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450 Results Found

  • Review
  • Open Access
890 Views
19 Pages

4 November 2025

The gut-brain axis has emerged as a critical pathway influencing central nervous system (CNS) tumor biology through complex microbiome-mediated mechanisms. Understanding these interactions is essential for developing novel therapeutic strategies and...

  • Review
  • Open Access
1,248 Views
20 Pages

26 September 2025

Tumors of the central nervous system (CNS) represent a unique therapeutic challenge due to the complexity of the CNS and the protective role of the blood–brain barrier (BBB). All gliomas are of glial origin, account for the majority of CNS tumo...

  • Review
  • Open Access
18 Citations
4,172 Views
13 Pages

26 September 2021

Despite the considerable advances in diagnostic methods in medicine, central nervous system (CNS) tumors, particularly the most common ones—gliomas—remain incurable, with similar incidence rates and mortality. A growing body of literature has reveale...

  • Article
  • Open Access
7 Citations
3,039 Views
28 Pages

17 June 2021

Despite extensive experimentation on pediatric tumors of the central nervous system (CNS), related to both prognosis, diagnosis and treatment, the understanding of pathogenesis and etiology of the disease remains scarce. MicroRNAs are known to be inv...

  • Review
  • Open Access
1 Citations
2,357 Views
13 Pages

Primary Co-Occurrence of Gonadal and Extragonadal Central Nervous System (CNS) Germ Cell Tumors (GCTs): Case Report and Review of the Literature

  • Francesco Tengattini,
  • Cesare Francesco Soffiati,
  • Pier Paolo Panciani,
  • Marco Zeppieri,
  • Tamara Ius,
  • Shahan Momjian,
  • Karl Schaller,
  • Marco Maria Fontanella and
  • Lucio De Maria

21 March 2024

Background: The primary co-occurrence of gonadal and extragonadal central nervous system (CNS) germ cell tumors (GCTs) has rarely been reported in the literature, and a common opinion on the underlying etiopathogenetic mechanism is lacking. Objective...

  • Review
  • Open Access
23 Citations
6,089 Views
18 Pages

BRAF and MEK Targeted Therapies in Pediatric Central Nervous System Tumors

  • Dario Talloa,
  • Silvia Triarico,
  • Pierpaolo Agresti,
  • Stefano Mastrangelo,
  • Giorgio Attinà,
  • Alberto Romano,
  • Palma Maurizi and
  • Antonio Ruggiero

31 August 2022

BRAF is a component of the MAPK and PI3K/AKT/mTOR pathways that play a crucial role in cellular proliferation, differentiation, migration, and angiogenesis. Pediatric central nervous system tumors very often show mutations of the MAPK pathway, as dem...

  • Review
  • Open Access
83 Citations
9,837 Views
15 Pages

Focused Ultrasound and Microbubbles-Mediated Drug Delivery to Brain Tumor

  • Sheng-Kai Wu,
  • Chia-Lin Tsai,
  • Yuexi Huang and
  • Kullervo Hynynen

The presence of blood–brain barrier (BBB) and/or blood–brain–tumor barriers (BBTB) is one of the main obstacles to effectively deliver therapeutics to our central nervous system (CNS); hence, the outcomes following treatment of mali...

  • Article
  • Open Access
9 Citations
3,914 Views
16 Pages

Evaluating Brain Tumor Detection with Deep Learning Convolutional Neural Networks Across Multiple MRI Modalities

  • Ioannis Stathopoulos,
  • Luigi Serio,
  • Efstratios Karavasilis,
  • Maria Anthi Kouri,
  • Georgios Velonakis,
  • Nikolaos Kelekis and
  • Efstathios Efstathopoulos

21 November 2024

Central Nervous System (CNS) tumors represent a significant public health concern due to their high morbidity and mortality rates. Magnetic Resonance Imaging (MRI) has emerged as a critical non-invasive modality for the detection, diagnosis, and mana...

  • Review
  • Open Access
20 Citations
6,049 Views
41 Pages

Revolutionizing Neuroimmunology: Unraveling Immune Dynamics and Therapeutic Innovations in CNS Disorders

  • Corneliu Toader,
  • Calin Petru Tataru,
  • Octavian Munteanu,
  • Razvan-Adrian Covache-Busuioc,
  • Matei Serban,
  • Alexandru Vlad Ciurea and
  • Mihaly Enyedi

19 December 2024

Neuroimmunology is reshaping the understanding of the central nervous system (CNS), revealing it as an active immune organ rather than an isolated structure. This review delves into the unprecedented discoveries transforming the field, including the...

