{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T19:26:11Z","timestamp":1785439571693,"version":"3.56.0"},"reference-count":60,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T00:00:00Z","timestamp":1625616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Supported by Ministry of Health, Italian Government","award":["funds R.C. 2021, to the IRCCS Istituto Tumori \"Giovanni Paolo II\", Bari, Italy (del. 153\/21)"],"award-info":[{"award-number":["funds R.C. 2021, to the IRCCS Istituto Tumori \"Giovanni Paolo II\", Bari, Italy (del. 153\/21)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: The continuously improving treatment outcome for classical Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL) over the last 25 years has led to a high number of long-term survivors. The impact of treatment, however, can sometimes be dramatic and long-lasting. Focusing on peripheral neuropathy (PN), cognitive impairment, fatigue, anxiety, and depression, researchers of the Fondazione Italiana Linfomi conducted a systematic review of the literature to collect the available data on sequelae incidence as well as evidence of follow-up strategies for long-term cHL and DLBCL survivors. Methods: The review was carried out under the methodological supervision of the Istituto di Ricerche Farmacologiche \u201cMario Negri\u201d, Milan, Italy. The literature search was conducted on three databases (MEDLINE, Embase, and the Cochrane Library) updated to November 2019. The selection process and data extraction were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: A total of 2236 abstracts were screened, 247 full texts were analyzed, and 35 papers were included in the final analysis. Fatigue was the most extensively studied among neuropsychological sequelae, with a mean prevalence among cHL survivors of 10\u201343%. Although many of the papers showed an increased incidence of PN, cognitive impairment, and anxiety and depression in long-term cHL and DLBCL survivors, no definite conclusions can be drawn because of the methodological limitations of the analyzed studies. No data on monitoring and follow-up strategies of PN and other neuropsychological sequelae were highlighted. Conclusions: Based on our findings, future studies in this setting should include well-defined study populations and have a longitudinal trial design to assess the outcomes of interest over time, thus as to structure follow-up programs that can be translated into daily practice.<\/jats:p>","DOI":"10.3390\/cancers13143401","type":"journal-article","created":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T12:31:25Z","timestamp":1625661085000},"page":"3401","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Late Neurological and Cognitive Sequelae and Long-Term Monitoring of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi"],"prefix":"10.3390","volume":"13","author":[{"given":"Silvia","family":"Franceschetti","sequence":"first","affiliation":[{"name":"Haematology Unit, Ospedale Civile di Legnano, ASST Ovest Milanese, 20025 Legnano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Antonietta","family":"Annunziata","sequence":"additional","affiliation":[{"name":"Oncological Psychology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Agostinelli","sequence":"additional","affiliation":[{"name":"Oncological Psychology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Gerardi","sequence":"additional","affiliation":[{"name":"Istituto di Ricerche Farmacologiche \u201cMario Negri\u201d IRCCS, 20156 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Allocati","sequence":"additional","affiliation":[{"name":"Istituto di Ricerche Farmacologiche \u201cMario Negri\u201d IRCCS, 20156 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5707-0689","authenticated-orcid":false,"given":"Carla","family":"Minoia","sequence":"additional","affiliation":[{"name":"Hematology Unit, IRCCS Istituto Tumori \u201cGiovanni Paolo II\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Attilio","family":"Guarini","sequence":"additional","affiliation":[{"name":"Hematology Unit, IRCCS Istituto Tumori \u201cGiovanni Paolo II\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"363","DOI":"10.3322\/caac.21565","article-title":"Cancer treatment and survivorship statistics, 2019","volume":"69","author":"Miller","year":"2019","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.clml.2017.08.097","article-title":"Improving Provision of Care for Long-term Survivors of Lymphoma","volume":"17","author":"Ciavarella","year":"2017","journal-title":"Clin. Lymphoma Myeloma Leuk."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.6004\/jnccn.2009.0078","article-title":"NCCN task force report: Management of neuropathy in cancer","volume":"7","author":"Stubblefield","year":"2009","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2354","DOI":"10.1016\/j.bbmt.2018.05.026","article-title":"Safety Analysis of Brentuximab Vedotin from the Phase III AETHERA Trial in Hodgkin Lymphoma in the Post-Transplant Consolidation Setting","volume":"24","author":"Nademanee","year":"2018","journal-title":"Biol. Blood Marrow Transpl."