<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">tumors</journal-id><journal-title-group><journal-title xml:lang="ru">Malignant tumours</journal-title><trans-title-group xml:lang="en"><trans-title>Malignant tumours</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2224-5057</issn><issn pub-type="epub">2587-6813</issn><publisher><publisher-name>Rosoncoweb</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.18027/2224-5057-2013-3-42-50</article-id><article-id custom-type="elpub" pub-id-type="custom">tumors-51</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL REPORTS</subject></subj-group></article-categories><title-group><article-title>ОТЕЧЕСТВЕННЫЙ ОПЫТ ПРОФИЛАКТИКИ И ЛЕЧЕНИЯ ПРОЯВЛЕНИЙ КОЖНОЙ ТОКСИЧНОСТИ У ПАЦИЕНТОВ МКРР, ПОЛУЧАЮЩИХ ИНГИБИТОРЫ EGFR, НА ПРИМЕРЕ ПРЕПАРАТА ПАНИТУМУМАБ</article-title><trans-title-group xml:lang="en"><trans-title>Domestic experience of prevention and treatment of skin toxicity in patients with metastatic colorectal cancer receiving inhibitors of EGFR: the example of using of panitumumab</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Варламова</surname><given-names>С. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Varlamova</surname><given-names>S. E.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Орлова</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Orlova</surname><given-names>E. V.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Птушкин</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Ptushkin</surname><given-names>V. V.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Болотина</surname><given-names>Л. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Bolotina</surname><given-names>L. V.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Антимоник</surname><given-names>Н. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Antimonik</surname><given-names>N. Yu.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Владимирова</surname><given-names>Л. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Vladimirova</surname><given-names>L. Yu.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Макеев</surname><given-names>Ю. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Makeev</surname><given-names>Yu. M.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Козлова</surname><given-names>Н. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Kozlova</surname><given-names>N. M.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бердов</surname><given-names>Б. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Berdov</surname><given-names>B. A.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Феоктистова</surname><given-names>П. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Feoktistova</surname><given-names>P. S.</given-names></name></name-alternatives><xref ref-type="aff" rid="aff-9"/></contrib></contrib-group><aff xml:lang="ru" id="aff-1"><institution>ФГБУ ГНЦ ФМБЦ им. А. И. Бурназяна ФМБА России, г. Москва</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-2"><institution>ГБОУ ВПО Первый МГМУ им. И. М. Сеченова Минздрава России, г. Москва.</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-3"><institution>ФГБУ «ФНКЦ ДГОИ им. Дмитрия Рогачева» Минздрава России, г. Москва</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-4"><institution>Московский научно-исследовательский онкологический институт им. П. А. Герцена, г. Москва</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-5"><institution>«Городской клинический онкологический диспансер», г. Санкт-Петербург</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-6"><institution>ФГБУ «Ростовский научно-исследовательский онкологический институт» Минздрава России, г. Ростов-на-Дону</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-7"><institution>ГБУЗ «Московский областной онкологический диспансер», г. Балашиха</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-8"><institution>ФГБУ «Медицинский радиологический научный центр» Минздрава России, г. Обнинск.