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https://www.readbyqxmd.com/read/29244996/health-seeking-behavior-and-barriers-to-care-in-patients-with-rectal-bleeding-in-nigeria
#1
Olusegun I Alatise, Sara E Fischer, Omobolaji O Ayandipo, Akinlolu G Omisore, Samuel A Olatoke, T Peter Kingham
Purpose Colorectal cancer (CRC) incidence rates are steadily increasing in Nigeria. Organized screening is still largely unused because of financial and logistical barriers; most CRCs are detected by symptoms. One symptom of CRC is rectal bleeding. This study sought to determine health-seeking behavior and barriers to care in patients with rectal bleeding in Nigeria. This study also surveyed physicians to determine major breakdowns in access to care. Methods The recruitment process for this study involved patients referred for colonoscopy because of rectal bleeding as well as response to a media advertisement for a free colonoscopy...
December 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/29243245/treatment-deintensification-in-human-papillomavirus-positive-oropharynx-cancer-outcomes-from-the-national-cancer-data-base
#2
Shayan Cheraghlou, Phoebe K Yu, Michael D Otremba, Henry S Park, Aarti Bhatia, Cheryl K Zogg, Saral Mehra, Wendell G Yarbrough, Benjamin L Judson
BACKGROUND: The growing epidemic of human papillomavirus-positive (HPV+) oropharyngeal cancer and the favorable prognosis of this disease etiology have led to a call for deintensified treatment for some patients with HPV+ cancers. One of the proposed methods of treatment deintensification is the avoidance of chemotherapy concurrent with definitive/adjuvant radiotherapy. To the authors' knowledge, the safety of this form of treatment de-escalation is unknown and the current literature in this area is sparse...
December 15, 2017: Cancer
https://www.readbyqxmd.com/read/29242746/a-practical-method-of-i-131-thyroid-cancer-therapy-dose-optimization-using-estimated-effective-renal-clearance
#3
Brandon A Howard, Olga G James, Jennifer M Perkins, Robert A Pagnanelli, Salvador Borges-Neto, Robert E Reiman
In thyroid cancer patients with renal impairment or other complicating factors, it is important to maximize I-131 therapy efficacy while minimizing bone marrow and lung damage. We developed a web-based calculator based on a modified Benua and Leeper method to calculate the maximum I-131 dose to reduce the risk of these toxicities, based on the effective renal clearance of I-123 as measured from two whole-body I-123 scans, performed at 0 and 24 h post-administration.
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29242398/actual-impact-of-68ga-psma-11-pet-ct-on-the-management-of-prostate-cancer-patients-with-biochemical-recurrence
#4
Jérémie Calais, Wolfgang P Fendler, Matthias Eiber, Jeannine Gartmann, Fang-I Chu, Nicholas G Nickols, Robert R Reiter, Matthew B Rettig, Leonard S Marks, Thomas E Ahlering, Lynda Huynh, Roger Slavik, Pawan Gupta, Andrew Quon, Martin S Allen-Auerbach, Johannes Czernin, Ken Herrmann
Purpose: In this prospective survey of referring physicians, we investigated whether and how Gallium-68 Prostate Specific Membrane Antigen Positron Emission Tomography/Computed Tomography (PSMA-11 PET/CT) affects the actually implemented management of prostate cancer patients wih biochemical recurrence (BCR). Methods: We conducted a prospective survey of physicians (NCT02940262) who referred 161 patients with prostate cancer BCR (median Prostate Specific Antigen (PSA) value 1.7 ng/ml (range 0.05-202)). Referring physicians completed one questionnaire prior to the scan to indicate the treatment plan without PSMA-11 PET/CT information (Q1; n = 101); one immediately after the scan to denote intended management changes (Q2; n = 101); and one 3 to 6 months later to document the final implemented management (Q3; n = 56)...