  • Review
  • Open Access
29 Citations
7,374 Views
23 Pages

The Added Value of Diagnostic and Theranostic PET Imaging for the Treatment of CNS Tumors

  • Ilanah J. Pruis,
  • Guus A. M. S. van Dongen and
  • Sophie E. M. Veldhuijzen van Zanten

4 February 2020

This review highlights the added value of PET imaging in Central Nervous System (CNS) tumors, which is a tool that has rapidly evolved from a merely diagnostic setting to multimodal molecular diagnostics and the guidance of targeted therapy. PET is t...

  • Review
  • Open Access
2 Citations
4,102 Views
28 Pages

Pediatric CNS Radiation Oncology: Recent Developments and Novel Techniques

  • Justin Oh,
  • Samir Patel,
  • Mary-Pat Schlosser,
  • Andrew J. Arifin,
  • Carol Oliveira,
  • Anne-Marie Charpentier and
  • Derek S. Tsang

Radiation therapy (RT) is a cornerstone in the management of pediatric central nervous system (CNS) tumors. Recent advancements in RT delivery and techniques aim to enhance therapeutic effectiveness while minimizing both acute and long-term complicat...

  • Review
  • Open Access
62 Citations
21,225 Views
26 Pages

Leptomeningeal Metastasis: A Review of the Pathophysiology, Diagnostic Methodology, and Therapeutic Landscape

  • Andrew Nguyen,
  • Alexander Nguyen,
  • Oluwaferanmi T. Dada,
  • Persis D. Desai,
  • Jacob C. Ricci,
  • Nikhil B. Godbole,
  • Kevin Pierre and
  • Brandon Lucke-Wold

19 June 2023

The present review aimed to establish an understanding of the pathophysiology of leptomeningeal disease as it relates to late-stage development among different cancer types. For our purposes, the focused metastatic malignancies include breast cancer,...

  • Article
  • Open Access
27 Citations
4,213 Views
14 Pages

Tumor and Cerebrospinal Fluid microRNAs in Primary Central Nervous System Lymphomas

  • Michalina Zajdel,
  • Grzegorz Rymkiewicz,
  • Maria Sromek,
  • Maria Cieslikowska,
  • Pawel Swoboda,
  • Mariusz Kulinczak,
  • Krzysztof Goryca,
  • Zbigniew Bystydzienski,
  • Katarzyna Blachnio and
  • Jan Konrad Siwicki
  • + 5 authors

25 October 2019

Primary central nervous system lymphoma (PCNSL) is a rare, highly aggressive, extranodal form of non-Hodgkin lymphoma, predominantly diagnosed as primary diffuse large B-cell lymphoma of the central nervous system (CNS DLBCL). Fast and precise diagno...

  • Review
  • Open Access
1 Citations
2,238 Views
41 Pages

Sirtuins in Central Nervous System Tumors—Molecular Mechanisms and Therapeutic Targeting

  • Agnieszka Nowacka,
  • Martyna Śniegocka,
  • Maciej Śniegocki and
  • Ewa Aleksandra Ziółkowska

19 July 2025

Sirtuins (SIRTs), a family of NAD+-dependent enzymes, play crucial roles in epigenetic regulation, metabolism, DNA repair, and stress response, making them relevant to glioma biology. This review systematically summarizes the molecular mechanisms and...

  • Review
  • Open Access
10 Citations
4,849 Views
25 Pages

The Potential Application of Resveratrol and Its Derivatives in Central Nervous System Tumors

  • Agnieszka Nowacka,
  • Martyna Śniegocka,
  • Wojciech Smuczyński,
  • Sara Liss,
  • Ewa Ziółkowska,
  • Dominika Bożiłow,
  • Maciej Śniegocki and
  • Michał Wiciński

12 December 2024

Resveratrol, a naturally occurring polyphenolic compound found in various plants, has been extensively studied for its broad spectrum of beneficial biological effects. These encompass its potent antioxidant properties, anti-inflammatory activities, a...

