Pub Date : 2025-11-03DOI: 10.1016/j.prro.2025.09.007
Juliet Maina, Anouk Benseler, Oleksandra Dzyubak, Genevieve Bouchard-Fortier, Sarah E Ferguson, Julia Skliarenko, Kathy Han
Magnetic resonance imaging-guided brachytherapy is an essential component of curative treatment in locally advanced cervical cancer. The use of interstitial needles improves local control rate for locally advanced cervical cancer compared to intracavitary brachytherapy alone. Bleeding is one of the most common complications from cervix interstitial brachytherapy, typically managed by pressure with surgical sponge/packing with or without a hemostatic agent. Herein, we present a case of stage IVA cervical cancer with retained surgical sponge in the pelvis from magnetic resonance imaging-guided intracavitary/interstitial brachytherapy, and recommendations for future brachytherapy procedures.
{"title":"Retained Surgical Sponge in the Pelvis From Magnetic Resonance Imaging-Guided Cervix Brachytherapy.","authors":"Juliet Maina, Anouk Benseler, Oleksandra Dzyubak, Genevieve Bouchard-Fortier, Sarah E Ferguson, Julia Skliarenko, Kathy Han","doi":"10.1016/j.prro.2025.09.007","DOIUrl":"10.1016/j.prro.2025.09.007","url":null,"abstract":"<p><p>Magnetic resonance imaging-guided brachytherapy is an essential component of curative treatment in locally advanced cervical cancer. The use of interstitial needles improves local control rate for locally advanced cervical cancer compared to intracavitary brachytherapy alone. Bleeding is one of the most common complications from cervix interstitial brachytherapy, typically managed by pressure with surgical sponge/packing with or without a hemostatic agent. Herein, we present a case of stage IVA cervical cancer with retained surgical sponge in the pelvis from magnetic resonance imaging-guided intracavitary/interstitial brachytherapy, and recommendations for future brachytherapy procedures.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453941","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}
Pub Date : 2025-11-03DOI: 10.1016/j.prro.2025.10.005
Kaitlyn Heintzelman, John C Knoth, Casey Mozingo, Adrienne Duckworth, Cody Kilar, David A Clump, Jason Lamb, Mohammed Almubarak, Phillip M Pifer
This case highlights the challenges of treating patients with non-small cell lung cancer who initially receive neoadjuvant chemoimmunotherapy (chemo-IO) and do not proceed to planned surgery. After multidisciplinary evaluation, a 58-year-old man with stage IIIA squamous cell carcinoma of the left lower lobe received neoadjuvant chemo-IO and was planned for definitive surgical resection. His neoadjuvant course was complicated by the development of IO-related dermatitis and colitis. He was ultimately not offered definitive surgery, representing the ∼20% of patients on neoadjuvant chemo-IO trials that do not proceed to planned surgical resection. The patient completed chemoradiation therapy with 60 Gy in 30 fractions. He subsequently developed multiple significant postradiation toxicities, including a grade 5 bronchial-esophageal fistula, which was managed with palliative intent. This case underscores the importance of comprehensive multidisciplinary discussion before definitive treatment, the data-free zone for the management of patients who receive neoadjuvant chemo-IO and do not undergo definitive resection, and the potential for increased completed chemoradiation toxicity in this setting.