</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-9"><institution>Учреждение ХМАО-ЮГРЫ «Нижневартовский онкологический диспансер», г. Нижневартовск</institution><country>Russian Federation</country></aff><pub-date pub-type="collection"><year>2013</year></pub-date><pub-date pub-type="epub"><day>20</day><month>05</month><year>2015</year></pub-date><volume>0</volume><issue>3</issue><fpage>42</fpage><lpage>50</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Варламова С.Е., Орлова Е.В., Птушкин В.В., Болотина Л.В., Антимоник Н.Ю., Владимирова Л.Ю., Макеев Ю.М., Козлова Н.М., Бердов Б.А., Феоктистова П.С., 2015</copyright-statement><copyright-year>2015</copyright-year><copyright-holder xml:lang="ru">Варламова С.Е., Орлова Е.В., Птушкин В.В., Болотина Л.В., Антимоник Н.Ю., Владимирова Л.Ю., Макеев Ю.М., Козлова Н.М., Бердов Б.А., Феоктистова П.С.</copyright-holder><copyright-holder xml:lang="en">Varlamova S.E., Orlova E.V., Ptushkin V.V., Bolotina L.V., Antimonik N.Y., Vladimirova L.Y., Makeev Y.M., Kozlova N.M., Berdov B.A., Feoktistova P.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.malignanttumors.org/jour/article/view/51">https://www.malignanttumors.org/jour/article/view/51</self-uri><abstract><p>Освещены результаты первого отечественного опыта коррекции кожной токсичности у пациентов мКРР, получающих ингибиторы EGRF, на примере препарата Панитумумаб. Сбор и оценка данных произведены в рамках проекта рабочей группы по поддерживающей терапии Профессионального Общества онкологов-химиотерапевтов (RUSSCO) по разработке рекомендаций для профилактики и лечения дерматологической токсичности у пациентов, получающих ингибиторы EGFR. В проекте принимали участие 10 центров РФ. У 58 пациентов, получавших Панитумумаб, оценивалась эффективность профилактической медикаментозной и симптоматической терапии клинических проявлений дерматологической токсичности доступными средствами. Полученные результаты подтверждают эффективность профилактической терапии. Разработаны оптимальные схемы коррекции различных проявлений кожной токсичности в зависимости от клинических проявлений и степени тяжести.</p></abstract><trans-abstract xml:lang="en"><p>The results of the first national experience of skin toxicity correction in patients with metastatic colorectal cancer (mCRC) receiving EGRF-inhibitors shown on the example of using of Panitumumab. The collection and evaluation of the data were produced in the framework of the project of the working group on maintenance therapy of Russian society of clinical oncologists and chemotherapeutists (RUSSCO) to develop recommendations for the prevention and treatment of dermatological toxicity in patients receiving EGFR-inhibitors. The project involved 10 centers in Russia.  In 58 patients receiving Panitumumab, the efficacy of prophylactic medication and symptomatic treatment of clinical manifestations of dermatological toxicity using available remedies was evaluated. The results confirm the effectiveness of preventive therapy. Optimal correction schemes of various manifestations of dermal toxicity were developed depending on the clinical manifestations and severity.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>проявления кожной токсичности</kwd><kwd>ингибиторы EGFR</kwd><kwd>панитумумаб</kwd></kwd-group><kwd-group xml:lang="en"><kwd>manifestations of dermal toxicity</kwd><kwd>EGFR-inhibitors</kwd><kwd>panitumumab</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Elez 2008, Bosch 2008, Lacouture ME. Mechanisms of cutaneous toxicities to EGFR inhibitors. Nat Rev Cancer. 2006; 6: 803-812.</mixed-citation><mixed-citation xml:lang="en">Elez 2008, Bosch 2008, Lacouture ME. Mechanisms of cutaneous toxicities to EGFR inhibitors. Nat Rev Cancer. 2006; 6: 803-812.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Perez-Soler R, Saltz L. Cutaneous adverse effects with HER1 / EGFR-targeted agents:</mixed-citation><mixed-citation xml:lang="en">Perez-Soler R, Saltz L. Cutaneous adverse effects with HER1 / EGFR-targeted agents:</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">is there a silver lining? J Clin Oncol. 2005; 23: 5235-5246.</mixed-citation><mixed-citation xml:lang="en">is there a silver lining? J Clin Oncol. 2005; 23: 5235-5246.</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Segaert S &amp; Van Cutsem E. Ann Oncol 2005;16:1425-33.</mixed-citation><mixed-citation xml:lang="en">Segaert S &amp; Van Cutsem E. Ann Oncol 2005;16:1425-33.