  • Review
  • Open Access
32 Citations
9,180 Views
33 Pages

MicroRNA Signatures as Biomarkers and Therapeutic Target for CNS Embryonal Tumors: The Pros and the Cons

  • Tarek Shalaby,
  • Giulio Fiaschetti,
  • Martin Baumgartner and
  • Michael A. Grotzer

24 November 2014

Embryonal tumors of the central nervous system represent a heterogeneous group of childhood cancers with an unknown pathogenesis; diagnosis, on the basis of histological appearance alone, is controversial and patients’ response to therapy is difficul...

  • Case Report
  • Open Access
2,253 Views
22 Pages

Comprehensive Fertility Management After Pituitary Adenoma Surgery: Lessons from a Rural Japanese Case and Practical Review

  • Daisuke Numahata,
  • Kosuke Kojo,
  • San-e Ishikawa,
  • Takumi Kuramae,
  • Ayumi Nakazono,
  • Kaoru Yanagida,
  • Hiroyuki Nishiyama and
  • Tatsuya Takayama

15 August 2025

Background and Clinical Significance: Pituitary adenomas, also termed pituitary neuroendocrine tumors, pose a significant risk of hypogonadotropic hypogonadism (HH) after surgical resection, with profound consequences for fertility and sexual functio...

  • Review
  • Open Access
17 Citations
4,783 Views
10 Pages

27 August 2021

The overall survival of pediatric gliomas varies over a wide spectrum depending on the tumor grade. Low-grade gliomas have an excellent long-term survival, with a possible burden of surgery, irradiation, and chemotherapy; in contrast, high-grade glio...

  • Review
  • Open Access
10 Citations
3,388 Views
23 Pages

Nanotechnology in Advancing Chimeric Antigen Receptor T Cell Therapy for Cancer Treatment

  • Xuejia Kang,
  • Nur Mita,
  • Lang Zhou,
  • Siqi Wu,
  • Zongliang Yue,
  • R. Jayachandra Babu and
  • Pengyu Chen

Chimeric antigen receptor (CAR) T cell therapy has emerged as a groundbreaking treatment for hematological cancers, yet it faces significant hurdles, particularly regarding its efficacy in solid tumors and concerning associated adverse effects. This...

  • Review
  • Open Access
18 Citations
8,637 Views
19 Pages

Advances in Molecular Imaging of Locally Delivered Targeted Therapeutics for Central Nervous System Tumors

  • Umberto Tosi,
  • Christopher S. Marnell,
  • Raymond Chang,
  • William C. Cho,
  • Richard Ting,
  • Uday B. Maachani and
  • Mark M. Souweidane

Thanks to the recent advances in the development of chemotherapeutics, the morbidity and mortality of many cancers has decreased significantly. However, compared to oncology in general, the field of neuro-oncology has lagged behind. While new molecul...

  • Review
  • Open Access
127 Citations
14,975 Views
16 Pages

The brain has high-order functions and is composed of several kinds of cells, such as neurons and glial cells. It is becoming clear that many kinds of neurodegenerative diseases are more-or-less influenced by astrocytes, which are a type of glial cel...

  • Article
  • Open Access
1,444 Views
15 Pages

Direct oHSV Infection Induces DC Maturation and a Tumor Therapeutic Response

  • Doyeon Kim,
  • Michael Kelly,
  • Jack Hedberg,
  • Alexia K. Martin,
  • Ilse Hernandez-Aguirre,
  • Yeaseul Kim,
  • Lily R. Cain,
  • Ravi Dhital and
  • Kevin A. Cassady

19 August 2025

Oncolytic herpes simplex virus (oHSV) is a promising cancer immunotherapy that induces tumor cell lysis and stimulates anti-tumor immunity. Our previous single-cell RNA sequencing analysis of oHSV-treated medulloblastoma tumors revealed expansion and...

  • Review
  • Open Access
16 Citations
6,772 Views
17 Pages

The Central Nervous Mechanism of Stress-Promoting Cancer Progression

  • Yuchuan Hong,
  • Lu Zhang,
  • Nian Liu,
  • Xirong Xu,
  • Dan Liu and
  • Jie Tu

21 October 2022

Evidence shows that stress can promote the occurrence and development of tumors. In recent years, many studies have shown that stress-related hormones or peripheral neurotransmitters can promote the proliferation, survival, and angiogenesis of tumor...