December 14, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/29242113/professionals-knowledge-attitude-and-referral-behaviour-of-preimplantation-genetic-diagnosis-for-hereditary-breast-and-ovarian-cancer
#5
J J G Gietel-Habets, C E M de Die-Smulders, V C G Tjan-Heijnen, I A P Derks-Smeets, R van Golde, E Gomez-Garcia, L A D M van Osch
Hereditary breast and ovarian cancer caused by a BRCA1/2 mutation is the most frequent indication for preimplantation genetic diagnosis (PGD) in the Netherlands. The extent to which involved professionals are informed about this option, however, is unclear. The few available international studies mostly represent a limited range of professionals, and suggest that their knowledge about PGD for hereditary cancer syndromes is sparse and referral for PGD is based on limited understanding. A cross-sectional survey assessing awareness, knowledge, acceptability and PGD-referral for BRCA was completed by 188 professionals involved in the field of breast and ovarian cancer or reproduction...
December 6, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/29241901/comparison-of-timed-automata-with-discrete-event-simulation-for-modeling-of-biomarker-based-treatment-decisions-an-illustration-for-metastatic-castration-resistant-prostate-cancer
#6
Koen Degeling, Stefano Schivo, Niven Mehra, Hendrik Koffijberg, Rom Langerak, Johann S de Bono, Maarten J IJzerman
BACKGROUND: With the advent of personalized medicine, the field of health economic modeling is being challenged and the use of patient-level dynamic modeling techniques might be required. OBJECTIVES: To illustrate the usability of two such techniques, timed automata (TA) and discrete event simulation (DES), for modeling personalized treatment decisions. METHODS: An early health technology assessment on the use of circulating tumor cells, compared with prostate-specific antigen and bone scintigraphy, to inform treatment decisions in metastatic castration-resistant prostate cancer was performed...
December 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29241727/simple-classifiers-for-molecular-subtypes-of-colorectal-cancer
#7
Woo Gyeong Kim, Joo Yeon Kim, Do Youn Park
BACKGROUND AND STUDY AIM: Colorectal cancer (CRC) is a heterogeneous disease entity with a diverse biological pathogenesis. This study aims to validate the two studies published in 2013 which established a separate CRC molecular subtype classification by utilizing a rapidly accessible miniclassifier, and verify a simplified version thereof. PATIENTS AND METHODS: Participants diagnosed with CRC (n = 568) were subtyped in three classifications for characteristic, and prognostic purposes...
December 11, 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/29240775/ornithine-decarboxylase-as-a-therapeutic-target-for-endometrial-cancer
#8
Hong Im Kim, Chad R Schultz, Andrea L Buras, Elizabeth Friedman, Alyssa Fedorko, Leigh Seamon, Gadisetti V R Chandramouli, G Larry Maxwell, André S Bachmann, John I Risinger
Ornithine Decarboxylase (ODC) a key enzyme in polyamine biosynthesis is often overexpressed in cancers and contributes to polyamine-induced cell proliferation. We noted ubiquitous expression of ODC1 in our published endometrial cancer gene array data and confirmed this in the cancer genome atlas (TCGA) with highest expression in non-endometrioid, high grade, and copy number high cancers, which have the worst clinical outcomes. ODC1 expression was associated with worse overall survival and increased recurrence in three endometrial cancer gene expression datasets...
2017: PloS One
https://www.readbyqxmd.com/read/29240007/alternative-fistula-risk-score-for-pancreatoduodenectomy-a-frs-design-and-international-external-validation
#9
Timothy H Mungroop, L Bengt van Rijssen, David van Klaveren, F Jasmijn Smits, Victor van Woerden, Ralph J Linnemann, Matteo de Pastena, Sjors Klompmaker, Giovanni Marchegiani, Brett L Ecker, Susan van Dieren, Bert Bonsing, Olivier R Busch, Ronald M van Dam, Joris Erdmann, Casper H van Eijck, Michael F Gerhards, Harry van Goor, Erwin van der Harst, Ignace H de Hingh, Koert P de Jong, Geert Kazemier, Misha Luyer, Awad Shamali, Salvatore Barbaro, Thomas Armstrong, Arjun Takhar, Zaed Hamady, Joost Klaase, Daan J Lips, I Quintus Molenaar, Vincent B Nieuwenhuijs, Coen Rupert, Hjalmar C van Santvoort, Joris J Scheepers, George P van der Schelling, Claudio Bassi, Charles M Vollmer, Ewout W Steyerberg, Mohammed Abu Hilal, Bas Groot Koerkamp, Marc G Besselink
OBJECTIVE: The aim of this study was to develop an alternative fistula risk score (a-FRS) for postoperative pancreatic fistula (POPF) after pancreatoduodenectomy, without blood loss as a predictor. BACKGROUND: Blood loss, one of the predictors of the original-FRS, was not a significant factor during 2 recent external validations. METHODS: The a-FRS was developed in 2 databases: the Dutch Pancreatic Cancer Audit (18 centers) and the University Hospital Southampton NHS...
