***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE To compare directly the effect of intensity-modulated radiotherapy ( IMRT ) vs. conventional radiotherapy ( CRT ) on salivary flow and quality of life ( QoL ) in patients with early-stage nasopharyngeal carcinoma ( NPC ) . METHODS AND MATERIAL S Fifty-one patients with T2 , N0/N1 , M0 NPC took part in a r and omized controlled clinical study and received IMRT or CRT .  Stimulated whole ( SWS ) and parotid ( SPS ) saliva flow were measured and Medical Outcomes Short Form 36 ( SF-36 ) , European Organization for Research and Treatment of Cancer ( EORTC ) core quetionnaire , and EORTC head- and -neck module ( QLQ-H&N35 ) were completed at baseline and 2 , 6 , and 12 months after radiotherapy . RESULTS Forty-six patients ( 88 % ) were in disease remission 12 months after radiotherapy . At 12 months postradiotherapy , 12 ( 50.0 % ) and 20 patients ( 83.3 % ) in the IMRT group had recovered at least 25 % of preradiotherapy SWS and SPS flow respectively , compared with 1 ( 4.8 % ) and 2 patients ( 9.5 % ) , respectively , in the CRT group . Global health scores showed continuous improvement in QoL after both treatments ( p < 0.001 ) . However , after 12 months subscale scores for role-physical , bodily pain , and physical function were significantly higher in the IMRT group , indicating a better condition ( p < 0.05 ) . Dry mouth and sticky saliva were problems in both groups 2 months after treatment . In the IMRT group , there was consistent improvement over time with xerostomia-related symptoms significantly less common than in the CRT group at 12 months postradiotherapy . CONCLUSIONS IMRT was significantly better than CRT in terms of parotid sparing and improved QoL for early-stage disease . The findings support the case for assessment of health-related QoL in relation to head- and -neck cancer using a site-specific approach PURPOSE Many cancer patients take antioxidant vitamin supplements with the hope of improving the outcome of conventional therapies and of reducing the adverse effects of these treatments . A r and omized trial was conducted to determine whether supplementation with antioxidant vitamins could reduce the occurrence and severity of acute adverse effects of radiation therapy and improve quality of life without compromising treatment efficacy . PATIENTS AND METHODS We conducted a r and omized , double-blind , placebo-controlled trial among 540 head and neck cancer patients treated with radiation therapy . Patients were r and omly assigned into two arms . The supplementation with alpha-tocopherol ( 400 IU/d ) and beta-carotene ( 30 mg/d ) or placebos was administered during radiation therapy and for 3 years thereafter . During the course of the trial , supplementation with beta-carotene was discontinued because of ethical concerns . RESULTS Patients r and omly assigned in the supplement arm tended to have less severe acute adverse effects during radiation therapy ( odds ratio [ OR ] , 0.72 ; 95 % CI , 0.52 to 1.02 ) . The reduction was statistically significant when the supplementation combined alpha-tocopherol and beta-carotene for adverse effects to the larynx ( OR , 0.38 ; 95 % CI , 0.21 to 0.71 ) and overall at any site ( OR , 0.38 ; 95 % CI , 0.20 to 0.74 ) . Quality of life was not improved by the supplementation . The rate of local recurrence of the head and neck tumor tended to be higher in the supplement arm of the trial ( hazard ratio , 1.37 ; 95 % CI , 0.93 to 2.02 ) . CONCLUSION Supplementation with high doses of alpha-tocopherol and beta-carotene during radiation therapy could reduce the severity of treatment adverse effects . However , this trial suggests that use of high doses of antioxidants as adjuvant therapy might compromise radiation treatment efficacy The current Phase I/II study assessed induction docetaxel/carboplatin given weekly for 4 weeks , followed by weekly docetaxel/carboplatin and concomitant boost radiotherapy ( CB‐XRT ) for locally advanced head and neck squamous cell carcinoma PURPOSE This study was design ed to investigate the quality of life ( QOL ) of patients enrolled onto the High-Dose Chemotherapy for Breast Cancer Study Group trial ( PEGASE 02 ) , a French pilot multicenter trial of the treatment of inflammatory breast cancer ( IBC ) aim ed at evaluating ( 1 ) toxicity and feasibility of sequential high-dose chemotherapy ( HDC ) with recombinant human granulocyte colony-stimulating factor ( filgrastim ) and stem-cell support and ( 2 ) response to HDC in terms of pathologic response and survival . PATIENTS AND METHODS QOL measures were performed at inclusion and four times subsequently up to 1 year using an ad hoc side-effect question naire ( 19 physical symptoms ) and the European Organization for Research and Treatment of Cancer Quality -of-Life Question naire ( EORTC QLQ-C30 ) . RESULTS Of the 95 patients entered , the overall QOL question naire completion compliance was 75.6 % . During cycle 3 of HDC , the number of symptoms was high ( mean + /- SD QOL score , 10 + /- 3 ) , with fatigue , hair loss , appetite loss , nausea , change in taste , vomiting , fever , and weight loss reported by more than 60 % of patients . Toxicity and distress associated with HDC were reflected in the decline of four EORTC QLQ-C30 scores : global QOL ( P = .001 ) , and physical , role , and social functioning ( P < .001 for all statistics ) . However , QOL deterioration disappeared after treatment completion , except for physical functioning ( P = .025 ) . One year after inclusion , most QOL scores returned to baseline , and both emotional functioning and global QOL scores were even higher than baseline ( P = .030 and P = .009 , respectively ) . CONCLUSION If it is confirmed that improvements in pathologic response rates with HDC effectively translate into increased probabilities of survival for IBC patients , adoption of such treatment as PEGASE 02 will not involve crucial choices between length of life and QOL and should not be delayed for QOL arguments PURPOSE This open-label , multicenter trial evaluated the efficacy of a mucoadherent , anesthetic medication ( MGI 209 ) for relief from  painful oral ulcers associated with cytotoxic chemotherapy . PATIENTS AND METHODS Twenty-eight eligible cancer patients who had up to five discrete oral ulcers ( total area < or = 5 cm2 ) completed this study . Mean age was 53.5 years ( range , 21 to 81 ) . Subjective assessment s of oral discomfort before and after an orange juice pain challenge ( OJPC ) , which was measured using a visual analog scale ( VAS ) , and visual estimates of the amount of MGI 209 that remained on treated ulcers were collected at ( 1 ) baseline ( before MGI 209 treatment ) ; and ( 2 ) 30 , 60 , 120 , and 180 minutes posttreatment . RESULTS Most subjects had low VAS scores ( 4 or less ) , which was indicative of oral discomfort , at baseline before and after the OJPC . At 30 , 60 , 120 , and 180 minutes after MGI 209 treatment , most subjects had high VAS scores before and after an OJPC compared with baseline scores , which was indicative of a substantial increase in oral comfort ; these differences were statistically significant ( P < .0001 ) . Mean percent of MGI  209 estimated to remain on ulcers at the previously mentioned times was 93.7 % , 90.3 % , 79.6 % , and 71.3 % of the total amount applied , respectively . CONCLUSION Benzocaine hydrochloride in combination with the protective , mucoadherent film-coating relieved discomfort for at least 3 hours even with exposure to an irritating beverage . MGI 209 treatment should allow patients with chemotherapy-induced oral ulcers to drink and eat with significantly diminished pain or no pain PURPOSE The purpose of this study was to evaluate the feasibility , toxicity , and efficacy of a novel combined-modality treatment for patients with locally advanced squamous carcinoma of the head and neck . PATIENTS AND METHODS In this multicenter , community-based phase II study , 123 previously untreated patients with locally advanced squamous carcinoma of the head and neck received 6 weeks of induction chemotherapy followed by concurrent high-dose radiation therapy and weekly chemotherapy . Induction chemotherapy included paclitaxel ( 200 mg/m2 , 1-hour i.v . infusion ) on days 1 and 22 , carboplatin ( AUC 6.0 i.v . ) on days 1 and 22 , and 5-fluorouracil ( 225 mg/m2 per day , 24-hour continuous i.v . infusion ) on days 1–43 . After 1 week without therapy , radiation therapy , 1.8 Gy/day , 5 days weekly , to a total dose of 68.4 Gy , was administered to the primary site