  • Review
  • Open Access
100 Citations
13,007 Views
33 Pages

The Process and Regulatory Components of Inflammation in Brain Oncogenesis

  • A.G.M. Mostofa,
  • Surendra R. Punganuru,
  • Hanumantha Rao Madala,
  • Mohammad Al-Obaide and
  • Kalkunte S. Srivenugopal

Central nervous system tumors comprising the primary cancers and brain metastases remain the most lethal neoplasms and challenging to treat. Substantial evidence points to a paramount role for inflammation in the pathology leading to gliomagenesis, m...

  • Review
  • Open Access
23 Citations
5,681 Views
17 Pages

Short and Long-Term Toxicity in Pediatric Cancer Treatment: Central Nervous System Damage

  • Iside Alessi,
  • Anna Maria Caroleo,
  • Luca de Palma,
  • Angela Mastronuzzi,
  • Stefano Pro,
  • Giovanna Stefania Colafati,
  • Alessandra Boni,
  • Nicoletta Della Vecchia,
  • Margherita Velardi and
  • Umberto Raucci
  • + 7 authors

17 March 2022

Neurotoxicity caused by traditional chemotherapy and radiotherapy is well known and widely described. New therapies, such as biologic therapy and immunotherapy, are associated with better outcomes in pediatric patients but are also associated with ce...

  • Review
  • Open Access
14 Citations
6,160 Views
16 Pages

Pediatric central nervous system (CNS) tumors are the most common solid tumor in children, with the majority being glial in origin. These tumors are classified by the World Health Organization (WHO) as either being low grade (WHO grade 1 and 2) or hi...

  • Editorial
  • Open Access
4,828 Views
4 Pages

Pediatric Neuro-Oncology is a highly specialized field encompassing molecular biology, clinical acumen, evidence based medicine, cancer genetics and neuropsychological care for the diagnosis and treatment of children with central nervous system (CNS)...

  • Review
  • Open Access
3 Citations
4,920 Views
20 Pages

The Role of Immunotherapy in the Treatment of Rare Central Nervous System Tumors

  • Andrew Rodriguez,
  • Carlos Kamiya-Matsuoka and
  • Nazanin K. Majd

25 May 2023

Establishing novel therapies for rare central nervous system (CNS) tumors is arduous due to challenges in conducting clinical trials in rare tumors. Immunotherapy treatment has been a rapidly developing field and has demonstrated improvements in outc...

  • Review
  • Open Access
33 Citations
6,305 Views
19 Pages

Liquid Biomarkers for Improved Diagnosis and Classification of CNS Tumors

  • Severa Bunda,
  • Jeffrey A. Zuccato,
  • Mathew R. Voisin,
  • Justin Z. Wang,
  • Farshad Nassiri,
  • Vikas Patil,
  • Sheila Mansouri and
  • Gelareh Zadeh

Liquid biopsy, as a non-invasive technique for cancer diagnosis, has emerged as a major step forward in conquering tumors. Current practice in diagnosis of central nervous system (CNS) tumors involves invasive acquisition of tumor biopsy upon detecti...

  • Review
  • Open Access
35 Citations
8,594 Views
17 Pages

Pediatric Glioma: An Update of Diagnosis, Biology, and Treatment

  • Yusuke Funakoshi,
  • Nobuhiro Hata,
  • Daisuke Kuga,
  • Ryusuke Hatae,
  • Yuhei Sangatsuda,
  • Yutaka Fujioka,
  • Kosuke Takigawa and
  • Masahiro Mizoguchi

12 February 2021

Recent research has promoted elucidation of the diverse biological processes that occur in pediatric central nervous system (CNS) tumors. Molecular genetic analysis is essential not only for proper classification, but also for monitoring biological b...

  • Case Report
  • Open Access
1 Citations
4,788 Views
10 Pages

Long-Term Survival of a Child with Atypical Teratoid-Rhabdoid Tumor and Acute Lymphoblastic Leukemia: A Case Report

  • Kolcheva Maria Andreevna,
  • Kumirova Ella Vyacheslavovna,
  • Gorbatykh Svetlana Valeryevna,
  • Makhmudova Gunai Nariman,
  • Livshits Matvey Igorevich,
  • Chmutin Gennadiy Yegorovich,
  • Kislyakov Alexey Nikolaevich,
  • Umerenkov Viktor Nikolaevich,
  • Manuel de Jesus Encarnacion Ramirez and
  • Nicola Montemurro

3 April 2024

Atypical teratoid-rhabdoid tumor (AT/RT) is a rare but one of the most aggressive embryonal tumors of the central nervous system (CNS), most often occurring in children under 3 years of age. AT/RT accounts for about 1–2% of all CNS neoplasms an...