December 12, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29238985/impaired-functional-vitamin-b6-status-is-associated-with-increased-risk-of-lung-cancer
#10
Despoina Theofylaktopoulou, Øivind Midttun, Per M Ueland, Klaus Meyer, Anouar Fanidi, Wei Zheng, Xiao-Ou Shu, Yong-Bing Xiang, Ross Prentice, Mary Pettinger, Cynthia A Thomson, Graham G Giles, Allison Hodge, Qiuyin Cai, William J Blot, Jie Wu, Mikael Johansson, Johan Hultdin, Kjell Grankvist, Victoria L Stevens, Marjorie M McCullough, Stephanie J Weinstein, Demetrius Albanes, Regina Ziegler, Neal D Freedman, Arnulf Langhammer, Kristian Hveem, Marit Naess, Howard D Sesso, J Michael Gaziano, Julie E Buring, I-Min Lee, Gianluca Severi, Xuehong Zhang, Meir J Stampfer, Jiali Han, Stephanie A Smith-Warner, Anne Zeleniuch-Jacquotte, Loic le Marchand, Jian-Min Yuan, Renwei Wang, Lesley M Butler, Woon-Puay Koh, Yu-Tang Gao, Nathaniel Rothman, Ulrika Ericson, Emily Sonestedt, Kala Visvanathan, Miranda R Jones, Caroline Relton, Paul Brennan, Mattias Johansson, Arve Ulvik
Circulating vitamin B6 levels have been found to be inversely associated with lung cancer. Most studies have focused on the B6 form pyridoxal 5'-phosphate (PLP), a direct biomarker influenced by inflammation and other factors. Using a functional B6 marker allows further investigation of the potential role of vitamin B6 status in the pathogenesis of lung cancer. We prospectively evaluated the association of the functional marker of vitamin B6 status, the 3-hydroxykynurenine:xanthurenic acid ratio (HK:XA), with risk of lung cancer in a nested case-control study consisting of 5,364 matched case control pairs from the Lung Cancer Cohort Consortium (LC3)...
December 14, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/29238749/a-feasibility-study-of-neoadjuvant-talazoparib-for-operable-breast-cancer-patients-with-a-germline-brca-mutation-demonstrates-marked-activity
#11
J K Litton, M Scoggins, D L Ramirez, R K Murthy, G J Whitman, K R Hess, B E Adrada, S L Moulder, C H Barcenas, V Valero, J Schwartz Gomez, E A Mittendorf, A Thompson, T Helgason, G B Mills, H Piwnica-Worms, B K Arun
This study was undertaken to determine the feasibility of enrolling breast cancer patients on a single-agent-targeted therapy trial before neoadjuvant chemotherapy. Specifically, we evaluated talazoparib in patients harboring a deleterious BRCA mutation (BRCA+). Patients with a germline BRCA mutation and ≥1 cm, HER2-negative primary tumors were eligible. Study participants underwent a pretreatment biopsy, 2 months of talazoparib, off-study core biopsy, anthracycline, and taxane-based chemotherapy ± carboplatin, followed by surgery...
