***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: IMPORTANCE Although many patients with end-stage cancer are offered chemotherapy to improve quality of life ( QOL ) , the association between chemotherapy and QOL amid progressive metastatic disease has not been well-studied . American Society for Clinical Oncology guidelines recommend palliative chemotherapy only for solid tumor patients with good performance status . OBJECTIVE To evaluate the association between chemotherapy use and QOL near death ( QOD ) as a function of patients ' performance status . DESIGN , SETTING , AND PARTICIPANTS A multi-institutional , longitudinal cohort study of patients with end-stage cancer recruited between September 2002 and February 2008 . Chemotherapy use ( n = 158 [ 50.6 % ] ) and Eastern Cooperative Oncology Group ( ECOG ) performance status were assessed at baseline ( median = 3.8 months before death ) and patients with progressive metastatic cancer ( N = 312 ) following at least 1 chemotherapy regimen  were followed prospect ively until death at 6 outpatient oncology clinics in the United States . MAIN OUTCOMES AND MEASURES Patient QOD was determined using vali date d caregiver ratings of patients ' physical and mental distress in their final week . RESULTS Chemotherapy use was not associated with patient survival controlling for clinical setting and patients ' performance status . Among patients with good ( ECOG score = 1 ) baseline performance status , chemotherapy use compared with nonuse was associated with worse QOD ( odds ratio [ OR ] , 0.35 ; 95 % CI , 0.17 - 0.75 ; P = .01 ) . Baseline chemotherapy use was not associated with QOD among patients with moderate ( ECOG score = 2 ) baseline performance status ( OR , 1.06 ; 95 % CI , 0.51 - 2.21 ; P = .87 ) or poor ( ECOG score = 3 ) baseline performance status ( OR , 1.34 ; 95 % CI , 0.46 - 3.89 ; P = .59 ) . CONCLUSIONS AND RELEVANCE Although palliative chemotherapy is used to improve QOL for patients with end-stage cancer , its use did not improve QOD for patients with moderate or poor performance status and worsened QOD for patients with good performance status . The QOD in patients with end-stage cancer is not improved , and can be harmed , by chemotherapy use near death , even in patients with good performance status A self-control , r and omized , and open-label clinical trial was performed to test the effects of the unicellular green algae Chlorella and hot water extract supplementation on quality of life ( QOL ) in patients with breast cancer . Forty-five female patients with breast cancer who were living at home and not hospitalized were r and omly assigned to 3 groups receiving vitamin mix tablet ( control ) , Chlorella granules ( test food-1 ) , or Chlorella extract drink ( test food-2 ) daily for one month . The Functional Assessment of Cancer Therapy-Breast ( FACT-B ) , the Izumo scale for abdominal symptom-specific QOL , and a narrative-form question naire were used to determine outcomes . Data of thirty-six subjects were included for final analysis . FACT-B scores at presupplementation found no significant group differences in all subscales . Scores on the breast cancer subscale in the Chlorella granule group significantly increased during the supplementation period ( P = 0.042 ) . Fifty percent of the Chlorella extract group reported positive effects by the test food such as reduction of fatigue and improvements of dry skin ( P < 0.01 versus control group ) . The findings suggested the beneficial effects of Chlorella on breast cancer-related QOL and of Chlorella extract on vitality status in breast cancer patients . These findings need to be confirmed in a larger study Ginger supplementation could be an effective adjuvant treatment for  chemotherapy-induced nausea ( CIN ) .  The aim of this clinical trial was to address significant method ological limitations in previous trials . Patients ( N = 51 ) were r and omly allocated to receive either 1.2 g of st and ardised ginger extract or placebo per day , in addition to st and ard anti-emetic therapy , during the first three cycles of chemotherapy . The primary outcome was CIN-related quality of life ( QoL ) measured with the Functional Living Index- Emesis ( FLIE ) question naire . Secondary outcomes included acute and delayed nausea , vomiting , and retching as well as cancer-related fatigue , nutritional status , and CIN and vomiting-specific prognostic factors . Over three consecutive chemotherapy cycles , nausea was more prevalent than vomiting ( 47 % vs. 12 % ) . In chemotherapy Cycle 1 , intervention participants reported significantly better QoL related to CIN ( p = 0.029 ) , chemotherapy-induced nausea and vomiting (CINV)-related QoL ( p = 0.043 ) , global QoL ( p = 0.015 ) and less fatigue ( p = 0.006 ) than placebo participants . There were no significant results in Cycle 2 . In Cycle 3 , global QoL ( p = 0.040 ) and fatigue ( p = 0.013 ) were significantly better in the intervention group compared to placebo . This trial suggests adjuvant ginger supplementation is associated with better chemotherapy-induced nausea-related quality of life and less cancer-related fatigue , with no difference in adverse effects compared to placebo Purpose Aromatase inhibitor (AI)-induced joint symptoms negatively impact drug adherence and quality of life in breast cancer survivors . Mechanisms underlying symptoms may include inflammation . It is hypothesized that n − 3 polyunsaturated fatty acids ( PUFAs ) have anti-inflammatory properties and may reduce symptoms . Methods We conducted a r and omized , double-blind , placebo-controlled study comparing 4.3 g/day n − 3 PUFA supplements vs placebo for 24 weeks in postmenopausal breast cancer patients starting adjuvant AIs . Primary endpoints were adherence and tolerability ; secondary outcomes included inflammatory cytokines and symptoms assessed by the Brief Pain Inventory short form ( BPI-SF ) and Functional Assessment of Cancer Treatment-Endocrine Symptoms ( FACT-ES ) at 0 , 12 , and 24 weeks . Results Forty-four women were r and omized , of which 35 completed the study . Adherence was ≥ 88 % based on these 35 patients with pill counts as well as change in red blood cell ( RBC ) n − 3 PUFAs . Common toxicities included grade 1 flatulence ( 55 % of both groups ) and belching ( 45 % of n − 3 group ) . Mean pain severity scores ( BPI-SF ) did not change significantly by time or treatment arm . Quality of life , based on FACT-ES scores , significantly decreased within placebo ( p = 0.04 ) , but not the n − 3 group ( p = 0.58 ) , with a trend toward between-group differences ( p = 0.06 ) at 12 weeks , but no significant differences at 24 weeks . RBC n − 3 levels were strongly positively correlated with FACT-ES at 12 weeks , but attenuated at 24 weeks . Conclusion High-dose n − 3 PUFA supplementation is feasible and well tolerated when administered with AIs . Additional studies are needed to evaluate efficacy in prevention of joint symptoms PURPOSE A r and omized phase II study was performed to measure the potential therapeutic effects of yoga on fatigue , erectile dysfunction , urinary incontinence , and overall quality of life ( QOL ) in prostate cancer ( PCa ) patients undergoing external beam radiation therapy ( RT ) . METHODS AND MATERIAL S The participants were r and omized to yoga and no-yoga cohorts ( 1:1 ) . Twice-weekly yoga interventions were offered throughout the 6- to 9-week courses of RT . Comparisons of st and ardized assessment s were performed between the 2 cohorts for the primary endpoint of fatigue and the secondary endpoints of erectile dysfunction , urinary incontinence , and QOL before , during , and after RT . RESULTS From October 2014 to January 2016 , 68 eligible PCa patients underwent informed consent and agreed to participate in the study . Of the 68 patients , 18 withdrew early , mostly because of treatment schedule-related time constraints , result ing in 22 and 28 patients in the yoga and no-yoga groups , respectively . Throughout treatment , those in the yoga arm reported less fatigue than those in the control arm , with global fatigue , effect of fatigue , and severity of fatigue subscales showing statistically significant interactions ( P<.0001 ) . The sexual health scores ( International Index of Erectile Function Question naire ) also displayed a statistically significant interaction ( P=.0333 ) . The International Prostate Symptom Score revealed a statistically significant effect of time ( P<.0001 ) but no significant effect of treatment ( P=.1022 ) . The QOL measures had mixed results , with yoga having a significant time by treatment effect on the emotional , physical , and social scores but not on functional scores . CONCLUSIONS A structured yoga intervention of twice-weekly classes during a course of RT was associated with a significant reduction in pre-existing and RT-related fatigue and urinary and sexual dysfunction in PCa patients OBJECTIVE Although chemotherapy-induced cognitive impairment is common among breast cancer