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Hassel JC. Onkologie 2010.</mixed-citation><mixed-citation xml:lang="en">Hassel JC. Onkologie 2010.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Giusti RM et al. Clin Cancer Res. 2008;14:1296-302.</mixed-citation><mixed-citation xml:lang="en">Giusti RM et al. Clin Cancer Res. 2008;14:1296-302.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Douillard J, Siena S, Tabernero J, et al. Final skin toxicity (ST) and patient reported outcomes (PRO) results from PRIME: a randomized phase 3 study of panitumumab (pmab) + FOLFOX4 (CT) for 1st line metastatic colorectal cancer (mCRC). J Clin Oncol 2012;30 (Suppl 4):531 and poster.</mixed-citation><mixed-citation xml:lang="en">Douillard J, Siena S, Tabernero J, et al. Final skin toxicity (ST) and patient reported outcomes (PRO) results from PRIME: a randomized phase 3 study of panitumumab (pmab) + FOLFOX4 (CT) for 1st line metastatic colorectal cancer (mCRC). J Clin Oncol 2012;30 (Suppl 4):531 and poster.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Price TJ, Sobrero AF, Wilson G, et al. Randomized, open-label, phase III study of panitumumab with FOLFIRI versus FOLFIRI alone as second-line treatment in patients with metastatic colorectal cancer (mCRC): Efficacy by skin toxicity. J Clin Oncol 2010;28 (15S): 3529.</mixed-citation><mixed-citation xml:lang="en">Price TJ, Sobrero AF, Wilson G, et al. Randomized, open-label, phase III study of panitumumab with FOLFIRI versus FOLFIRI alone as second-line treatment in patients with metastatic colorectal cancer (mCRC): Efficacy by skin toxicity. J Clin Oncol 2010;28 (15S): 3529.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Van Cutsem E, Peeters M, Siena S, et al. Open-label phase III trial of panitumumab plus best supportive care compared with best supportive care alone in patients with chemotherapy-refractory metastatic colorectal cancer. J Clin Oncol. 2007;25 (13):1658-1664.</mixed-citation><mixed-citation xml:lang="en">Van Cutsem E, Peeters M, Siena S, et al. Open-label phase III trial of panitumumab plus best supportive care compared with best supportive care alone in patients with chemotherapy-refractory metastatic colorectal cancer. J Clin Oncol. 2007;25 (13):1658-1664.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Saltz LB, Meropol NJ, Loehrer PJ, Sr, Needle MN, Kopit J, Mayer RJ. Phase ii trial of cetuximab in patients with refractory colorectal cancer that expresses the epidermal growth factor receptor. J Clin Oncol. 2004;22:1201-8. doi: 10.1200 / JCO.2004.10.182.</mixed-citation><mixed-citation xml:lang="en">Saltz LB, Meropol NJ, Loehrer PJ, Sr, Needle MN, Kopit J, Mayer RJ. Phase ii trial of cetuximab in patients with refractory colorectal cancer that expresses the epidermal growth factor receptor. J Clin Oncol. 2004;22:1201-8. doi: 10.1200 / JCO.2004.10.182.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Jonker DJ, O’Callaghan CJ, Karapetis CS, et al. Cetuximab for the treatment of colorectal cancer. N Engl J Med. 2007;357:2040-8. doi: 10.1056 / NEJMoa071834.</mixed-citation><mixed-citation xml:lang="en">Jonker DJ, O’Callaghan CJ, Karapetis CS, et al. Cetuximab for the treatment of colorectal cancer. N Engl J Med. 2007;357:2040-8. doi: 10.1056 / NEJMoa071834.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Perez — Soler R. Can rash associated with</mixed-citation><mixed-citation xml:lang="en">Perez — Soler R. Can rash associated with</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">her1 / egfr inhibition be used as a marker of treatment outcome? Oncology (Williston Park) 2003.</mixed-citation><mixed-citation xml:lang="en">her1 / egfr inhibition be used as a marker of treatment outcome? Oncology (Williston Park) 2003.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Jatoi A, Rowland K, Sloan JA, et al. Tetracycline to prevent epidermal growth factor receptor inhibitor – induced skin rashes: results of a placebo-controlled trial from the North Central Cancer Treatment Group (N03CB) Cancer. 2008;113:847-53. doi: 10.1002 / cncr.23621.