2017: NPJ Breast Cancer
https://www.readbyqxmd.com/read/29236674/citrullus-colocynthis-linn-fruit-extract-ameliorates-cisplatin-induced-hepato-renal-toxicity-in-rats
#12
Olufunmilayo O Adeyemi, Ismail O Ishola, Ifeoluwa D Ajani
Background Cisplatin-induced acute liver and kidney injuries are serious problems in cancer patients during treatment of solid tumours. Objective This study sought to investigate possible protective effect of ethanolic fruit extract of Citrullus colocynthis (CC) against cisplatin-induced hepato-renal toxicity in rats. Methods Thirty male albino rats (150-200 g) were divided into five groups (n=6) and treated as follows: group 1: vehicle (10 mL/kg, p.o.; normal control); group 2: vehicle (10 mL/kg); groups 3-5: CC (100, 200 or 400 mg/kg, p...
December 13, 2017: Journal of Complementary & Integrative Medicine
https://www.readbyqxmd.com/read/29236593/role-of-genetic-testing-for-inherited-prostate-cancer-risk-philadelphia-prostate-cancer-consensus-conference-2017
#13
Veda N Giri, Karen E Knudsen, William K Kelly, Wassim Abida, Gerald L Andriole, Chris H Bangma, Justin E Bekelman, Mitchell C Benson, Amie Blanco, Arthur Burnett, William J Catalona, Kathleen A Cooney, Matthew Cooperberg, David E Crawford, Robert B Den, Adam P Dicker, Scott Eggener, Neil Fleshner, Matthew L Freedman, Freddie C Hamdy, Jean Hoffman-Censits, Mark D Hurwitz, Colette Hyatt, William B Isaacs, Christopher J Kane, Philip Kantoff, R Jeffrey Karnes, Lawrence I Karsh, Eric A Klein, Daniel W Lin, Kevin R Loughlin, Grace Lu-Yao, S Bruce Malkowicz, Mark J Mann, James R Mark, Peter A McCue, Martin M Miner, Todd Morgan, Judd W Moul, Ronald E Myers, Sarah M Nielsen, Elias Obeid, Christian P Pavlovich, Stephen C Peiper, David F Penson, Daniel Petrylak, Curtis A Pettaway, Robert Pilarski, Peter A Pinto, Wendy Poage, Ganesh V Raj, Timothy R Rebbeck, Mark E Robson, Matt T Rosenberg, Howard Sandler, Oliver Sartor, Edward Schaeffer, Gordon F Schwartz, Mark S Shahin, Neal D Shore, Brian Shuch, Howard R Soule, Scott A Tomlins, Edouard J Trabulsi, Robert Uzzo, Donald J Vander Griend, Patrick C Walsh, Carol J Weil, Richard Wender, Leonard G Gomella
Purpose Guidelines are limited for genetic testing for prostate cancer (PCA). The goal of this conference was to develop an expert consensus-driven working framework for comprehensive genetic evaluation of inherited PCA in the multigene testing era addressing genetic counseling, testing, and genetically informed management. Methods An expert consensus conference was convened including key stakeholders to address genetic counseling and testing, PCA screening, and management informed by evidence review. Results Consensus was strong that patients should engage in shared decision making for genetic testing...
December 13, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29236234/assessment-of-the-functional-impact-of-germline-brca1-2-variants-located-in-non-coding-regions-in-families-with-breast-and-or-ovarian-cancer-predisposition
#14
E Santana Dos Santos, S M Caputo, L Castera, M Gendrot, A Briaux, M Breault, S Krieger, P K Rogan, E J Mucaki, L J Burke, I Bièche, C Houdayer, D Vaur, D Stoppa-Lyonnet, M A Brown, F Lallemand, E Rouleau
PURPOSE: The molecular mechanism of breast and/or ovarian cancer susceptibility remains unclear in the majority of patients. While germline mutations in the regulatory non-coding regions of BRCA1 and BRCA2 genes have been described, screening has generally been limited to coding regions. The aim of this study was to evaluate the contribution of BRCA1/2 non-coding variants. METHODS: Four BRCA1/2 non-coding regions were screened using high-resolution melting analysis/Sanger sequencing or next-generation sequencing on DNA extracted from index cases with breast and ovarian cancer predisposition (3926 for BRCA1 and 3910 for BRCA2)...