  • Systematic Review
  • Open Access
5 Citations
5,594 Views
19 Pages

Patient-Derived Xenotransplant of CNS Neoplasms in Zebrafish: A Systematic Review

  • Beatriz E. Sarmiento,
  • Santiago Callegari,
  • Kemel A. Ghotme and
  • Veronica Akle

2 April 2022

Glioblastoma and neuroblastoma are the most common central nervous system malignant tumors in adult and pediatric populations. Both are associated with poor survival. These tumors are highly heterogeneous, having complex interactions among different...

  • Review
  • Open Access
3 Citations
1,817 Views
14 Pages

Natural Source of Drugs Targeting Central Nervous System Tumors—Focus on NAD(P)H Oxidoreductase 1 (NQO1) Activity

  • Nikola M. Stojanovic,
  • Milica Mitić,
  • Jovan Ilić,
  • Milica Radić,
  • Miša Radisavljević,
  • Marko Baralić and
  • Miljan Krstić

29 January 2025

Central nervous system (CNS) tumors involve a large and diverse group of malignancies that arise from various cell types within the brain tissue. Although there are advances in treatments, CNS tumors still remain challenging, due to their complex bio...

  • Review
  • Open Access
40 Citations
7,592 Views
38 Pages

Role of Nanomedicine-Based Therapeutics in the Treatment of CNS Disorders

  • Zi-Hua Guo,
  • Saadullah Khattak,
  • Mohd Ahmar Rauf,
  • Mohammad Azam Ansari,
  • Mohammad N. Alomary,
  • Sufyan Razak,
  • Chang-Yong Yang,
  • Dong-Dong Wu and
  • Xin-Ying Ji

28 January 2023

Central nervous system disorders, especially neurodegenerative diseases, are a public health priority and demand a strong scientific response. Various therapy procedures have been used in the past, but their therapeutic value has been insufficient. T...

  • Review
  • Open Access
14 Citations
3,686 Views
17 Pages

New Approaches with Precision Medicine in Adult Brain Tumors

  • Annette Leibetseder,
  • Matthias Preusser and
  • Anna Sophie Berghoff

29 January 2022

Primary central nervous system (CNS) tumors represent a heterogenous group of tumors. The 2021 fifth edition of the WHO Classification of Tumors of the CNS emphasizes the advanced role of molecular diagnostics with routine implementation of molecular...

  • Review
  • Open Access
2,820 Views
26 Pages

Conventional chemotherapy continues to form the backbone of treatment for many pediatric central nervous system (CNS) tumors. Advances have been made especially in the molecular underpinning of certain pediatric CNS tumors, allowing for advancement a...

  • Review
  • Open Access
1,440 Views
14 Pages

Approaches to Reduce Toxicity in Pediatric Brain Tumors

  • Hallie Coltin,
  • Christina Coleman and
  • Chantel Cacciotti

Pediatric central nervous system (CNS) tumor survivors are highly susceptible to long-term toxicity due to tumor location and also the treatment received. Advancements in treatment techniques, risk-adapted approaches to therapy with adjustments to tr...

  • Review
  • Open Access
5 Citations
3,977 Views
22 Pages

Tumors of the central nervous system (CNS) are severe and refractory diseases with poor prognosis, especially for patients with malignant glioblastoma and brain metastases. Currently, numerous studies have explored the potential role of bacteria and...

  • Review
  • Open Access
10 Citations
3,649 Views
11 Pages

Recent Advances in Progresses and Prospects of IL-37 in Central Nervous System Diseases

  • Xinrui Li,
  • Bing Yan,
  • Jin Du,
  • Shanshan Xu,
  • Lu Liu,
  • Caifei Pan,
  • Xianhui Kang and
  • Shengmei Zhu

Interleukin-37 (IL-37) is an effective anti-inflammatory factor and acts through intracellular and extracellular pathways, inhibiting the effects of other inflammatory cytokines, such as IL-1β, IL-6, and tumor necrosis factor-α (TNF-&alpha...

