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Intraoperative radiotherapy (IORT) or more aggressive surgical strategiessuch as sacrificing involved nerve rootsmay be necessary to improve local control ( Although surgery remains the primary curative modality, the clinical benefit of adjuvant radiotherapy and chemotherapy remains controversial

Another important mechanism involves oligoadenylate synthetase (OAS) pathway activated via dsRNA binding where US11 inhibits OAS activity, blocking RNase L, thereby aiding virus evade degradation while preserving infectivity (46)

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