***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: OBJECTIVES To determine the effect of acupuncture on hot flash frequency and intensity , quality of life , and sleep quality in patients undergoing hormonal therapy for prostate cancer . Hot flashes are a common adverse effect of hormonal therapy for prostate cancer . METHODS Men who had a hot flash score > 4 who were receiving and rogen deprivation therapy for prostate cancer underwent acupuncture with electrostimulation biweekly for 4 weeks , then weekly for 6 weeks , using a predefined treatment plan . The primary endpoint was a 50 % reduction in the hot flash score after 4 weeks of therapy , calculated from the patients ' daily hot flash diaries . The hot flash-related quality of life and sleep quality and biomarkers potentially related to hot flashes , including serotonin , calcitonin gene-related peptide , and urinary 5-hydroxyindoleacetic acid , were examined . RESULTS A total of 25 men were enrolled from September 2003 to April 2007 . Of these , 22 were eligible and evaluable . After 4 weeks , 9 ( 41 % , 95 % confidence interval 21%-64 % ) of 22 patients had had a > 50 % reduction in the hot flash score . Of the 22 patients , 12 ( 55 % , 95 % confidence interval 32%-76 % ) met this response definition at any point during the therapy course . No patient had a significant increase in hot flash score during therapy . A reduced hot flash score was associated with improvement in the hot flash-related quality of life and sleep quality . CONCLUSIONS Multiple placebo-controlled trials have demonstrated a 25 % response rate to placebo treatment for hot flashes . Of the 22 patients , 41 % had responded by week 4 and 55 % overall in the present pilot study , providing evidence of a potentially meaningful benefit . Additional studies of acupuncture for hot flashes in this population are warranted PURPOSE Most men who undergo castration therapy for prostatic carcinoma will have vasomotor symptoms that usually persist for years . Vasomotor symptoms are elicited from the thermoregulatory center , possibly due to a decrease in hypothalamic opioid activity induced by low sex steroid concentrations . Acupuncture treatment in women , which stimulates hypothalamic opioid activity , alleviates vasomotor symptoms . We report on men treated with acupuncture for relief of vasomotor symptoms after castration therapy . MATERIAL S AND METHODS We asked 7 men with vasomotor symptoms due to castration therapy to receive acupuncture treatment 30 minutes twice weekly for 2 weeks and once a week for 10 weeks . Effects on flushes were recorded in logbooks . RESULTS Of the 7 men 6 completed at least 10 weeks of acupuncture therapy and all had a substantial decrease in the number of hot flushes ( average 70 % after 10 weeks ) . At 3 months after the last treatment the number of flushes was 50 % lower than before therapy . Therapy was discontinued after 10 weeks because of a femoral neck fracture in 1 man and after 3 weeks due to severe back pain in 1 . CONCLUSIONS Acupuncture may be a therapeutic alternative in men with hot flushes after castration therapy and merits further evaluation Recommendations for treatment are commonly based on results evaluating variation in systematic effects ( group responses ) from r and omised controlled trials without taking the individual patient 's variation into account . In the evaluation of acupuncture-related treatment effects , the trial design and statistical analysis used are a challenge since the assessed variables commonly have subjective properties and are based on the person 's own self-report . Thus , the results that are seen are often varied , most likely due to inter-individual variation in rating of the actual variable such that the treatment effects are expressed more ( or less ) in some individuals than in others . The basis for the individual variation is probably multi-modal and could be related to the individuals ’ expectation , gender , genetic polymorphisms and the aetiology of the condition . The assessment methods used should preferably have proven useful in controlled trials , and the methods for statistical analysis should consider the non-metric properties of the variable and the contribution of the individuals ’ variation in the results . In order to evaluate the treatment effects more properly and increase the possibility of detecting any effectiveness , it is therefore important to assess the level of perceived dysfunction or symptom , taking into account the individual variation as well as the systematic effects ( the effects of the group ) . In the evaluation of acupuncture effects , both systematic and individual variation should be reported allowing for the detection of subgroup effects and thereby leading to treatment recommendations that are more likely to be based on each individual 's specific needs BACKGROUND Radiation treatment of head and neck