December 13, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29235566/long-term-survival-outcomes-of-triple-receptor-negative-breast-cancer-survivors-who-are-disease-free-at-5-years-and-relationship-with-low-hormone-receptor-positivity
#15
S M Reddy, C H Barcenas, A K Sinha, L Hsu, S L Moulder, D Tripathy, G N Hortobagyi, V Valero
BACKGROUND: We counsel our triple-negative breast cancer (TNBC) patients that the risk of recurrence is highest in the first 5 years after diagnosis. However, there are limited data with extended follow-up on the frequency, characteristics, and predictors of late events. METHODS: We queried the MD Anderson Breast Cancer Management System database to identify patients with stage I-III TNBC who were disease free at 5 years from diagnosis. The Kaplan-Meier method was used to estimate yearly recurrence-free interval (RFI), recurrence-free survival (RFS), and distant relapse-free survival (DRFS), as defined by the STEEP criteria...
December 12, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/29233869/mtorc1-as-the-main-gateway-to-autophagy
#16
REVIEW
Yoana Rabanal-Ruiz, Elsje G Otten, Viktor I Korolchuk
Cells and organisms must coordinate their metabolic activity with changes in their environment to ensure their growth only when conditions are favourable. In order to maintain cellular homoeostasis, a tight regulation between the synthesis and degradation of cellular components is essential. At the epicentre of the cellular nutrient sensing is the mechanistic target of rapamycin complex 1 (mTORC1) which connects environmental cues, including nutrient and growth factor availability as well as stress, to metabolic processes in order to preserve cellular homoeostasis...
December 12, 2017: Essays in Biochemistry
https://www.readbyqxmd.com/read/29232439/body-mass-index-and-breast-cancer-survival-a-mendelian-randomization-analysis
#17
Qi Guo, Stephen Burgess, Constance Turman, Manjeet K Bolla, Qin Wang, Michael Lush, Jean Abraham, Kristiina Aittomäki, Irene L Andrulis, Carmel Apicella, Volker Arndt, Myrto Barrdahl, Javier Benitez, Christine D Berg, Carl Blomqvist, Stig E Bojesen, Bernardo Bonanni, Judith S Brand, Hermann Brenner, Annegien Broeks, Barbara Burwinkel, Carlos Caldas, Daniele Campa, Federico Canzian, Jenny Chang-Claude, Stephen J Chanock, Suet-Feung Chin, Fergus J Couch, Angela Cox, Simon S Cross, Cezary Cybulski, Kamila Czene, Hatef Darabi, Peter Devilee, W Ryan Diver, Alison M Dunning, Helena M Earl, Diana M Eccles, Arif B Ekici, Mikael Eriksson, D Gareth Evans, Peter A Fasching, Jonine Figueroa, Dieter Flesch-Janys, Henrik Flyger, Susan M Gapstur, Mia M Gaudet, Graham G Giles, Gord Glendon, Mervi Grip, Jacek Gronwald, Lothar Haeberle, Christopher A Haiman, Per Hall, Ute Hamann, Susan Hankinson, Jaana M Hartikainen, Alexander Hein, Louise Hiller, Frans B Hogervorst, Bernd Holleczek, Maartje J Hooning, Robert N Hoover, Keith Humphreys, David J Hunter, Anika Hüsing, Anna Jakubowska, Arja Jukkola-Vuorinen, Rudolf Kaaks, Maria Kabisch, Vesa Kataja, Julia A Knight, Linetta B Koppert, Veli-Matti Kosma, Vessela N Kristensen, Diether Lambrechts, Loic Le Marchand, Jingmei Li, Annika Lindblom, Sara Lindström, Jolanta Lissowska, Jan Lubinski, Mitchell J Machiela, Arto Mannermaa, Siranoush Manoukian, Sara Margolin, Federik Marme, John W M Martens, Catriona McLean, Primitiva Menéndez, Roger L Milne, Anna Marie Mulligan, Taru A Muranen, Heli Nevanlinna, Patrick Neven, Sune F Nielsen, Børge G Nordestgaard, Janet E Olson, Jose I A Perez, Paolo Peterlongo, Kelly-Anne Phillips, Christopher J Poole, Katri Pylkäs, Paolo Radice, Nazneen Rahman, Thomas Rüdiger, Anja Rudolph, Elinor J Sawyer, Fredrick Schumacher, Petra Seibold, Caroline Seynaeve, Mitul Shah, Ann Smeets, Melissa C Southey, Rob A E M Tollenaar, Ian Tomlinson, Helen Tsimiklis, Hans-Ulrich Ulmer, Celine Vachon, Ans M W van den Ouweland, Laura J Van't Veer, Hans Wildiers, Walter Willett, Robert Winqvist, M Pilar Zamora, Georgia Chenevix-Trench, Thilo Dörk, Douglas F Easton, Montserrat García-Closas, Peter Kraft, John L Hopper, Wei Zheng, Marjanka K Schmidt, Paul D P Pharoah
Background: There is increasing evidence that elevated body mass index (BMI) is associated with reduced survival for women with breast cancer. However, the underlying reasons remain unclear. We conducted a Mendelian randomization analysis to investigate a possible causal role of BMI in survival from breast cancer. Methods: We used individual-level data from six large breast cancer case-cohorts including a total of 36 210 individuals (2475 events) of European ancestry...
