***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: Summary Background Patient-reported outcomes ( PROs ) might detect more toxic effects of radiotherapy than do clinician-reported outcomes . We did a quality of life ( QoL ) sub study to assess PROs up to 24 months after conventionally fractionated or hypofractionated radiotherapy in the Conventional or Hypofractionated High Dose Intensity Modulated Radiotherapy in Prostate Cancer ( CHHiP ) trial . Methods The CHHiP trial is a r and omised , non-inferiority phase 3 trial done in 71 centres , of which 57 UK hospitals took part in the QoL sub study . Men with localised prostate cancer who were undergoing radiotherapy were eligible for trial entry if they had histologically confirmed T1b – T3aN0M0 prostate cancer , an estimated risk of seminal vesicle involvement less than 30 % , prostate-specific antigen concentration less than 30 ng/mL , and a WHO performance status of 0 or 1 . Participants were r and omly assigned ( 1:1:1 ) to receive a st and ard fractionation schedule of 74 Gy in 37 fractions or one of two hypofractionated schedules : 60 Gy in 20 fractions or 57 Gy in 19 fractions . R and omisation was done with computer-generated permuted block sizes of six and nine , stratified by centre and National Comprehensive Cancer Network ( NCCN ) risk group . Treatment allocation was not masked . UCLA Prostate Cancer Index ( UCLA-PCI ) , including Short Form (SF)-36 and Functional Assessment of Cancer Therapy-Prostate ( FACT-P ) , or Exp and ed Prostate Cancer Index Composite ( EPIC ) and SF-12 quality -of-life question naires were completed at baseline , pre-radiotherapy , 10 weeks post-radiotherapy , and 6 , 12 , 18 , and 24 months post-radiotherapy . The CHHiP trial completed accrual on June 16 , 2011 , and the QoL sub study was closed to further recruitment on Nov 1 , 2009 . Analysis was on an intention-to-treat basis . The primary endpoint of the QoL sub study was overall bowel bother and comparisons between fractionation groups were done at 24 months post-radiotherapy . The CHHiP trial is registered with IS RCT N registry , number IS RCT N97182923 . Findings 2100 participants in the CHHiP trial consented to be included in the QoL sub study : 696 assigned to the 74 Gy schedule , 698 assigned to the 60 Gy schedule , and 706 assigned to the 57 Gy schedule . Of these individuals , 1659 ( 79 % ) provided data pre-radiotherapy and 1444 ( 69 % ) provided data at 24 months after radiotherapy . Median follow-up was 50·0 months ( IQR 38·4–64·2 ) on April 9 , 2014 , which was the most recent follow-up measurement of all data collected before the QoL data were analysed in September , 2014 . Comparison of 74 Gy in 37 fractions , 60 Gy in 20 fractions , and 57 Gy in 19 fractions groups at 2 years showed no overall bowel bother in 269 ( 66 % ) , 266 ( 65 % ) , and 282 ( 65 % ) men ; very small bother in 92 ( 22 % ) , 91 ( 22 % ) , and 93 ( 21 % ) men ; small bother in 26 ( 6 % ) , 28 ( 7 % ) , and 38 ( 9 % ) men ; moderate bother in 19 ( 5 % ) , 23 ( 6 % ) , and 21 ( 5 % ) men , and severe bother in four ( < 1 % ) , three ( < 1 % ) and three ( < 1 % ) men respectively ( 74 Gy vs 60 Gy , ptrend=0.64 , 74 Gy vs 57 Gy , ptrend=0·59 ) . We saw no differences between treatment groups in change of bowel bother score from baseline or pre-radiotherapy to 24 months . Interpretation The incidence of patient-reported bowel symptoms was low and similar between patients in the 74 Gy control group and the hypofractionated groups up to 24 months after radiotherapy . If efficacy outcomes from CHHiP show non-inferiority for hypofractionated treatments , these findings will add to the growing evidence for moderately hypofractionated radiotherapy schedules becoming the st and ard treatment for localised prostate cancer . Funding Cancer Research UK , Department of Health , and the National Institute for Health Research Cancer Research Network Objective To examine the prevalence of outcome reporting bias — the selection for publication of a subset of the original recorded outcome variables on the basis of the results — and its impact on Cochrane review s. Design A nine point classification system for missing outcome data in r and omised trials was developed and applied to the trials assessed in a large , unselected cohort of Cochrane