{"title":"A Case for Caution in a New Era of Managing Patients with Locally Advanced Non-Small Cell Lung Cancer: Fatal Bronchial-Esophageal Fistula After Neoadjuvant Chemo-Immunotherapy Followed by Definitive Chemoradiation Therapy.","authors":"Kaitlyn Heintzelman, John C Knoth, Casey Mozingo, Adrienne Duckworth, Cody Kilar, David A Clump, Jason Lamb, Mohammed Almubarak, Phillip M Pifer","doi":"10.1016/j.prro.2025.10.005","DOIUrl":"10.1016/j.prro.2025.10.005","url":null,"abstract":"<p><p>This case highlights the challenges of treating patients with non-small cell lung cancer who initially receive neoadjuvant chemoimmunotherapy (chemo-IO) and do not proceed to planned surgery. After multidisciplinary evaluation, a 58-year-old man with stage IIIA squamous cell carcinoma of the left lower lobe received neoadjuvant chemo-IO and was planned for definitive surgical resection. His neoadjuvant course was complicated by the development of IO-related dermatitis and colitis. He was ultimately not offered definitive surgery, representing the ∼20% of patients on neoadjuvant chemo-IO trials that do not proceed to planned surgical resection. The patient completed chemoradiation therapy with 60 Gy in 30 fractions. He subsequently developed multiple significant postradiation toxicities, including a grade 5 bronchial-esophageal fistula, which was managed with palliative intent. This case underscores the importance of comprehensive multidisciplinary discussion before definitive treatment, the data-free zone for the management of patients who receive neoadjuvant chemo-IO and do not undergo definitive resection, and the potential for increased completed chemoradiation toxicity in this setting.</p>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454015","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}
Pub Date : 2025-11-03DOI: 10.1016/j.prro.2025.10.006
Whoon Jong Kil, Wyatt Smith, Ashley Stiffler, David Cousins, Doris Dimitriadou, Hayeon Kim
{"title":"Unusual Intestinal Displacement Into Breast Radiation Therapy Field in a Patient With Breast Cancer and Ipsilateral Diaphragm Paralysis: Thoracic and Abdominal Organ-Sparing Breast Radiation Therapy Using Continuous Positive Airway Pressure in a Community Cancer Center.","authors":"Whoon Jong Kil, Wyatt Smith, Ashley Stiffler, David Cousins, Doris Dimitriadou, Hayeon Kim","doi":"10.1016/j.prro.2025.10.006","DOIUrl":"10.1016/j.prro.2025.10.006","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454007","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}
Pub Date : 2025-11-01DOI: 10.1016/j.prro.2025.02.013
Aysegul Ucuncu Kefeli MD, Umut Diremsizoglu MD, Ibrahim Halil Suyusal MD, Aykut Oguz Konuk MSc
{"title":"In Regard to Zhang et al","authors":"Aysegul Ucuncu Kefeli MD, Umut Diremsizoglu MD, Ibrahim Halil Suyusal MD, Aykut Oguz Konuk MSc","doi":"10.1016/j.prro.2025.02.013","DOIUrl":"10.1016/j.prro.2025.02.013","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 6","pages":"Pages 632-633"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398539","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}
Pub Date : 2025-11-01DOI: 10.1016/j.prro.2025.05.017
Arpit M. Chhabra MD, Bridget F. Koontz MD, FASTRO, Jordan Johnson MSHA, MLS, Mudit Chowdhary MD, Casey Chollet-Lipscomb MD, James E. Bates MD, Michael Weisman MD, Chirag Shah MD, Join Y. Luh MD
{"title":"In Regard to Skubish et al","authors":"Arpit M. Chhabra MD, Bridget F. Koontz MD, FASTRO, Jordan Johnson MSHA, MLS, Mudit Chowdhary MD, Casey Chollet-Lipscomb MD, James E. Bates MD, Michael Weisman MD, Chirag Shah MD, Join Y. Luh MD","doi":"10.1016/j.prro.2025.05.017","DOIUrl":"10.1016/j.prro.2025.05.017","url":null,"abstract":"","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 6","pages":"Pages 636-637"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145398541","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}
The recurrent laryngeal nerve (RLN) is especially vulnerable in cases of reirradiation, large-volume irradiation, or stereotactic body radiation therapy. Although RLN injury is rarely reported, it can cause hoarseness, swallowing difficulties, and airway obstruction, often with delayed onset. We aimed to map the course of bilateral RLNs on radiation therapy planning computed tomography scans to assess its feasibility as an organ at risk.
