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Cox regression analysis was performed to investigate favorable factors for PFS and OS

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SERMs are non-steroidal estradiol analogs with mixed agonist-antagonist effects on ERs and are used in osteoporosis and breast cancer treatment (Jordan, 2004)

Its anti-inflammatory mechanisms include reducing TNF-alpha production, downregulating NF-kB activation, and decreasing oxidative stress through enhanced antioxidant enzyme activity

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