{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T19:55:12Z","timestamp":1794254112058,"version":"4.9.0"},"reference-count":41,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"\n Importance<\/jats:title>\n Acute radiation oral mucositis (AROM) is a major dose-limiting toxic effect in patients with nasopharyngeal cancer undergoing radiotherapy. Reduction of severe (grade \u22653) AROM by bacterial decolonization (BD) could improve treatment tolerance and quality of life.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n To evaluate the efficacy of BD with mupirocin nasal ointment in alleviating severe AROM compared with standard of care (SoC) by reducing\n Staphylococcus aureus<\/jats:italic>\n colonization in nasal and oral mucosal during radiotherapy for nasopharyngeal cancer.\n <\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This was a single-center, open-label, phase 3 randomized clinical trial in China that enrolled patients with nasopharyngeal carcinoma (NPC) undergoing definitive chemoradiotherapy between July 2023 and February 2024. Data were analyzed from June 2024 to September 2024.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n The BD group received mupirocin nasal ointment twice daily for 3 days before radiotherapy for 5 consecutive days followed by a 1-week break, which was repeated throughout radiotherapy. Patients in the SoC group received routine nasal and oral care.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n The primary outcome was the incidence of severe (grade \u22653) AROM. Oral mucositis assessments were performed by independent evaluators who were blinded to group assignments. Secondary end points included quality of life assessed using the Quality-of-Life Questionnaire\u2212Head and Neck 43 [QLQ-H&amp;amp;N43]), and the colonization levels of\n S aureus<\/jats:italic>\n in nasal and oral mucosa.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 176 patients (mean [SD] age, 52.1 [10.1] years; 42 female [23.9%] individuals) were randomly assigned to the BD intervention group (n\u2009=\u200988) or the SoC control group (n\u2009=\u200988). In the BD group, severe AROM occurred in 20 of 88 patients (22.7%) compared with 42 (47.7%) in the SoC group (relative risk, 0.48; 95% CI, 0.31-0.74;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Multivariable logistic analysis confirmed the effect of BD (odds ratio, 0.27, 95% CI, 0.13-0.54;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) on severe AROM risk reduction. The QLQ-H&amp;amp;N43 assessment showed BD significantly reduced symptom severity compared to SoC during radiotherapy, with lower median (IQR) pain scores (25.0 [25.0-50.0] vs 50.0 [25.0-50.0]) and fewer swallowing difficulties (8.3 [8.3-33.3] vs 33.3 [8.3-33.3]). Colonization rates of\n S aureus<\/jats:italic>\n at the end of radiotherapy were lower in the BD than in the SoC group: nasal, 9.4% (8 of 85) vs 22.9 % (19 of 83) and oral, 5.9% (5 of 85) vs 20.5% (17 of 83).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n \n This phase 3 randomized clinical trial demonstrated that BD with mupirocin nasal ointment effectively reduced severe AROM, improved quality of life by alleviating oral pain and swallowing difficulties, and significantly reduced both nasal and oral\n S aureus<\/jats:italic>\n colonization during radiotherapy. This approach offers a cost-effective strategy for AROM management, and although further studies are required to validate the findings, these results highlight the potential of microbial management to reduce radiation-related complications in patients with nasopharyngeal carcinoma.\n <\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT05893810<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamaoncol.2025.2361","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T15:31:15Z","timestamp":1754580675000},"page":"1141","source":"Crossref","is-referenced-by-count":7,"title":["Bacterial Decolonization With Mupirocin Ointment for Acute Radiation Oral Mucositis Prevention"],"prefix":"10.1001","volume":"11","author":[{"given":"Zhaohui","family":"Liao","sequence":"first","affiliation":[{"name":"Clinical Training Center, Jiangxi Cancer Hospital, Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaopeng","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Jiangxi Cancer Hospital, Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"},{"name":"NHC Key Laboratory of Personalized Diagnosis and Treatment for Nasopharyngeal Carcinoma, Jiangxi Cancer Hospital, Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhao","sequence":"additional","affiliation":[{"name":"Nursing School of Nanchang University, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zipeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Jiangxi Cancer Hospital, Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunhong","family":"Guan","sequence":"additional","affiliation":[{"name":"NHC Key Laboratory of Personalized Diagnosis and Treatment for Nasopharyngeal Carcinoma, Jiangxi Cancer Hospital, Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Zhang","sequence":"additional","affiliation":[{"name":"NHC Key Laboratory of Personalized Diagnosis and Treatment for