{"title":"Pictorial Guide to Delineating the Recurrent Laryngeal Nerve as an Organ at Risk","authors":"Deepak Gupta MBBS, MD , Richa Arunendu MBBS , Shikha Goyal MBBS, MD, DNB , Smriti Ram MBBS , Shyam Singh Bisht MBBS, MD , Debolina Kabiraj MBBS , Sorun Shishak MBBS, MD, DNB , Susovan Banerjee MBBS, MD , Kushal Narang MBBS, MD , Mayur Mayank MBBS, MD, DNB , Tejinder Kataria MBBS, MD, DNB","doi":"10.1016/j.prro.2025.04.001","DOIUrl":"10.1016/j.prro.2025.04.001","url":null,"abstract":"<div><div><span>The recurrent laryngeal nerve<span><span> (RLN) is especially vulnerable in cases of reirradiation, large-volume irradiation, or </span>stereotactic body radiation therapy<span>. Although RLN injury<span> is rarely reported, it can cause hoarseness<span>, swallowing difficulties, and airway obstruction, often with delayed onset. We aimed to map the course of bilateral RLNs on radiation therapy planning </span></span></span></span></span>computed tomography scans to assess its feasibility as an organ at risk.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 6","pages":"Pages e567-e571"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055748","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}
To evaluate the safety and efficacy of the flattening filter-free (FFF) technique compared with the flattening filter (FF) technique in the context of lung tumor stereotactic body radiation therapy (SBRT).
Methods and Materials
The study included a total of 101 lung SBRT treatments among 82 consecutive patients. Patients were treated with an FF technique (FF group, n = 47) between 2012 and 2014 and with an FFF technique (FFF group, n = 54) between 2014 and 2016. Our risk-adapted SBRT fractionation protocol based on location (3 or 5 fractions) remained unchanged during the entire study. Treatment plans consisted of a dynamic conformal half-arc, and the dose was prescribed to the 80% isodose line. FFF treatments are delivered 2.33 times faster than FF treatments because of the higher dose rate of the machine.
Results
The median follow-up for the 82 patients was 55.4 months, and the median overall survival for all patients was 45.9 months. Local control at 2 years post-SBRT of the 101 lesions was excellent and similar in both groups (97.9% in the FF group vs 98.1% in the FFF group). There were no grade 4 or 5 toxicities and only 4 grade 3 lung toxicities (4.1%) in the FF group (vs none in the FFF group). Three patients in the FFF group versus 1 patient in the FF group had a symptomatic rib fracture. Among patients treated free breathing on a single lesion (n = 65), the local recurrence-free survival at 2 years was 85.7% (95% CI, 62.0-95.2) in the FFF group and 71.4% (95% CI, 52-84.1) in the FF group (P = .139).
Conclusions
Patient treatment with lung SBRT using the FFF technique is safe and provides an excellent long-term local control and low toxicity compared with the FF technique.
目的：比较无压平滤光片（FFF）技术与压平滤光片（FF）技术在肺肿瘤立体定向放射治疗（SBRT）中的安全性和有效性。方法和材料：本研究包括82例连续患者共101例肺SBRT治疗。患者于2012年至2014年接受压平滤镜治疗（FF组，n=47），于2014年至2016年接受FFF技术治疗（FFF组，n=54）。在整个研究过程中，我们基于位置的风险适应SBRT分级方案（3或5个分级）保持不变。治疗方案由动态适形半弧组成，剂量按80%等剂量线规定。由于机器的剂量率更高，FFF治疗的递送速度比FF治疗快2.33倍。结果：82例患者的中位随访时间为55.4个月，所有患者的中位总生存期为45.9个月。101个病灶在SBRT后2年的局部控制率很好，两组相似（FF组97.9% vs FFF组98.1%）。FF组没有4级或5级毒性，只有4例3级肺毒性（4.1%）（而FFF组没有）。FFF组3例患者出现症状性肋骨骨折，FF组1例。在对单一病灶进行自由呼吸治疗的患者中（n=65）， FFF组2年局部无复发生存率为85.7% (95% CI [62.0-95.2])， FF组为71.4% (95% CI [52-84.1]) （p=0.139）。结论：与fff技术相比，使用fff技术进行肺SBRT患者治疗是安全的，并且提供了良好的长期局部控制和低毒性。