systematic review s. Research ers who conducted the trials were contacted and the reason sought for the non-reporting of data . A sensitivity analysis was undertaken to assess the impact of outcome reporting bias on review s that included a single meta- analysis of the review primary outcome . Results More than half ( 157/283 ( 55 % ) ) the review s did not include full data for the review primary outcome of interest from all eligible trials . The median amount of review outcome data missing for any reason was 10 % , whereas 50 % or more of the potential data were missing in 70 ( 25 % ) review s. It was clear from the publications for 155 ( 6 % ) of the 2486 assessable trials that the research ers had measured and analysed the review primary outcome but did not report or only partially reported the results . For reports that did not mention the review primary outcome , our classification regarding the presence of outcome reporting bias was shown to have a sensitivity of 88 % ( 95 % CI 65 % to 100 % ) and specificity of 80 % ( 95 % CI 69 % to 90 % ) on the basis of responses from 62 trialists . A third of Cochrane review s ( 96/283 ( 34 % ) ) contained at least one trial with high suspicion of outcome reporting bias for the review primary outcome . In a sensitivity analysis undertaken for 81 review s with a single meta- analysis of the primary outcome of interest , the treatment effect estimate was reduced by 20 % or more in 19 ( 23 % ) . Of the 42 meta-analyses with a statistically significant result only , eight ( 19 % ) became non-significant after adjustment for outcome reporting bias and 11 ( 26 % ) would have overestimated the treatment effect by 20 % or more . Conclusions Outcome reporting bias is an under-recognised problem that affects the conclusions in a substantial proportion of Cochrane review s. Individuals conducting systematic review s need to address explicitly the issue of missing outcome data for their review to be considered a reliable source of evidence . Extra care is required during data extraction , review ers should identify when a trial reports that an outcome was measured but no results were reported or events observed , and contact with trialists should be encouraged INTRODUCTION Hypofractionated radiotherapy could increase the radiobiological tumor dose for localized prostate cancer . The effects of hypofractionation on sexual function are not well known . AIM To compare sexual function in patients with prostate cancer treated with 78 Gy in 39 fractions of 2 Gy or 64.6 Gy in 19 fractions of 3.4 Gy . METHODS In total , 820 men with intermediate- to high-risk T1b-T4NX-0MX-0 prostate cancer were enrolled in the phase III HYPRO trial ( 2007 - 2010 ) and r and omized to conventional fractionation ( 39 × 2 Gy ) or hypofractionation ( 19 × 3.4 Gy ) . Sexual function was assessed at baseline and at 6 , 12 , 24 , and 36 months after treatment using the International Index of Erectile Function ( IIEF ) . For this analysis , patients ( n = 322 ) with a baseline assessment , at least one follow-up assessment , and no or short-term ( 6-month ) and rogen-deprivation therapy were included . MAIN OUTCOME MEASURES Mean IIEF domain scores were compared between treatments in the total population and the hormone-naïve population ( n = 197 ) using the independent t-test . Incidences of severe erectile dysfunction ( domain score < 11 ) at last follow-up were calculated in patients with partial or full baseline function . Binary logistic regression analyses were applied to calculate the odds ratio of hypofractionation vs conventional fractionation and to adjust for clinical factors . RESULTS Median age was 71 years ( interquartile range = 67 - 71 ) and median follow-up was 37 months ( interquartile range = 25 - 38 ) . And rogen-deprivation therapy was prescribed in 125 ( 39 % ) . IIEF domain scores decreased after treatment but were comparable between treatment arms at baseline and during follow-up . Orgasmic function scores in hormone-naïve patients were significantly higher at 3 years after hypofractionation ( 4.08 vs 2.65 , P = .031 ) . In patients ( n = 120 ) with partial or full baseline erectile function , the incidence of erectile dysfunction at last follow-up was 34.4 % for hypofractionated treatment vs 39.3 % for conventional treatment ( adjusted