},{"key":"ref_5","unstructured":"International Health Conference (2002). Constitution of the World Health Organization. 1946. Bull. World Health Organ., 80, 983\u2013984."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1186\/s12955-016-0515-6","article-title":"Health-related quality of life in Hodgkin lymphoma: A systematic review","volume":"14","author":"Linendoll","year":"2016","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"123","DOI":"10.3322\/caac.21258","article-title":"Clinical characteristics, pathophysiology, and management of noncentral nervous system cancer-related cognitive impairment in adults","volume":"65","author":"Wefel","year":"2015","journal-title":"CA Cancer J. Clin."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1111\/bjh.14211","article-title":"What is known and unknown about chemotherapy-related cognitive impairment in patients with haematological malignancies and areas of needed research","volume":"174","author":"Williams","year":"2016","journal-title":"Br. J. Haematol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/S0165-0327(01)00413-X","article-title":"Excess mortality in depression: A meta-analysis of community studies","volume":"72","author":"Cuijpers","year":"2002","journal-title":"J. Affect. Disord."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1017\/S0033291709992285","article-title":"Depression and cancer mortality: A meta-analysis","volume":"40","author":"Pinquart","year":"2010","journal-title":"Psychol. Med."},{"key":"ref_11","unstructured":"(2020, October 15). National Comprehensive Cancer Network Guidelines Version 2.2020 \u201cSurvivorship\u201d. Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/survivorship\/pdf."},{"key":"ref_12","unstructured":"(2020, October 15). The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews. Available online: https:\/\/osf.io\/preprints\/metaaxiv\/v7gm2\/."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"j4008","DOI":"10.1136\/bmj.j4008","article-title":"AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both","volume":"358","author":"Shea","year":"2017","journal-title":"BMJ"},{"key":"ref_14","unstructured":"Higgins, J.P., and Green, S. (2010). The Cochrane Collaboration\u2019s tool for assessing risk of bias. Cochrane Handbook for Systematic Reviews of Interventions, John Wiley and Sons."},{"key":"ref_15","unstructured":"Wells Ga, S.B., O\u2019Connell, D., Peterson, J., Welch, V., Losos, M., and Tugwell, P. (1999). The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Non-Randomised Studies in Meta-Analyses, Ottawa Health Research Institute. Available online: http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1007\/s00277-014-2099-8","article-title":"Health-related quality of life and persistent symptoms in relation to (R-)CHOP14, (R)CHOP21, and other therapies among patients with diffuse large B-cell lymphoma: Results of the population-based PHAROS-registry","volume":"93","author":"Oerlemans","year":"2014","journal-title":"Ann. Hematol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2444","DOI":"10.1200\/JCO.1996.14.9.2444","article-title":"Late psychosocial sequelae in Hodgkin\u2019s disease survivors: A French population-based case-control study","volume":"14","author":"Joly","year":"1996","journal-title":"J. Clin. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/S0959-8049(99)00025-8","article-title":"Retrospective Assessment of Quality of Life and Treatment Outcome in Patients with Hodgkin\u2019s Disease from 1969 to 1994","volume":"35","author":"Greil","year":"1999","journal-title":"Eur. J. Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s00277-002-0582-0","article-title":"Quality of life and psychological well-being in Spanish long-term survivors of Hodgkin\u2019s disease: Results of a controlled pilot study","volume":"82","author":"Ramos","year":"2003","journal-title":"Ann. Hematol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"5240","DOI":"10.1200\/JCO.2007.15.5507","article-title":"Long-Term Effects of High-Dose Chemotherapy and Radiation for Relapsed and Refractory Hodgkin\u2019s Lymphoma","volume":"26","author":"Goodman","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1016\/S1470-2045(09)70258-X","article-title":"Quality of life after successful treatment of early-stage Hodgkin\u2019s lymphoma: 10-year follow-up of the EORTC\u2013GELA H8 randomised controlled trial","volume":"10","author":"Heutte","year":"2009","journal-title":"Lancet Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2012","DOI":"10.3109\/10428194.2010.513749","article-title":"Quality of life of long-term survivors with Hodgkin lymphoma after high-dose chemotherapy, autologous stem cell transplantation, and conventional chemotherapy","volume":"51","author":"Brandt","year":"2010","journal-title":"Leuk. Lymphoma"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1111\/bjh.12038","article-title":"Long-term outcomes after high dose therapy and autologous haematopoietic cell rescue for refractory\/relapsed Hodgkin Lymphoma","volume":"159","author":"Minn","year":"2012","journal-title":"Br. J. Haematol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1038\/bjc.2013.779","article-title":"Chronic fatigue in Hodgkin lymphoma survivors and associations with anxiety, depression and comorbidity","volume":"110","author":"Daniels","year":"2014","journal-title":"Br. J. Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1007\/s00277-014-2091-3","article-title":"Health-related quality of life in Korean lymphoma survivors compared with the general population","volume":"93","author":"Kim","year":"2014","journal-title":"Ann. Hematol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"678","DOI":"10.3109\/0284186X.2014.996664","article-title":"High levels of physical activity are associated with lower levels of fatigue among lymphoma patients: Results from the longitudinal PROFILES registry","volume":"54","author":"Husson","year":"2015","journal-title":"Acta Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.ejca.2005.09.028","article-title":"Quality of life in long-term Hodgkin\u2019s disease survivors with chronic fatigue","volume":"42","author":"Hjermstad","year":"2006","journal-title":"Eur. J. Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"6587","DOI":"10.1200\/JCO.2005.09.936","article-title":"Fatigue in Long-Term Hodgkin\u2019s Disease Survivors: A Follow-Up Study","volume":"23","author":"Hjermstad","year":"2005","journal-title":"J. Clin. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3109\/0284186X.2014.948057","article-title":"Fatigue in male lymphoma survivors differs between diagnostic groups and is associated with latent hypothyroidism","volume":"54","author":"Kiserud","year":"2015","journal-title":"Acta Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1034\/j.1399-6576.1999.430911.x","article-title":"Fatigue. Measures and relation to pain","volume":"43","author":"Kaasa","year":"1999","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/S0885-3924(99)00148-7","article-title":"Fatigue and Psychiatric Morbidity Among Hodgkin\u2019s Disease Survivors","volume":"19","author":"Loge","year":"2000","journal-title":"J. Pain Symptom Manag."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1023\/A:1008315525997","article-title":"Reduced health-related quality of life among Hodgkin\u2019s disease survivors: A comparative study with general population norms","volume":"10","author":"Loge","year":"1999","journal-title":"Ann. Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1200\/JCO.1999.17.1.253","article-title":"Hodgkin\u2019s disease survivors more fatigued than the general population","volume":"17","author":"Loge","year":"1999","journal-title":"J. Clin. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3226","DOI":"10.1200\/JCO.2001.19.13.3226","article-title":"Late medical complications and fatigue in Hodgkin\u2019s disease survivors","volume":"19","author":"Knobel","year":"2001","journal-title":"J. Clin. Oncol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1177\/030089161009600413","article-title":"Quality of life and fatigue in Hodgkin\u2019s lymphoma patients","volume":"96","author":"Magyari","year":"2010","journal-title":"Tumori J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2794","DOI":"10.1016\/j.ejca.2006.08.006","article-title":"Better quality of life among 10\u201315 year survivors of Hodgkin\u2019s lymphoma compared to 5\u20139 year survivors: A population-based study","volume":"42","author":"Mols","year":"2006","journal-title":"Eur. J. Cancer"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Oldervoll, L.M., Loge, J.H., Kaasa, S., Lydersen, S., Hjermstad, M.J., Thorsen, L., Holte, H., Jacobsen, A.B., and Foss\u00e5, S.D. (2007). Physical activity in Hodgkin\u2019s lymphoma survivors with and without chronic fatigue compared with the general population\u2014A cross-sectional study. BMC Cancer, 7.","DOI":"10.1186\/1471-2407-7-210"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/S0959-8049(02)00483-5","article-title":"Exercise reduces fatigue in chronic fatigued Hodgkin\u2019s disease survivors\u2014Results from a pilot study","volume":"39","author":"Oldervoll","year":"2003","journal-title":"Eur. J. Cancer"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1093\/oxfordjournals.annonc.a058768","article-title":"The quality of life of long-term survivors of Hodgkin\u2019s disease","volume":"5","author":"Aaronson","year":"1994","journal-title":"Ann. Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2153","DOI":"10.1007\/s00520-013-1775-x","article-title":"Association of social network and social support with health-related quality of life and fatigue in long-term survivors of Hodgkin lymphoma","volume":"21","author":"Soares","year":"2013","journal-title":"Support. Care Cancer"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2179","DOI":"10.1016\/S0959-8049(03)00545-8","article-title":"Fatigue in long-term survivors of Hodgkin\u2018s lymphoma; a report from the German Hodgkin Lymphoma Study Group (GHSG)","volume":"39","author":"Flechtner","year":"2003","journal-title":"Eur. J. Cancer"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1023\/B:QURE.0000040790.43372.69","article-title":"Determinants of health-related quality of life in long-term survivors of Hodgkin\u2019s lymphoma","volume":"13","author":"Wettergren","year":"2004","journal-title":"Qual. Life Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1007\/s11764-013-0299-1","article-title":"The impact of comorbidity on Health-Related Quality of Life among cancer survivors: Analyses of data from the PROFILES registry","volume":"7","author":"Vissers","year":"2013","journal-title":"Cancer Surviv."