{"title":"Lung Stereotactic Body Radiation Therapy Using Dynamic Conformal Arc Therapy With or Without Flattening Filter Photon Beam: A French Institutional Experience","authors":"Mickael Preault MD , Leonor Chaltiel MSc , Jonathan Khalifa MD, PhD , Audrey Keller MD , Sarah Zahi MD , Audrey Rabeau MD , Laure Parent PhD , Carole Massabeau MD","doi":"10.1016/j.prro.2025.04.006","DOIUrl":"10.1016/j.prro.2025.04.006","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the safety and efficacy of the flattening filter-free (FFF) technique compared with the flattening filter (FF) technique in the context of lung tumor stereotactic body radiation therapy (SBRT).</div></div><div><h3>Methods and Materials</h3><div>The study included a total of 101 lung SBRT treatments among 82 consecutive patients. Patients were treated with an FF technique (FF group, n = 47) between 2012 and 2014 and with an FFF technique (FFF group, n = 54) between 2014 and 2016. Our risk-adapted SBRT fractionation protocol based on location (3 or 5 fractions) remained unchanged during the entire study. Treatment plans consisted of a dynamic conformal half-arc, and the dose was prescribed to the 80% isodose line. FFF treatments are delivered 2.33 times faster than FF treatments because of the higher dose rate of the machine.</div></div><div><h3>Results</h3><div>The median follow-up for the 82 patients was 55.4 months, and the median overall survival for all patients was 45.9 months. Local control at 2 years post-SBRT of the 101 lesions was excellent and similar in both groups (97.9% in the FF group vs 98.1% in the FFF group). There were no grade 4 or 5 toxicities and only 4 grade 3 lung toxicities (4.1%) in the FF group (vs none in the FFF group). Three patients in the FFF group versus 1 patient in the FF group had a symptomatic rib fracture. Among patients treated free breathing on a single lesion (n = 65), the local recurrence-free survival at 2 years was 85.7% (95% CI, 62.0-95.2) in the FFF group and 71.4% (95% CI, 52-84.1) in the FF group (<em>P</em> = .139).</div></div><div><h3>Conclusions</h3><div>Patient treatment with lung SBRT using the FFF technique is safe and provides an excellent long-term local control and low toxicity compared with the FF technique.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 6","pages":"Pages e553-e566"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994783","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}
Pub Date : 2025-11-01DOI: 10.1016/j.prro.2025.04.011
Jose G. Bazan MD, MS , Sachin R. Jhawar MD, MSC , Sasha Beyer MD, PhD , Erin Healy MD , Karla Kuhn CMD , Julia R. White MD
Purpose
Two randomized controlled trials of external beam accelerated partial breast irradiation (EB-APBI) using 38.5 Gy/10 fractions twice daily demonstrated excellent cancer control outcomes in appropriately selected patients, but with conflicting results regarding cosmesis. A recent randomized controlled trial reported high rates of acceptable cosmesis using 30 Gy/5 fractions every other day, calling into question the most appropriate schedule for EB-APBI. Our accelerated partial breast irradiation approach uses strict contouring, dosimetric, and planning guidelines. We report our experience with twice-daily and every-other-day EB-APBI, hypothesizing that our treatment planning approach would result in acceptable acute toxicity and cosmesis.
Methods and Materials
We identified patients who received EB-APBI from April 2017 to December 2021. Clinical, pathologic, acute toxicity, cosmesis, and dosimetric data for the lumpectomy gross tumor volume, clinical target volume, and planning target volume were collected. Cosmesis was physician-reported using the 4-point Radiation Therapy Oncology Group (RTOG) global cosmetic score: excellent, good, fair (F), and poor (P). We report descriptive statistics to summarize our results.
