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Notably, certain plant-derived metabolites activate neuroprotective signaling pathways, such as the MAPK/NF-B system, (Md et al., 2021), and interact with estrogen receptor beta (ER), a known regulator of synaptic plasticity and neuroprotection (Cardona-Gmez et al., 2006)

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Key patient-related factors are systemic conditions such as poorly controlled diabetes, peripheral neuropathy, disorders causing tissue hypoxia, connective tissue diseases, malnutrition or obesity, alcohol or illicit drug use, smoking, corticosteroid therapy, and inadequate adherence to treatment protocols

Overall, the reduction in tumour size appears to be due more to the decrease in cell density rather than any change in fibrosis

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