012 at the Mercy Hospital for Women, Heidelberg, Australia. Outcome measures: Outcomes measures were tumour recurrence rates, relapse-free survival and overall survival relating to the different adjuvant treatment modalities. Method: A retrospective, single-institution study on 62 women with stage I-IV USC diagnosed between 1996 and 2012 was performed. Results: Thirty patients had stage I, 5 stage II, 16 stage III and 11 stage IV, disease. Twenty patients received no adjuvant treatment, 19 patients adjuvant radiotherapy, 13 adjuvant chemotherapy and 10 adjuvant chemoradiation. Thirty-two (52%) patients experienced a recurrence and 32 patients were deceased, of whom 29 deaths were USC related. Recurrence risk correlated with stage (p-value 0.000). Early-stage (I and II) disease was associated with significant better relapse-free survival and overall survival than advanced-stage (III and IV) disease (p-value 0.000 and p-value 0.001, respectively). Adjuvant treatment significantly improved relapse-free survival and overall survival (p-value 0.008 and p-value 0.020, respectively), compared to no adjuvant treatment. Furthermore, a statistically significant improvement in relapse-free survival (p-value 0.035) and a trend towards better overall survival (p-value 0.064) was demonstrated with chemotherapy. Conclusion: USC has a high recurrence rate and overall prognosis is poor. The stage of disease seems to be the best predictor of prognosis. This study suggests that even patients with early-stage (I and II) disease, i.e. either pure or mixed USC, should receive adjuvant treatment, as all of these women have a significantly high risk of recurrence. Currently, radiotherapy and chemotherapy are the adjuvant therapies used for USC. Prospective studies may help to determine the most effective adjuvant therapies.
摘要目的:本研究旨在评价我科对子宫浆液性癌(USC)的处理情况,并探讨不同辅助治疗方式对I-IV期患者复发率和生存率的影响。设计:进行回顾性、单机构、观察性队列研究。研究对象和环境:研究参与者是1996年至2012年间在澳大利亚海德堡妇女慈善医院诊断为I-IV期南加州大学的女性。结果测量:结果测量是与不同辅助治疗方式相关的肿瘤复发率、无复发生存期和总生存期。方法:对1996年至2012年间诊断为I-IV期USC的62名女性进行回顾性、单机构研究。结果:ⅰ期30例,ⅱ期5例,ⅲ期16例,ⅳ期11例。无辅助治疗20例,辅助放疗19例,辅助化疗13例,辅助放化疗10例。32例(52%)患者复发,32例患者死亡,其中29例死亡与USC相关。复发风险与分期相关(p值0.000)。与晚期(III和IV)疾病相比,早期(I和II)疾病的无复发生存期和总生存期明显更好(p值分别为0.000和0.001)。与无辅助治疗相比,辅助治疗显著提高了无复发生存期和总生存期(p值分别为0.008和0.020)。此外,化疗可显著改善无复发生存(p值0.035),并有改善总生存的趋势(p值0.064)。结论:USC复发率高,整体预后较差。疾病的分期似乎是预测预后的最佳指标。本研究表明,即使是早期(I和II)疾病的患者,即单纯或混合性USC,也应接受辅助治疗,因为所有这些女性都有明显的高复发风险。目前,放疗和化疗是USC的辅助治疗方法。前瞻性研究可能有助于确定最有效的辅助治疗。
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引用次数: 4
Retrospective analysis of patients with cancer of the cervix attending a radiotherapy outpatient department: experience from a university-based hospital in eastern Uttar Pradesh, India 在印度北方邦东部一所大学附属医院接受放射治疗的宫颈癌患者的回顾性分析
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2015-01-02 DOI: 10.1080/20742835.2015.1083680
M. Nandi, A. Mandal, A. Asthana