Nasopharyngeal Carcinoma, Jiangxi Cancer Hospital, Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangyan","family":"Zhong","sequence":"additional","affiliation":[{"name":"NHC Key Laboratory of Personalized Diagnosis and Treatment for Nasopharyngeal Carcinoma, Jiangxi Cancer Hospital, Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Rao","sequence":"additional","affiliation":[{"name":"NHC Key Laboratory of Personalized Diagnosis and Treatment for Nasopharyngeal Carcinoma, Jiangxi Cancer Hospital, Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xunsong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Clinical Laboratory, Jiangxi Cancer Hospital, Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Jiangxi Cancer Hospital, Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochang","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Jiangxi Cancer Hospital, Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shao Hui","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Princess Margaret Cancer Centre\/University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Jiangxi Cancer Hospital, Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"},{"name":"NHC Key Laboratory of Personalized Diagnosis and Treatment for Nasopharyngeal Carcinoma, Jiangxi Cancer Hospital, Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianzhu","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Jiangxi Cancer Hospital, Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"},{"name":"NHC Key Laboratory of Personalized Diagnosis and Treatment for Nasopharyngeal Carcinoma, Jiangxi Cancer Hospital, Second Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"4","key":"coi250039r1","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1016\/j.annonc.2020.12.007","article-title":"Nasopharyngeal carcinoma: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up.","volume":"32","author":"Bossi","year":"2021","journal-title":"Ann Oncol"},{"issue":"10192","key":"coi250039r2","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/S0140-6736(19)30956-0","article-title":"Nasopharyngeal carcinoma.","volume":"394","author":"Chen","year":"2019","journal-title":"Lancet"},{"issue":"9","key":"coi250039r3","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1016\/j.oraloncology.2015.06.008","article-title":"Weekly cetuximab concurrent with IMRT aggravated radiation-induced oral mucositis in locally advanced nasopharyngeal carcinoma: results of a randomized phase II study.","volume":"51","author":"Xu","year":"2015","journal-title":"Oral Oncol"},{"issue":"10022","key":"coi250039r4","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1016\/S0140-6736(15)00055-0","article-title":"Nasopharyngeal carcinoma.","volume":"387","author":"Chua","year":"2016","journal-title":"Lancet"},{"issue":"8","key":"coi250039r5","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1001\/jama.2022.13997","article-title":"Effect of radiotherapy alone vs radiotherapy with concurrent chemoradiotherapy on survival without disease relapse in patients with low-risk nasopharyngeal carcinoma: a randomized clinical trial.","volume":"328","author":"Tang","year":"2022","journal-title":"JAMA"},{"issue":"4","key":"coi250039r6","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1001\/jamaoncol.2023.6552","article-title":"Induction chemotherapy followed by radiotherapy vs chemoradiotherapy in nasopharyngeal carcinoma: a randomized clinical trial.","volume":"10","author":"Dai","year":"2024","journal-title":"JAMA Oncol"},{"issue":"11","key":"coi250039r7","doi-asserted-by":"publisher","first-page":"1509","DOI":"10.1016\/S1470-2045(16)30410-7","article-title":"Induction chemotherapy plus concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: a phase 3, multicentre, randomised controlled trial.","volume":"17","author":"Sun","year":"2016","journal-title":"Lancet Oncol"},{"issue":"7","key":"coi250039r8","doi-asserted-by":"publisher","first-page":"1081","DOI":"10.1002\/cncr.31907","article-title":"A randomized, double-blind, placebo-controlled trial of probiotics to reduce the severity of oral mucositis induced by chemoradiotherapy for patients with nasopharyngeal carcinoma.","volume":"125","author":"Jiang","year":"2019","journal-title":"Cancer"},{"issue":"2","key":"coi250039r9","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.anr.2023.04.002","article-title":"Incidence and risk factors for radiotherapy-induced oral mucositis among patients with nasopharyngeal carcinoma: a meta-analysis.","volume":"17","author":"Li","year":"2023","journal-title":"Asian Nurs Res (Korean Soc Nurs Sci)"},{"issue":"3","key":"coi250039r10","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1007\/s11864-022-00959-z","article-title":"Pathogenesis and Amelioration of Radiation-Induced Oral Mucositis.","volume":"23","author":"Lee","year":"2022","journal-title":"Curr Treat Options Oncol"},{"issue":"8","key":"coi250039r11","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1007\/s00520-024-08752-4","article-title":"Updated perspectives on the contribution of the microbiome to the pathogenesis of mucositis using the MASCC\/ISOO framework.","volume":"32","author":"Stringer","year":"2024","journal-title":"Support