cancer can cause chronic xerostomia which impairs patients ' quality of life . The study reported here examined the efficacy of acupuncture in alleviating xerostomia symptoms especially dry mouth . PATIENTS AND METHODS A total of 145 patients with chronic radiation-induced xerostomia > 18 months after treatments were recruited from seven UK cancer centres . The study employed a r and omised crossover design with participants receiving two group sessions of oral care education and eight of acupuncture using st and ardised methods . Patient-reported outcome ( PROs ) measures were completed at baseline and weeks 5 , 9 , 13 , 17 , and 21 . The primary outcome was improvement in dry mouth . OBJECTIVE saliva measurements were also carried out . RESULTS Acupuncture compared with oral care , produced significant reductions in patient reports of severe dry mouth ( OR = 2.01 , P = 0.031 ) sticky saliva ( OR = 1.67 , P = 0.048 ) , needing to sip fluids to swallow food ( OR = 2.08 , P = 0.011 ) and in waking up at night to drink ( OR = 1.71 , P = 0.013 ) . There were no significant changes in either stimulated or unstimulated saliva measurements over time . CONCLUSION Eight sessions of weekly group acupuncture compared with group oral care education provide significantly better relief of symptoms in patients suffering from chronic radiation-induced xerostomia More than 70 % of seriously ill patients with cancer suffer from xerostomia and the associated problems of swallowing , chewing and speaking . This study aims to investigate whether treatment with acupuncture is a viable option for hospice patients with xerostomia . During a 2-year period , 117 patients were assessed for xerostomia . Eighty-two patients were found to have moderate xerostomia . Sixty-seven fulfilled the criteria for inclusion . Of these , 14 were included but only eight completed the study . Ten acupuncture treatments were given during a 5-week period . The effect of acupuncture was measured using a visual analogue scale , and by measuring the saliva production before and after the series of treatment . The results show that all the patients experienced alleviation of dryness of the mouth and the associated symptoms , and thus benefited from the acupuncture treatment . However , conducting a 5-week acupuncture intervention study is not feasible at an inpatient hospice due to the patients being too close to death Purpose / Objective : Patients with cancer or symptoms referable to cancer therapy were offered acupuncture as potential palliation of their symptoms . This paper describes the physical integration of the discipline into the Oncology Clinic , and patient perspectives on its availability and efficacy . Patients and methods : Between August 1999 and May 2000 , 123 patients with varying symptoms received acupuncture in our Center 's Radiation and Medical Oncology Clinics and Breast Health Center . These patients had 823 visits during this time period . A practice outcome analysis was performed on patients receiving therapy between 1 January 2000 and 30 April 2000 . The 89 patients treated during this interval had 444 total visits . In June and July 2000 , a question naire was administered by phone to 79 of these patients ( 89 % ) . St and ard allopathic care continued while patients were receiving acupuncture . Results : Major reasons for referral included pain ( 53 % ) , xerostomia ( 32 % ) , hot flashes ( 6 % ) and nausea/loss of appetite ( 6 % ) . Patients had a mean of five acupuncture visits ( range 1– 9 ) . Most patients ( 60 % ) showed at least 30 % improvement in their symptoms . About one-third of patients had no change in severity of symptoms . There were no untoward effects reported related to the acupuncture . When analysed by diagnosis , these values persist . Irrespective of response to therapy , 86 % of respondents considered it ‘ very important ' that we continue to provide acupuncture services . Conclusion : Acupuncture may contribute to control of symptoms for cancer patients . Expansion of providers , continued patient follow-up , optimization of techniques and prospect i ve objective measurement of response continue in our clinic Of 21 patients with severe xerostomia , 11 were treated with acupuncture and 10 patients received placebo acupuncture . Those patients who received acupuncture treatment showed increased salivary flow rates during and after the acupuncture treatment . The improved salivary values persisted during the observation year , whereas the patients who received placebo acupuncture showed some improvement of salivary flow rates only during the actual treatment . The results of the present study indicate that acupuncture may be a useful adjunct for the stimulation of salivary flow in some patients with xerostomia PURPOSE We aim ed to assess the effectiveness of acupuncture for  cancer-related fatigue ( CRF ) in patients with breast cancer . PATIENTS AND METHODS We conducted a pragmatic , r and omized controlled trial comparing acupuncture with enhanced usual care .  