  • Review
  • Open Access
36 Citations
7,114 Views
23 Pages

The Role of the JC Virus in Central Nervous System Tumorigenesis

  • Nicholas Ahye,
  • Anna Bellizzi,
  • Dana May and
  • Hassen S. Wollebo

28 August 2020

Cancer is the second leading cause of mortality worldwide. The study of DNA tumor-inducing viruses and their oncoproteins as a causative agent in cancer initiation and tumor progression has greatly enhanced our understanding of cancer cell biology. T...

  • Review
  • Open Access
17 Citations
4,836 Views
17 Pages

15 February 2020

Efficacious therapies are not available for the cure of both gliomas and glioneuronal tumors, which represent the most numerous and heterogeneous primary cancers of the central nervous system (CNS), and for neoplasms of the peripheral nervous system...

  • Article
  • Open Access
6 Citations
4,875 Views
20 Pages

Germline Variants in Cancer Predisposition Genes in Pediatric Patients with Central Nervous System Tumors

  • Aleksa Jovanović,
  • Nataša Tošić,
  • Irena Marjanović,
  • Jovana Komazec,
  • Branka Zukić,
  • Marina Nikitović,
  • Rosanda Ilić,
  • Danica Grujičić,
  • Dragana Janić and
  • Sonja Pavlović

12 December 2023

Central nervous system (CNS) tumors comprise around 20% of childhood malignancies. Germline variants in cancer predisposition genes (CPGs) are found in approximately 10% of pediatric patients with CNS tumors. This study aimed to characterize variants...

  • Review
  • Open Access
36 Citations
15,126 Views
26 Pages

Detection of TERT Promoter Mutations as a Prognostic Biomarker in Gliomas: Methodology, Prospects, and Advances

  • Tsimur Hasanau,
  • Eduard Pisarev,
  • Olga Kisil,
  • Naosuke Nonoguchi,
  • Florence Le Calvez-Kelm and
  • Maria Zvereva

This article reviews the existing approaches to determining the TERT promoter mutational status in patients with various tumoral diseases of the central nervous system. The operational characteristics of the most common methods and their transferabil...

  • Review
  • Open Access
2 Citations
2,484 Views
19 Pages

The Role of RAS in CNS Tumors: A Key Player or an Overlooked Oncogene?

  • Isabel de Souza Barbosa,
  • Carlos Pilotto Heming,
  • Vivaldo Moura Neto and
  • Veronica Aran

This review examines the prevalence, molecular mechanisms, and clinical implications of RAS mutations in Central Nervous System (CNS) tumors, with a particular focus on glioblastoma. We summarize the current understanding of RAS-driven oncogenic path...

  • Article
  • Open Access
5 Citations
3,398 Views
31 Pages

DUBing Primary Tumors of the Central Nervous System: Regulatory Roles of Deubiquitinases

  • Thomas Klonisch,
  • Susan E. Logue,
  • Sabine Hombach-Klonisch and
  • Jerry Vriend

10 October 2023

The ubiquitin proteasome system (UPS) utilizes an orchestrated enzymatic cascade of E1, E2, and E3 ligases to add single or multiple ubiquitin-like molecules as post-translational modification (PTM) to proteins. Ubiquitination can alter protein funct...

  • Communication
  • Open Access
27 Citations
7,483 Views
12 Pages

Polo-Like Kinase 4 (PLK4) Is Overexpressed in Central Nervous System Neuroblastoma (CNS-NB)

  • Anders W. Bailey,
  • Amreena Suri,
  • Pauline M. Chou,
  • Tatiana Pundy,
  • Samantha Gadd,
  • Stacey L. Raimondi,
  • Tadanori Tomita and
  • Simone Treiger Sredni

Neuroblastoma (NB) is the most common extracranial solid tumor in pediatrics, with rare occurrences of primary and metastatic tumors in the central nervous system (CNS). We previously reported the overexpression of the polo-like kinase 4 (PLK4) in em...

  • Review
  • Open Access
20 Citations
4,313 Views
14 Pages

22 March 2022

Introduction: Survivors of pediatric central nervous system (CNS) tumors are at high risk for late effects and long-term morbidity. The quality of survival became increasingly important, as advances in diagnostics, multimodal treatment strategies, an...

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