Abstract Objective: A retrospective analysis of all patients with cancer of the cervix attending a radiotherapy outpatients department in a single unit from January 2005 to December 2006 was carried out to study their epidemiology, stage and status of presentation, compliance with treatment and follow-up, as well as response and complication rates. Design: This was a retrospective study. Setting and subjects: Four hundred and ninety-five consecutively registered patients with cancer of the cervix were included in the study, which was carried out between January 2007 and December 2008. Outcome measures: The epidemiology, stage and status of presentation, compliance with treatment and follow-up, as well as the response and complication rates of the treated patients were the outcome measures. Results: Most of the patients hailed from the various districts of Uttar Pradesh (58%) and Bihar (32%), India. The majority (> 50%) were aged 40-59 years. Stage information was available for 70% of the patients, of which stage 1 comprised 5%, stage 2, 36%; stage 3, 56%; and stage 4, 3%. Squamous cell carcinoma was the most common reported histopathology (~90%). A significant proportion of the women defaulted after registration, or after undergoing investigations (34%). Of the 65% cases planned for treatment, 50% initiated it, but only 35% completed it, according to protocol. Radical radiotherapy was planned for the majority of women (>90%) with or without chemotherapy. Compliance with follow-up was poor (26%). At the time of the analysis, 63% patients had a complete response, 12% residual disease, 16% progressive disease and 7% locoregional recurrence. Recorded late complications were mostly grade I and II bladder and rectal toxicity. Conclusion: The outcome of this study will significantly help us to define region-specific strategies needed for the management of cervical cancer in eastern Uttar Pradesh, India.
摘要目的:回顾性分析2005年1月至2006年12月在同一单位放射治疗门诊部就诊的宫颈癌患者的流行病学、分期及表现、治疗依从性、随访情况、疗效及并发症发生率。设计:这是一项回顾性研究。背景和对象:在2007年1月至2008年12月期间,495名连续登记的宫颈癌患者被纳入研究。结局指标:以流行病学、病程分期及状况、治疗依从性及随访、治疗后患者的反应及并发症发生率为结局指标。结果:大多数患者来自印度北方邦(58%)和比哈尔邦(32%)的各区。大多数(50%)年龄在40-59岁之间。70%的患者可获得分期信息,其中一期占5%,二期占36%;第三阶段,56%;第4阶段,3%鳞状细胞癌是最常见的组织病理(约90%)。很大一部分妇女在登记后或接受调查后违约(34%)。根据协议,在计划治疗的65%病例中,50%开始治疗,但只有35%完成治疗。大多数女性(约90%)伴化疗或不伴化疗均计划进行根治性放疗。随访依从性较差(26%)。在分析时,63%的患者完全缓解,12%的患者残留疾病,16%的患者进展,7%的患者局部复发。记录的晚期并发症多为I级和II级膀胱和直肠毒性。结论:本研究的结果将极大地帮助我们确定印度北方邦东部宫颈癌管理所需的区域特定策略。
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引用次数: 4
Epithelioid trophoblastic tumour: a report of two cases 上皮样滋养细胞瘤附2例报告
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2015-01-02 DOI: 10.1080/20742835.2015.1030893
M. Elhassan, H-T Wu, A. V. van Wijk
An epithelioid trophoblalstic tumour (ETT) is an extremely rare form of gestational trophoblastic disease (GTD). 1 Usually, patients are of child-bearing age with a prior gestation. 2 The uterus is the most common site for an ETT. 3 This tumour has the same clinical behaviour as that of a placental site trophblastic tumour, but the treatment options may differ. Histologically, an ETT is a distinct neoplasm whose cytological features and growth patterns mimic those of squamous cell carcinoma. 3 An ETT does not appear to be as chemosensitive as other GTDs, making hysterectomy the treatment of choice in patients with disease confined to the uterus. 3 This tumour may present a diagnostic challenge to the pathologist, while clinicians often face problems with treating this tumour because of its rarity. We describe two cases of an ETT occurring in two women, one aged 44 years and the other 42 years.