Three hundred two out patients with breast cancer participated . We r and omly assigned 75 patients to usual care and 227 patients to acupuncture plus usual care  ( r and om assignment of 1:3 respectively ) with minimization controlling for baseline general fatigue and maintenance treatment . Treatment was delivered by acupuncturists once a week for 6 weeks through needling three pairs of acupoints . The usual care group received a booklet with information about fatigue and its management . Primary outcome was general fatigue at 6 weeks , measured with the  Multidimensional Fatigue Inventory ( MFI ) . Other measurements included the Hospital Anxiety and Depression Scale , Functional Assessment of Cancer Therapy-General quality -of-life scale , and expectation of acupuncture effect . Analyses were by intention to treat . RESULTS Two hundred forty-six of 302 patients r and omly assigned provided complete data at 6 weeks . The difference in the mean General Fatigue score , between those who received the intervention and those who did not , was -3.11 ( 95 % CI , -3.97 to -2.25 ; P < .001 ) . The intervention also improved all other fatigue aspects measured by MFI , including Physical Fatigue and Mental Fatigue  ( acupuncture effect , -2.36 and -1.94 , respectively ; both at P < .001 ) , anxiety and depression ( acupuncture effect , -1.83 and -2.13 , respectively ; both at P < .001 ) , and quality of life ( Physical Well-Being effect , 3.30 ; Functional Well-Being effect , 3.57 ; both at P < .001 ; Emotional Well-Being effect , 1.93 ; P = .001 ; and Social Functioning Well-Being effect , 1.05 ; P < .05 ) . CONCLUSION Acupuncture is an effective intervention for managing the symptom of CRF and improving patients ' quality of life The m and ate of Human Reproduction Up date involves several roles : ( i ) to provide a synthesis of evidence that can aid scientists and clinicians in their daily work ; ( ii ) to help reproductive specialists underst and concepts from related disciplines ; and ( iii ) to summarize current knowledge generated by basic science as the foundation of future scientific and clinical advancement . Given that review and synthesis are central to good scientific and clinical practice , and that a grasp of the current state of knowledge is a prerequisite to design ing new studies , it is pertinent to ask which review s are most likely to fulfil the needs of readers . A related question concerns whether systematic review s meet the needs of all review topics and all readers . Summarizing evidence or knowledge is a difficult problem in reproductive medicine , as in other branches of science and medical care ( Eddy et al. , 1992 ) . For each question there may be multiple studies that use different design s and inclusion criteria . For clinical questions , the interventions , outcomes and measures of effect may vary : the effect measures in treatment studies include odds ratios , relative risks and absolute differences . For scientific questions , the experimental species , models and design s may differ . Moreover , it is always uncertain whether all of the relevant evidence has been evaluated . Even when the search has been exhaustive , there are no simple guides on how to interpret conflicting results and whether to accept apparently outlying studies . The choices that the review er makes to address the variable conditions and uncertainties may be conservative , strict and exclusive , or liberal , open and inclusive . The decisions made by the review er may not be consistent throughout and these choices may or may not satisfy the reader who seeks out the review to address a clinical or research question . Faced with uncertainty and doubt , readers nonetheless must form an impression of the evidence and synthesize the state of knowledge in order to address the clinical or research question that stimulated their interest in the review . We argue that the reader is better served when the choices made in the review , regardless of whether they are strict or open , should be explicit , transparent , clearly stated and reproducible by interested readers . This list of objectives for review s is more easily satisfied by systematic review s , which use explicit methods to method ically search , critically appraise and synthesize the available literature on a specific issue . The question or issue need not be clinical : indeed , the concept evolved primarily in psychology studies ( Light and Pillemer , 1984 ) . The systematic review attempts to reduce 
    Output:
    
Benefit was reported for other cancer-related symptoms , including pain , fatigue , hot flushes , xerostomia , dyspnoea and anxiety .
Much of the primary research reported in review s is innovative and indicates potential benefit for people with cancer-related symptoms .