December 1, 2017: International Journal of Epidemiology
https://www.readbyqxmd.com/read/29230692/seom-clinical-guideline-on-unknown-primary-cancer-2017
#18
F Losa, G Soler, A Casado, A Estival, I Fernández, S Giménez, F Longo, R Pazo-Cid, J Salgado, M Á Seguí
Cancer of unknown primary site is a histologically confirmed cancer that manifests in advanced stage, with no identifiable primary site following standard diagnostic procedures. Patients are initially categorized based on the findings of the initial biopsy: adenocarcinoma, squamous-cell carcinoma, neuroendocrine carcinoma, and poorly differentiated carcinoma. Appropriate patient management requires understanding several clinical and pathological features that aid in identifying several subsets of patients with more responsive tumors...
December 11, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29229607/race-disparities-in-the-contribution-of-mirna-isoforms-and-trna-derived-fragments-to-triple-negative-breast-cancer
#19
Aristeidis G Telonis, Isidore Rigoutsos
Triple-Negative Breast Cancer (TNBC) is a breast cancer subtype characterized by marked differences between White and Black/African-American women. We performed a systems-level analysis on datasets from The Cancer Genome Atlas (TCGA) to elucidate how the expression patterns of messenger RNAs (mRNAs) are shaped by regulatory non-coding RNAs (ncRNAs). Specifically, we studied isomiRs, i.e. isoforms of microRNAs (miRNAs), and tRNA-derived fragments (tRFs). In normal breast tissue, we observed a marked cohesiveness in both the ncRNA and mRNA layers and the associations between them...
December 11, 2017: Cancer Research
https://www.readbyqxmd.com/read/29229507/patient-reported-dry-mouth-instrument-comparison-and-model-performance-for-correlation-with-quality-of-life-in-head-and-neck-cancer-survivors
#20
Mona Kamal, David I Rosenthal, Stefania Volpe, Ryan P Goepfert, Adam S Garden, Katherine A Hutcheson, Karine A Al Feghali, Mohamed Ahmed Mohamed Meheissen, Salman A Eraj, Amy E Dursteler, Bowman Williams, Joshua B Smith, Jeremy M Aymard, Joel Berends, Aubrey L White, Steven J Frank, William H Morrison, Richard Cardoso, Mark S Chambers, Erich M Sturgis, Tito R Mendoza, Charles Lu, Abdallah S R Mohamed, Clifton D Fuller, G Brandon Gunn
PURPOSE: To identify a clinically meaningful cut-point for the single item dry mouth question of the MD Anderson Symptom Inventory-Head and Neck module (MDASI-HN). METHODS: Head and neck cancer survivors who had received radiation therapy (RT) completed the MDASI-HN, the University of Michigan Hospital Xerostomia Questionnaire (XQ), and the health visual analog scale (VAS) of the EuroQol Five Dimension Questionnaire (EQ-5D). The Bayesian information criteria (BIC) were used to test the prediction power of each tool for EQ-5D VAS...
December 8, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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