odds ratio = 0.84 , 95 % CI = 0.37 - 1.90 , P = .67 ) . CONCLUSION No significant differences in erectile functioning  between conventional and hypofractionated radiotherapy were found . Hormone-naïve patients reported significantly higher orgasmic function scores at 3 years after hypofractionation PURPOSE To compare the toxicity between hypofractionation vs. conventional fractionation schedules in patients with high-risk prostate cancer . METHODS AND MATERIAL S Between January 2003 and December 2007 , 168 patients were r and omized to receive either hypofractionated ( 62 Gy in 20 fractions within 5 weeks , 4 fractions/wk ) or conventionally fractionated ( 80 Gy in 40 fractions within 8 weeks ) three-dimensional conformal radiotherapy to the prostate and seminal vesicles . All patients had undergone a 9-month course of total and rogen deprivation , with radiotherapy starting 2 months after initiation of the total and rogen deprivation . RESULTS The median follow-up was 32 and 35 months in the hypofractionation and conventional fractionation arms , respectively . For the patients developing acute toxicity , no difference between the two fractionation groups was found in either severity or duration of gastrointestinal or genitourinary toxicity . Also , no difference was found in the incidence and severity of late gastrointestinal and genitourinary toxicity between the two treatment schedules , with a 3-year rate of Grade 2 or greater toxicity of 17 % and 16 % for the hypofractionation arm and 14 % and 11 % for the conventional fractionation arm , respectively . A statistically significant correlation between acute and late gastrointestinal toxicity was found only in the conventional fractionation group . CONCLUSION Our findings suggest that the hypofractionation regimen used in our study is safe , with only a slight , nonsignificant increase in tolerable and temporary acute toxicity compared with the conventional fractionation schedule . The severity and frequency of late complications was equivalent between the two treatment groups PURPOSE To compare the toxicity and efficacy of hypofractionated ( 62 Gy/20 fractions/5 weeks , 4 fractions per week ) vs. conventional fractionation radiotherapy ( 80 Gy/40 fractions/8 weeks ) in patients with high-risk prostate cancer . METHODS AND MATERIAL S From January 2003 to December 2007 , 168 patients were r and omized to receive either hypofractionated or conventional fractionated schedules of three-dimensional conformal radiotherapy to the prostate and seminal vesicles . All patients received a 9-month course of total and rogen deprivation ( TAD ) , and radiotherapy started 2 months thereafter . RESULTS The median ( range ) follow-up was 32 ( 8 - 66 ) and 35 ( 7 - 64 ) months in the hypofractionation and conventional fractionation arms , respectively . No difference was found for late toxicity between the two treatment groups , with 3-year Grade 2 rates of 17 % and 16 % for gastrointestinal and 14 % and 11 % for genitourinary in the hypofractionation and conventional fractionation groups , respectively . The 3-year freedom from biochemical failure ( FFBF ) rates were 87 % and 79 % in the hypofractionation and conventional fractionation groups , respectively ( p = 0.035 ) . The 3-year FFBF rates in patients at a very high risk ( i.e. , pretreatment prostate-specific antigen ( iPSA ) > 20 ng/mL , Gleason score > or=8 , or T > or=2c ) , were 88 % and 76 % ( p = 0.014 ) in the former and latter arm , respectively . The multivariate Cox analysis confirmed fractionation , iPSA , and Gleason score as significant prognostic factors . CONCLUSIONS Our findings suggest that late toxicity is equivalent between the two treatment groups and that the hypofractionated schedule used in this trial is superior to the conventional fractionation in terms of FFBF PURPOSE We aim ed to assess the impact of spin ( ie , reporting to convince readers that the beneficial effect of the experimental treatment is 
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AUTHORS ' CONCLUSIONS These findings suggest that moderate hypofractionation ( up to a fraction size of 3.4 Gy ) results in similar oncologic outcomes in terms of disease-specific , metastasis-free and overall survival .
There appears to be little to no increase in both acute and late toxicity