上皮样滋养细胞瘤(ETT)是一种极为罕见的妊娠滋养细胞疾病(GTD)。1患者通常为育龄且有妊娠史。子宫是ETT最常见的部位。该肿瘤具有与胎盘部位滋养性肿瘤相同的临床表现,但治疗选择可能不同。组织学上,ETT是一种独特的肿瘤,其细胞学特征和生长模式与鳞状细胞癌相似。ETT似乎不像其他gtd那样具有化疗敏感性,这使得子宫切除术成为局限于子宫的疾病患者的治疗选择。这种肿瘤可能对病理学家提出诊断挑战,而临床医生在治疗这种肿瘤时往往面临问题,因为它的罕见性。我们描述了两例发生在两名女性的ETT,一名年龄44岁,另一名年龄42岁。
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引用次数: 3
Psoas abscess: a rare metastatic presentation of asymptomatic carcinoma of the cervix 腰肌脓肿:一种罕见的宫颈无症状癌的转移性表现
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2015-01-02 DOI: 10.1080/20742835.2015.1030894
Ruquiya Afrose, Mohammad Akram, Saifullah Khalid, S. S. Ahmad, S. Siddiqui
Abstract Isolated metastasis to the iliopsoas muscle is rare and is often misdiagnosed as psoas abcess, especially when it is the only presenting feature in the absence of a known primary tumour. A 52-year-old woman presented to us with a clinicoradiological diagnosis of psoas abscess. Initially, the patient was managed as a case of tubercular psoas abscess. However, later on, when the disease had not responded to antitubercular therapy, a cytological examination of aspirated material was performed, which confirmed it as being malignant in origin. While searching for primary malignancy, a small growth on the cervix was noticed. A biopsy and histopathological examination confirmed the diagnosis of squamous cell carcinoma of the cervix. A final diagnosis of squamous cell carcinoma of the cervix with isolated iliopsoas muscle metastasis was proposed. This case highlights an unusual site of metastasis in an asymptomatic primary tumour which was diagnosed retrospectively.
孤立的髂腰肌转移是罕见的,经常被误诊为腰肌脓肿,特别是当它是唯一的表现特征,没有已知的原发肿瘤。一位52岁的女性向我们提出了腰肌脓肿的临床放射诊断。最初,病人被处理为结核性腰肌脓肿。然而,后来,当疾病对抗结核治疗没有反应时,对吸入的物质进行细胞学检查,证实其起源是恶性的。在寻找原发性恶性肿瘤时,注意到宫颈上有一个小的生长。活检和组织病理学检查证实了宫颈癌的诊断。最后诊断宫颈鳞状细胞癌与孤立髂腰肌转移提出。本病例强调了回顾性诊断的无症状原发性肿瘤的不寻常转移部位。
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引用次数: 0
Living with the late effects of cervical cancer treatment: a descriptive qualitative study at an academic hospital in Gauteng 生活与宫颈癌治疗的后期影响:在豪登省一家学术医院进行的描述性定性研究
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2015-01-02 DOI: 10.1080/20742835.2015.1030890
SN Ntinga, J. Maree
Abstract Objective: The late effects of cervical cancer and its treatment are well known. However, qualitative research describing how women experience these effects seems to be unavailable. The purpose of our study was to describe how women experienced the late effects of cervical cancer treatment. Design: A qualitative descriptive design was used. Subjects and setting: Purposive sampling was employed to select the participants treated at an academic hospital in Gauteng. Sixteen in-depth interviews were conducted. Data saturation determined the sample size. Thematic analysis was used to analyse the data. Results: The average age of the sample was 44.1 years, and half of the participants had stage IIB cancer. Most were treated with external beam radiation in combination with brachytherapy. Five themes arose from the data, namely experiencing the physical consequences of the treatment, struggling with the socio-economic implications of the treatment, living with the sexual consequences of the treatment, spiritual issues relating to cervical cancer and facing health system challenges. Conclusion: The late effects deriving from cervical cancer treatment deprived women of the lives they lived before they were treated for cervical cancer. They were burdened with physical changes which aggravated their already difficult financial situation, and they had to live with unattended healthcare needs. Sexual dysfunction changed their intimate partner relationships, leading to anxiety about the possible loss of their life partners. Despite all this, they were positive about their future owing to their faith. Nurses should assess patients for the late effects of cervical cancer and implement interventions to meet their individual needs.