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"4329","DOI":"10.1200\/JCO.2016.67.7450","article-title":"Cancer-Related Fatigue in Patients with and Survivors of Hodgkin Lymphoma: The Impact on Treatment Outcome and Social Reintegration","volume":"34","author":"Behringer","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S1470-2045(16)30093-6","article-title":"Cancer-related fatigue in patients with and survivors of Hodgkin\u2019s lymphoma: A longitudinal study of the German Hodgkin Study Group","volume":"17","author":"Kreissl","year":"2016","journal-title":"Lancet Oncol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1111\/bjh.12698","article-title":"Psychosocial factors associated with impact of cancer in longterm haematological cancer survivors","volume":"164","author":"Korszun","year":"2014","journal-title":"Br. J. Haematol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1038\/bjc.1997.464","article-title":"Psychological distress after cancer cure: A survey of 459 Hodgkin\u2019s disease survivors","volume":"76","author":"Loge","year":"1997","journal-title":"Br. J. Cancer"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1186\/s12955-017-0758-x","article-title":"Employment status and health related quality of life among Hodgkin-lymphoma survivors\u2019\u2014Results based on data from a major treatment center in Hungary","volume":"15","author":"Magyari","year":"2017","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1007\/s00520-007-0227-x","article-title":"Young survivors of malignant bone tumours in the extremities: A comparative study of quality of life, fatigue and mental distress","volume":"15","author":"Aksnes","year":"2007","journal-title":"Support. Care Cancer"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The Hospital Anxiety and Depression Scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1093\/jnci\/djy208","article-title":"Survivorship Science at the NIH: Lessons Learned from Grants Funded in Fiscal Year 2016","volume":"111","author":"Rowland","year":"2019","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_52","unstructured":"(2021, January 15). Haematological Malignancy Research Network (HMRN). Available online: https:\/\/www.hmrn.org\/statistics\/survival."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1182\/blood-2016-02-699850","article-title":"Five-year survival and durability results of brentuximab vedotin in patients with relapsed or refractory Hodgkin lymphoma","volume":"128","author":"Chen","year":"2016","journal-title":"Blood"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2639","DOI":"10.1182\/blood-2018-07-861641","article-title":"Five-year PFS from the AETHERA thrial of brentuximab vedotin for Hodgkin lymphoma at high risk of progression or relapse","volume":"132","author":"Moskowitz","year":"2018","journal-title":"Blood"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.radonc.2012.10.012","article-title":"Radiation-induced neuropathy in cancer survivors","volume":"105","author":"Delanian","year":"2012","journal-title":"Radiother. Oncol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1007\/s00066-015-0857-8","article-title":"Radiation-induced camptocormia and dropped head syndrome Review and case report of radiation-induced movement disorders","volume":"191","author":"Seidel","year":"2015","journal-title":"Strahlenther. Onkol."},{"key":"ref_57","first-page":"159","article-title":"Hodgkin\u2019s disease\u2014Results from a program in radiation therapy","volume":"7","author":"Micaily","year":"1984","journal-title":"J. Clin. Oncol."},{"key":"ref_58","first-page":"1","article-title":"Patient-Reported Survivorship Care Practices and Late Effects After Treatment of Hodgkin and Non-Hodgkin Lymphoma","volume":"2","author":"Frick","year":"2018","journal-title":"JCO Clin. Cancer Inf."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1111\/bjh.15448","article-title":"Cognitive impairment in Hodgkin lymphoma survivors","volume":"182","author":"Trachtenberg","year":"2018","journal-title":"Br. J. Haematol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1080\/0284186X.2016.1189092","article-title":"Neurocognitive function of lymphoma patients after treatment with chemotherapy","volume":"55","author":"Wouters","year":"2016","journal-title":"Acta Oncol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/13\/14\/3401\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:27:04Z","timestamp":1760164024000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/13\/14\/3401"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,7]]},"references-count":60,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2021,7]]}},"alternative-id":["cancers13143401"],"URL":"https:\/\/doi.org\/10.3390\/cancers13143401","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,7]]}}}