Care Cancer"},{"issue":"12","key":"coi250039r12","doi-asserted-by":"publisher","first-page":"1436","DOI":"10.1200\/JCO.23.02706","article-title":"Understanding protective mechanisms of an oral probiotic in reducing radiation-induced oral mucositis.","volume":"42","author":"Wardill","year":"2024","journal-title":"J Clin Oncol"},{"key":"coi250039r13","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.ebiom.2017.02.002","article-title":"The potential effect of oral microbiota in the prediction of mucositis during radiotherapy for nasopharyngeal carcinoma.","volume":"18","author":"Zhu","year":"2017","journal-title":"EBioMedicine"},{"key":"coi250039r14","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.oraloncology.2016.05.005","article-title":"Head and neck intensity modulated radiation therapy leads to an increase of opportunistic oral pathogens.","volume":"58","author":"Schuurhuis","year":"2016","journal-title":"Oral Oncol"},{"issue":"4","key":"coi250039r15","doi-asserted-by":"publisher","first-page":"290","DOI":"10.3390\/jof7040290","article-title":"Breakdown of symbiosis in radiation-induced oral mucositis.","volume":"7","author":"Ingrosso","year":"2021","journal-title":"J Fungi (Basel)"},{"issue":"12","key":"coi250039r16","doi-asserted-by":"publisher","first-page":"1426","DOI":"10.1200\/JCO.23.00837","article-title":"Streptococcus salivarius K12 alleviates oral mucositis in patients undergoing radiotherapy for malignant head and neck tumors: a randomized controlled trial.","volume":"42","author":"Peng","year":"2024","journal-title":"J Clin Oncol"},{"key":"coi250039r17","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.618150","article-title":"A phase II randomized clinical trial and mechanistic studies using improved probiotics to prevent oral mucositis induced by concurrent radiotherapy and chemotherapy in nasopharyngeal carcinoma.","volume":"12","author":"Xia","year":"2021","journal-title":"Front Immunol"},{"issue":"6","key":"coi250039r18","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1016\/j.ejca.2011.06.010","article-title":"Lactobacillus brevis CD2 lozenges reduce radiation- and chemotherapy-induced mucositis in patients with head and neck cancer: a randomized double-blind placebo-controlled study.","volume":"48","author":"Sharma","year":"2012","journal-title":"Eur J Cancer"},{"issue":"4","key":"coi250039r19","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1590\/S0103-64402011000400009","article-title":"Frequency of oral mucositis and microbiological analysis in children with acute lymphoblastic leukemia treated with 0.12% chlorhexidine gluconate.","volume":"22","author":"Soares","year":"2011","journal-title":"Braz Dent J"},{"issue":"12","key":"coi250039r20","doi-asserted-by":"publisher","first-page":"E559","DOI":"10.1111\/1469-0691.12287","article-title":"Oral bacterial community dynamics in paediatric patients with malignancies in relation to chemotherapy-related oral mucositis: a prospective study.","volume":"19","author":"Ye","year":"2013","journal-title":"Clin Microbiol Infect"},{"issue":"9","key":"coi250039r21","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1177\/0022034514540174","article-title":"Review of preclinical studies on treatment of mucositis and associated pain.","volume":"93","author":"Viet","year":"2014","journal-title":"J Dent Res"},{"issue":"4","key":"coi250039r22","doi-asserted-by":"publisher","DOI":"10.1111\/jicd.12454","article-title":"Oral mucositis and microbial colonization in oral cancer patients undergoing radiotherapy and chemotherapy: a prospective analysis in a tertiary care dental hospital.","volume":"10","author":"Subramaniam","year":"2019","journal-title":"J Investig Clin Dent"},{"key":"coi250039r23","doi-asserted-by":"publisher","DOI":"10.20396\/bjos.v22i00.8667697","article-title":"Oral mucositis and microbial status in acute lymphoblastic leukemia subjects undergoing high-dose chemotherapy.","volume":"22","author":"Duarte","year":"2023","journal-title":"Braz J Oral Sci"},{"issue":"3","key":"coi250039r24","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1128\/CMR.10.3.505","article-title":"Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks.","volume":"10","author":"Kluytmans","year":"1997","journal-title":"Clin Microbiol Rev"},{"issue":"6","key":"coi250039r25","doi-asserted-by":"publisher","first-page":"765","DOI":"10.3390\/pathogens12060765","article-title":"Unveiling the relevance of the oral cavity as a staphylococcus aureus colonization site and potential source of antimicrobial resistance.","volume":"12","author":"Campos","year":"2023","journal-title":"Pathogens"},{"issue":"12","key":"coi250039r26","doi-asserted-by":"publisher","first-page":"2186","DOI":"10.3390\/pharmaceutics13122186","article-title":"Therapeutic potential of injectable nano-mupirocin liposomes for infections involving multidrug-resistant bacteria.","volume":"13","author":"Cern","year":"2021","journal-title":"Pharmaceutics"},{"issue":"4","key":"coi250039r27","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006216.pub2","article-title":"Mupirocin ointment for preventing Staphylococcus aureus infections in nasal carriers.","volume":"2008","author":"van