patients , evidence for effective interventions addressing cognitive deficits is limited . This r and omized controlled trial examined the feasibility and preliminary efficacy of a Tibetan Sound Meditation ( TSM ) program to improve cognitive function and quality of life in breast cancer patients . METHODS Forty-seven breast cancer patients ( mean age 56.3 years ) , who were staged I-III at diagnosis , 6 - 60 months post-chemotherapy , and reported cognitive impairment at study entry were recruited . Participants were r and omized to either two weekly TSM sessions for 6 weeks or a wait list control group . Neuropsychological assessment s  were completed at baseline and 1 month post-treatment . Self-report measures of cognitive function ( Functional Assessment of Cancer Therapy (FACT)-Cog ) , quality of life ( SF-36 ) , depressive symptoms ( Center for Epidemiologic Studies Depression Scale ) , sleep disturbance ( Pittsburgh Sleep Quality Index ) , fatigue ( Brief Fatigue Inventory ) , and spirituality ( FACT-Sp ) were completed at baseline , the end of treatment , and 1 month later . RESULTS Relative to the control group , women in the TSM group performed better on the verbal memory test ( Rey Auditory Verbal Learning Test trial 1 ) ( p = 0.06 ) and the short-term memory and processing speed task ( Digit Symbol ) ( p = 0.09 ) and reported improved cognitive function ( p = 0.06 ) , cognitive abilities ( p = 0.08 ) , mental health ( p = 0.04 ) , and spirituality ( p = 0.05 ) at the end of treatment but not 1 month later . CONCLUSIONS This r and omized controlled trial revealed that TSM program appears to be a feasible and acceptable intervention and may be associated with short-term improvements in objective and subjective cognitive function as well as mental health and spirituality in breast cancer patients Purpose This study was to evaluate the efficacy of a complementary Chinese treatment modality Guolin-Qigong ( GLQG ) for patients with breast cancer on the body-mind health . Methods A r and omized controlled clinical trial was conducted among 158 women with breast cancer . Subjects were r and omized to receive GLQG ( test group ) versus a physical stretching program ( control group )  following conventional treatment for breast cancer .  GLQG and stretching interventions were performed twice a week over 24 weeks . The primary outcome was the change in quality of life ( QoL ) . Secondary outcome measures included anxiety , depression , and clinical indicators . All participants were assessed at four time-points , at the beginning of the study ( T1 ) , after 12 weeks of the intervention ( T2 ) , immediately after 24-week intervention ( T3 ) , and at 48-week follow-up visit ( T4 ) . Results Improvements in QoL were evident in both groups but the test group fared better than the control group at the 12th week ( P < 0.01 ) and particularly in emotional well-being ( P < 0.01 ) and breast cancer-specific well-being ( P < 0.001 ) . The test group showed an improvement in anxiety levels ( P < 0.01 ) , whereas the control group showed improvements in depression ( P < 0.05 ) but there was no significant difference between groups ( P > 0.05 ) . Both groups showed improvements in immunological function and the test group fared better than the control in TNF-α levels ( P < 0.05 ) . The results in subjects who practice d more than 4 times and 6 h per week were similar to that of all subjects ; however , the improvement in anxiety in the GLQG group was more obvious . There are positive correlations between QoL and anxiety and depression . Conclusions Both GLQG and physical stretching are beneficial during recovery following breast cancer . GLQC was more effective in terms of Qol improvements than physical stretching . Both programs brought improvements in anxiety or depression but had were comparable . GLQC group had a greater effect on immunological function than physical exercise BACKGROUND Bojungikki-tang ( Bu-Zhong-Yi-Qi-Tang in Chinese or Hochu-ekki-to in Japanese ) is a widely used herbal prescription in traditional medicine in China , Japan , and Korea . The aim of this study was to investigate the effectiveness of Bojungikki-tang for cancer-related fatigue . METHODS A total of 40 patients with cancer-related fat 
    Output:
    
As a whole , the results showed clearly superior efficacy of CIM  in improving HRQOL .
For different domains of HRQOL , different CIM interventions may play different roles .
In conclusion , CIM may improve the HRQOL of cancer patients .