Results
A total of 245 patients were included with a median follow-up of 19 months (IQR, 9-30 months); the median age was 66 years (IQR, 59-71 years), 82% had invasive breast cancer, 100% had invasive tumors that were hormone-receptor positive/human epidermal growth factor receptor 2 negative, and 96% had nodal surgery for invasive disease. Fractionation was twice daily in 55% of patients, and every other day in 45%. Three-dimensional conformal radiation was used in 88%, with a median of 6 fields, and 96% were treated prone. Most patients had no acute toxicity (55% grade 0 dermatitis; 57% grade 0 fatigue; 97% grade 0 pruritis). The rate of excellent/good cosmesis was 97.1% (n = 238), and F/P was 2.9% (n = 7). The ipsilateral breast V100 was marginally associated with increased odds of F/P cosmesis (odds ratio, 1.18; 95% CI, 0.99-1.42; P = .07).
Conclusions
With multiple-field 3-dimensional conformal radiation in the prone position, EB-APBI can be delivered with extremely low toxicity and great cosmetic results with twice-daily or every-other-day fractionation. Given the low rate of F/P cosmesis, longer follow-up is needed to confirm the stability of these results and to help identify optimal planning dose-volume parameters to help minimize the rate of F/P cosmesis.
{"title":"Favorable Rates of Excellent or Good Cosmetic Outcomes in Patients Treated With Carefully Planned Accelerated Partial Breast Irradiation Delivered Twice Daily or Once Every Other Day","authors":"Jose G. Bazan MD, MS , Sachin R. Jhawar MD, MSC , Sasha Beyer MD, PhD , Erin Healy MD , Karla Kuhn CMD , Julia R. White MD","doi":"10.1016/j.prro.2025.04.011","DOIUrl":"10.1016/j.prro.2025.04.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Two randomized controlled trials of external beam accelerated partial breast irradiation (EB-APBI) using 38.5 Gy/10 fractions twice daily demonstrated excellent cancer control outcomes in appropriately selected patients, but with conflicting results regarding cosmesis. A recent randomized controlled trial reported high rates of acceptable cosmesis using 30 Gy/5 fractions every other day, calling into question the most appropriate schedule for EB-APBI. Our accelerated partial breast irradiation approach uses strict contouring, dosimetric, and planning guidelines. We report our experience with twice-daily and every-other-day EB-APBI, hypothesizing that our treatment planning approach would result in acceptable acute toxicity and cosmesis.</div></div><div><h3>Methods and Materials</h3><div>We identified patients who received EB-APBI from April 2017 to December 2021. Clinical, pathologic, acute toxicity, cosmesis, and dosimetric data for the lumpectomy gross tumor volume, clinical target volume, and planning target volume were collected. Cosmesis was physician-reported using the 4-point Radiation Therapy Oncology Group (RTOG) global cosmetic score: excellent, good, fair (F), and poor (P). We report descriptive statistics to summarize our results.</div></div><div><h3>Results</h3><div>A total of 245 patients were included with a median follow-up of 19 months (IQR, 9-30 months); the median age was 66 years (IQR, 59-71 years), 82% had invasive breast cancer, 100% had invasive tumors that were hormone-receptor positive/human epidermal growth factor receptor 2 negative, and 96% had nodal surgery for invasive disease. Fractionation was twice daily in 55% of patients, and every other day in 45%. Three-dimensional conformal radiation was used in 88%, with a median of 6 fields, and 96% were treated prone. Most patients had no acute toxicity (55% grade 0 dermatitis; 57% grade 0 fatigue; 97% grade 0 pruritis). The rate of excellent/good cosmesis was 97.1% (n = 238), and F/P was 2.9% (n = 7). The ipsilateral breast V100 was marginally associated with increased odds of F/P cosmesis (odds ratio, 1.18; 95% CI, 0.99-1.42; <em>P</em> = .07).</div></div><div><h3>Conclusions</h3><div>With multiple-field 3-dimensional conformal radiation in the prone position, EB-APBI can be delivered with extremely low toxicity and great cosmetic results with twice-daily or every-other-day fractionation. Given the low rate of F/P cosmesis, longer follow-up is needed to confirm the stability of these results and to help identify optimal planning dose-volume parameters to help minimize the rate of F/P cosmesis.</div></div>","PeriodicalId":54245,"journal":{"name":"Practical Radiation Oncology","volume":"15 6","pages":"Pages e529-e539"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991755","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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