and the bilateral cervical lymph nodes . During radiation therapy , patients also received six weekly doses of paclitaxel ( 50 mg/m2 , 1-hour i.v . infusion ) and carboplatin ( AUC 1.0 i.v ) . After completion of therapy , patients were restaged with computed tomographic and endoscopic examination ; patients in complete remission were followed up without further treatment . RESULTS One hundred twenty-three patients ( 74 % with stage IV disease ) entered this trial , and 111 patients ( 90 % ) completed the entire treatment course . Seventy of 116 evaluable patients ( 60 % ; 95 % CI , 51%-69 % ) had a clinical complete response to treatment . After a median follow-up of 24 months , the 2- and 3-year actuarial survivals were 66 % and 51 % , respectively . Local toxicity was moderately severe during combined-modality therapy ; however , xerostomia has been the only frequent chronic toxicity of this program . CONCLUSIONS This novel combined-modality treatment program , containing paclitaxel and avoiding the use of cisplatin , is feasible , is highly active , and can be administered with acceptable toxicity in a community-based setting . Aggressive nutritional support should be considered in patients receiving this regimen , to improve acute palliation and to maximize the delivery of combined-modality therapy . Further evaluation of this treatment program is warranted . Incorporation of various novel biologic agents , particularly the epidermal growth factor receptor antagonists , may further improve efficacy Goal of the workOral mucositis ( OM ) is a functionally destructive complication of aggressive head and neck cancer therapy , often result ing in intense pain , an inability to eat and drink and secondary malnutrition and dehydration . The barrier-forming properties of Gelclair have shown promise in relieving such symptoms . The aim of this r and omised-controlled trial was to evaluate the efficacy of Gelclair , as compared to st and ard therapy , as a means of short-term symptom control for patients suffering from radiotherapy-induced OM . Material s and methods Twenty patients , with radiotherapy-induced OM seen in two oncology centres in Devon , were r and omised to either st and ard therapy ( Sucralfate and Mucaine ) or Gelclair and assessed over 24 h. Both treatments were taken four times during the 24-h period , 30 min before meals . Main results No significant difference was found between the Gelclair and st and ard therapy arms in terms of general pain ( F = 1.512 , df = 1 , 17 , ns ) . There did appear to be a trend towards pain improvement initially after the use of Gelclair , but this did not last for the full 24-h assessment period . There was no significant reduction in pain on speaking ( F = 0.261 , df = 1 , 17 , ns ) nor an improvement in capacity to eat and drink , although the effects of st and ard therapy did appear to last longer than the Gelclair . Conclusion This study indicates that Gelclair is no more effective than current st and ard practice in relieving the pain associated with radiotherapy-induced OM . Nevertheless , observations from this preliminary study warrant further investigation , with a view to shaping the way forward for head and neck cancer practice on a national level The National Institutes of Health recently recommended research initiatives to investigate oral complications of cancer chemotherapy . This prospect i ve cohort study investigated orofacial complications of combination chemotherapy ( cyclophosphamide , methotrexate , fluorouracil , vincristine , and prednisone ) in women with breast cancer . Thirty-four patients were given baseline interviews and examinations . Each patient was given weekly orofacial examinations and biweekly interviews for the first seven cycles of cytotoxic treatment . The orofacial complications included neurotoxicity caused by vincristine , mucositis , and c and idiasis . Neurotoxicity affected 22 of 34 ( 65 % ) patients , was significantly associated with age less than 50 years ( p less than 0.05 ) , and manifested as pain 
    Output:
    
Conclusions This systematic review identified the presence of pain before cancer therapy , likely attributable to the cancer ; an increase in pain during therapy and the common persistence of pain following cancer treatment .