摘要目的:宫颈癌的晚期效应及其治疗已为人们所熟知。然而,描述女性如何经历这些影响的定性研究似乎是不可用的。我们研究的目的是描述妇女如何经历宫颈癌治疗的后期影响。设计:采用定性描述设计。对象和环境:采用有目的抽样方法选择在豪登省一所学术医院接受治疗的参与者。共进行了16次深度访谈。数据饱和度决定了样本量。采用主题分析法对数据进行分析。结果:样本的平均年龄为44.1岁,一半的参与者患有IIB期癌症。大多数采用外束放射联合近距离治疗。数据产生了五个主题,即经历治疗的身体后果,与治疗的社会经济影响作斗争,与治疗的性后果生活,与宫颈癌有关的精神问题以及面临卫生系统挑战。结论:宫颈癌治疗的后期效应剥夺了妇女在宫颈癌治疗前的生活。他们承受着身体变化的负担,这加剧了他们本已困难的经济状况,他们不得不在无人照顾的医疗需求下生活。性功能障碍改变了他们的亲密伴侣关系,导致他们对可能失去生活伴侣的焦虑。尽管如此,由于他们的信仰,他们对未来充满信心。护士应评估患者宫颈癌的后期影响,并实施干预措施,以满足他们的个人需求。
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引用次数: 20
Pharmacological options for the protection of ovarian function in patients undergoing chemotherapy 化疗患者卵巢功能保护的药理选择
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2015-01-02 DOI: 10.1080/20742835.2015.1030888
M. Botha
Abstract Chemotherapy, particularly alkylating agents, can be toxic to germ cells, and may lead to treatment amenorrhoea in young women. The age at which chemotherapy is administered is a strong predictor of subsequent premature ovarian failure, with older patients being at the highest risk. Smaller primordial follicles may survive the insult of chemotherapy better, and the suppression of follicle development may protect the germ cell pool. The suppression of follicle development by gonadotrophin-releasing hormone agonists (or antagonists) or combined oral contraceptives has been reported in the literature. The results are promising, but conflicting reports on the protection makes further studies essential.
化疗,特别是烷基化剂,可能对生殖细胞有毒性,并可能导致年轻女性闭经治疗。接受化疗的年龄是随后卵巢早衰的一个强有力的预测指标,年龄较大的患者风险最高。较小的原始卵泡可以更好地承受化疗的伤害,抑制卵泡发育可以保护生殖细胞池。促性腺激素释放激素激动剂(或拮抗剂)或联合口服避孕药对卵泡发育的抑制已有文献报道。结果是有希望的,但是关于保护的相互矛盾的报告使得进一步的研究是必要的。
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引用次数: 3
About this issue… 关于这个问题……
IF 0.3 Q4 OBSTETRICS & GYNECOLOGY Pub Date : 2014-01-01 DOI: 10.1080/20742835.2014.11441220
G. Dreyer
{"title":"About this issue…","authors":"G. Dreyer","doi":"10.1080/20742835.2014.11441220","DOIUrl":"https://doi.org/10.1080/20742835.2014.11441220","url":null,"abstract":"","PeriodicalId":41638,"journal":{"name":"Southern African Journal of Gynaecological Oncology","volume":"6 1","pages":"3 - 4"},"PeriodicalIF":0.3,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/20742835.2014.11441220","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60046609","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}
引用次数: 0
期刊
Southern African Journal of Gynaecological Oncology
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