</mixed-citation><mixed-citation xml:lang="en">Jatoi A, Rowland K, Sloan JA, et al. Tetracycline to prevent epidermal growth factor receptor inhibitor – induced skin rashes: results of a placebo-controlled trial from the North Central Cancer Treatment Group (N03CB) Cancer. 2008;113:847-53. doi: 10.1002 / cncr.23621.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">N. Mittmann, PhD, S. J. Seung, BSc. Rash rates with egfr inhibitors: meta-analysis, Curr Oncol. 2011 April; 18 (2): e54 — e63. PMCID: PMC3070712.</mixed-citation><mixed-citation xml:lang="en">N. Mittmann, PhD, S. J. Seung, BSc. Rash rates with egfr inhibitors: meta-analysis, Curr Oncol. 2011 April; 18 (2): e54 — e63. PMCID: PMC3070712.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Segaert S et al. J Dtsch Dermatol Ges 2005; 3:599-606.</mixed-citation><mixed-citation xml:lang="en">Segaert S et al. J Dtsch Dermatol Ges 2005; 3:599-606.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Perez-Soler R et al. Oncologist 2005; 10:345-56.</mixed-citation><mixed-citation xml:lang="en">Perez-Soler R et al. Oncologist 2005; 10:345-56.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Lynch TJ et al. Oncologist 2007; 12:610-21.</mixed-citation><mixed-citation xml:lang="en">Lynch TJ et al. Oncologist 2007; 12:610-21.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Melosky B et al. Oncologist 2009; 16:16-26.</mixed-citation><mixed-citation xml:lang="en">Melosky B et al. Oncologist 2009; 16:16-26.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Scope A et al. J Clin Oncol 2007; 25:5390-6.</mixed-citation><mixed-citation xml:lang="en">Scope A et al. J Clin Oncol 2007; 25:5390-6.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Jatoi et al. Cancer 2008; 113:847-53.</mixed-citation><mixed-citation xml:lang="en">Jatoi et al. Cancer 2008; 113:847-53.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Segaert S, Van Cutsem E. Ann Oncol 2005; 16:1425-33.</mixed-citation><mixed-citation xml:lang="en">Segaert S, Van Cutsem E. Ann Oncol 2005; 16:1425-33.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Robert C et al. Lancet Oncol 2005; 6:491-500.</mixed-citation><mixed-citation xml:lang="en">Robert C et al. Lancet Oncol 2005; 6:491-500.</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Guillot B, Bessis D. Ann Dermatol Venerol 2006; 133:1017-20.</mixed-citation><mixed-citation xml:lang="en">Guillot B, Bessis D. Ann Dermatol Venerol 2006; 133:1017-20.</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Gutzmer et al. Hautarzt 2006; 57:509-13.</mixed-citation><mixed-citation xml:lang="en">Gutzmer et al. Hautarzt 2006; 57:509-13.</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Панитумумаб в терапии метастатического колоректального рака: данные клинических исследований, проблема кожной токсичности / Е. В. Артамонова // Современная онкология. — 2010. — Т.12, № 3. — С.65-70.</mixed-citation><mixed-citation xml:lang="en">Панитумумаб в терапии метастатического колоректального рака: данные клинических исследований, проблема кожной токсичности / Е. В. Артамонова // Современная онкология. — 2010. — Т.12, № 3. — С.65-70.</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Lacouture ME, Mitchell EP, Piperdi B et al. Skin Toxicity Evaluation Protocol With Panitumumab (STEPP), a Phase II, Open-Label, Randomized Trial Evaluating the Impact of a Pre-Emptive Skin Treatment Regimen on Skin Toxicities and Quality of Life in Patients With Metastatic Colorectal Cancer / published online ahead of print at www.jco.org on February 8, 2010.</mixed-citation><mixed-citation xml:lang="en">Lacouture ME, Mitchell EP, Piperdi B et al. Skin Toxicity Evaluation Protocol With Panitumumab (STEPP), a Phase II, Open-Label, Randomized Trial Evaluating the Impact of a Pre-Emptive Skin Treatment Regimen on Skin Toxicities and Quality of Life in Patients With Metastatic Colorectal Cancer / published online ahead of print at www.jco.org on February 8, 2010.</mixed-citation></citation-alternatives></ref><ref id="cit28"><label>28</label><citation-alternatives><mixed-citation xml:lang="ru">NCI-CTCAE V.4.0. Available at: http://ctep.cancer.gov</mixed-citation><mixed-citation xml:lang="en">NCI-CTCAE V.4.0. Available at: http://ctep.cancer.gov</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