Rijen","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"issue":"18","key":"coi250039r28","doi-asserted-by":"publisher","first-page":"1742","DOI":"10.1001\/jama.2023.4852","article-title":"Decolonization strategies to prevent staphylococcal infections: mupirocin by a nose.","volume":"330","author":"Talbot","year":"2023","journal-title":"JAMA"},{"issue":"11S","key":"coi250039r29","doi-asserted-by":"publisher","first-page":"A64","DOI":"10.1016\/j.ajic.2023.02.004","article-title":"Nasal decolonization: what antimicrobials and antiseptics are most effective before surgery and in the ICU.","volume":"51","author":"Smith","year":"2023","journal-title":"Am J Infect Control"},{"issue":"7","key":"coi250039r30","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1001\/jamaoncol.2023.0444","article-title":"Bacterial decolonization for prevention of radiation dermatitis: a randomized clinical trial.","volume":"9","author":"Kost","year":"2023","journal-title":"JAMA Oncol"},{"issue":"9","key":"coi250039r31","first-page":"6792","article-title":"Efficacy of kangfuxin liquid on radiotherapy-induced oral mucositis for patients with head and neck squamous cell carcinoma and its effect on salivary glands and immune function.","volume":"14","author":"Yuan","year":"2022","journal-title":"Am J Transl Res"},{"issue":"2","key":"coi250039r32","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1128\/CMR.00049-15","article-title":"Decolonization in prevention of health care-associated infections.","volume":"29","author":"Septimus","year":"2016","journal-title":"Clin Microbiol Rev"},{"issue":"7","key":"coi250039r33","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1001\/jamaoncol.2023.0454","article-title":"Association of staphylococcus aureus colonization with severity of acute radiation dermatitis in patients with breast or head and neck cancer.","volume":"9","author":"Kost","year":"2023","journal-title":"JAMA Oncol"},{"issue":"1","key":"coi250039r34","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1001\/jamaoncol.2023.5007","article-title":"Bacterial decolonization for prevention of radiation dermatitis-Fragility Index Analysis.","volume":"10","author":"Shah","year":"2024","journal-title":"JAMA Oncol"},{"issue":"7","key":"coi250039r35","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1038\/sj.bjc.6600824","article-title":"Oral mucositis and selective elimination of oral flora in head and neck cancer patients receiving radiotherapy: a double-blind randomised clinical trial.","volume":"88","author":"Stokman","year":"2003","journal-title":"Br J Cancer"},{"issue":"2","key":"coi250039r36","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/S0360-3016(01)01444-4","article-title":"Mucositis reduction by selective elimination of oral flora in irradiated cancers of the head and neck: a placebo-controlled double-blind randomized study.","volume":"50","author":"Wijers","year":"2001","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"3","key":"coi250039r37","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/0030-4220(90)90295-4","article-title":"Chlorhexidine prophylaxis for chemotherapy- and radiotherapy-induced stomatitis: a randomized double-blind trial.","volume":"69","author":"Ferretti","year":"1990","journal-title":"Oral Surg Oral Med Oral Pathol"},{"issue":"1","key":"coi250039r38","doi-asserted-by":"publisher","first-page":"3","DOI":"10.4103\/0973-1482.39597","article-title":"The effect of three mouthwashes on radiation-induced oral mucositis in patients with head and neck malignancies: a randomized control trial.","volume":"4","author":"Madan","year":"2008","journal-title":"J Cancer Res Ther"},{"key":"coi250039r39","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.1070322","article-title":"Distinctive microbiota of delayed healing of oral mucositis after radiotherapy of nasopharyngeal carcinoma.","volume":"12","author":"Jiang","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"issue":"3","key":"coi250039r40","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1128\/CMR.00134-14","article-title":"Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management.","volume":"28","author":"Tong","year":"2015","journal-title":"Clin Microbiol Rev"},{"issue":"5","key":"coi250039r41","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1111\/j.1469-0691.2009.02836.x","article-title":"Body site colonization in patients with community-associated methicillin-resistant Staphylococcus aureus and other types of S. aureus skin infections.","volume":"16","author":"Yang","year":"2010","journal-title":"Clin Microbiol Infect"}],"container-title":["JAMA Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/articlepdf\/2837267\/jamaoncology_liao_2025_oi_250039_1759848047.56378.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T15:01:14Z","timestamp":1760626874000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2837267"}},"subtitle":["A Phase 3 Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2025,10,1]]},"references-count":41,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaoncol.2025.2361","relation":{},"ISSN":["2374-2437"],"issn-type":[{"value":"2374-2437","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10,1]]}}}