***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 A prospect i ve r and omized double-blind trial comparing the butyrophenone analogue domperidone ( D ) and the synthetic cannabinoid nabilone ( N ) in the treatment of cytotoxic-induced emesis was conducted in 38 patients receiving highly emetogenic chemotherapy regimens ( 70 % containing cisplatin ) . Patients received 20 mg D or 1 mg N the night before chemotherapy and 8-hourly on each chemotherapy day for two consecutive cycles of treatment . Three of 19 patients r and omized to N completed only one cycle because of disease progression ( 2 ) or subjectively adverse effects ( 1 ) . Four of 19 patients completed only one cycle of D because of lack of efficacy ( 3 ) or chemotherapy toxicity ( 1 ) . In all , 32 cycles of N and 33 cycles of D were evaluable for efficacy . The mean number of vomiting episodes in cycle 1 was 4.76 for N and 12.95 for D ( P<0.02 ) . The corresponding values for cycle 2 were 4.27 and 7.69 ( P>0.10 ) , and for cycles 1 and 2 combined , 4.53 for N and 10.81 for D ( P<0.01 ) . Nausea and food intake scores did not differ significantly , although there was a trend towards less nausea and an increased food intake with N. Subjectively adverse effects were more frequent with N and included drowsiness , dizziness , dry mouth , and postural hypotension . N is superior to D for the control of cytotoxic-induced emesis A prospect i ve r and omised double blind crossover trial was conducted comparing the new synthetic cannabinoid nabilone with oral domperidone in a group of children receiving repeated identical courses of emetogenic chemotherapy for a variety of malignant diseases . Eighteen of 23 consecutive eligible children , aged 10 months to 17 years , completed the trial . When taking nabilone they experienced significantly fewer vomiting episodes and less nausea , and two thirds expressed a preference for the drug . The most common side effects of treatment with nabilone were somnolence and dizziness , with one patient being disturbed by hallucinations . The results indicate that nabilone is an effective antiemetic for children having chemotherapy , even for young children . It seems to be superior in this respect to domperidone , and although it has a higher incidence of side effects , these are mostly acceptable to patients . It can be recommended as an alternative to conventional antiemetic treatment throughout childhood The antinausea and antivomiting effects of delta-9-tetrahydrocannabinol ( THC ) in children receiving cancer chemotherapy were compared with those of metoclopramide syrup and prochlorperazine tablets in two double-blind studies . THC was found to be a significantly better antinausea and antivomiting agent , but not all patients obtained relief of nausea and vomiting with THC . In some patients , THC enhanced appetite during a course of chemotherapy . In two patients , a " high " associated with  THC administrationwas reported . Drowsiness was reported significantly more frequently with THC Twenty cancer patients who received chemotherapy  were entered into a double-blind crossover design antiemetic study comparing 1 mg levonantradol , an investigational synthetic cannabinoid , to 10 mg prochlorperazine .  Sixteen patients completed the crossover . For each antiemetic course , four doses of each study medication were given intramuscularly 2 hours before chemotherapy and then 2 , 6 , and 10 hours after chemotherapy administration . There were no statistical differences in patients ' responses to levonantradol and prochlorperazine . The frequency of side effects was greater with levonantradol than with prochlorperazine . The most common side effect of levonantradol were somnolence , dry mouth , dizziness , tachycardia , postural hypotension , and blurred vision , while those for prochlorperazine were somnolence , dry mouth , and tachycardia Nabilone , a synthetic cannabinoid , and Prochlorperazine were compared in a double-blind crossover study of 34 patients with lung cancer undergoing a 3-day schedule of chemotherapy with Cyclophosphamide , Adriamycin and Etoposide .  Symptom scores were significantly better for patients on nabilone for nausea , retching and vomiting ( P less than 0.05 ) . Fewer subjects vomited with nabilone ( P = 0.05 ) and the number of vomiting episodes was lower ( P less than 0.05 ) ; no patients on nabilone required additional parenteral anti-emetic . More patients preferred nabilone for anti-emetic control ( P less than 0.005 ) . Adverse effects common with nabilone were drowsiness ( 57 % ) , postural dizziness ( 35 % ) and lightheadedness ( 18 % ) . Euphoria was seen in 14 % and a " high " in 7 % . Erect systolic blood pressure was lower in nabilone patients on Day 1 ( P = 0.05 ) but postural hypotension was a major problem in only 7 % . Nabilone is an effective oral anti-emetic drug for moderately toxic chemotherapy , but the range and unpredictability of its side-effects warrant caution in its use FACTORS INFLUENCING PREFERENCE FOR THC vs. COMPAZINE ( prochlorperazine ) as an antiemetic agent during cancer chemotherapy were studied in 139 patients who received both medications in a double-blind r and omized crossover design trial . Nausea reduction was the main determinant of preference . THC preference was associated with more , rather than fewer , drug-related side effects than Compa-zine , particularly sedation .  Patients who reported being anxious or depressed did not experience accentuation of their mood states with either regime . Mood effects , nausea reduction , incidence of side effects , and drug preference were the same in patients under and over 50 years of age . Patients with a history of illicit drug use reported fewer side effects from THC , but reported no difference in drug preference or nausea reduction compared to those patients without a history of illicit use A double blind-cross-over r and omised clinical trial has been conducted to compare the antiemetic effects of tetrahydrocannabinol , thiethylperazine and metoclopramide . There were no significant differences in the antiemetic effects of these drugs . The incidence of adverse reactions as recorded by both the staff and the patients was significantly higher in the tetrahydrocannabinol group than in either the metoclopramide or thiethylperazine groups . This trial has established that in the dosages used tetrahydrocannabinol given by mouth has an antiemetic effect of approximately the same order as thiethylperazine and metoclopramide . However , its adverse effects are sufficiently greater than those of the other agents to prevent is widespread usage for this purpose . Tetrahydrocannabinol taken by mouth is not recommended as a routine antiemetic agent in cancer chemotherapy The antiemetic effect of oral nabilone , a synthetic cannabinoid , given at a dose of 2 mg every 12 hours was compared to oral slow-release capsules of prochlorperazine given at a dose of 10 mg every 12 hours by a double-blind crossover method in 37 patients receiving cancer chemotherapy .  Patients received one of the following as the primary emetic stimulus : high-dose cis-dichlorodiammineplatinum(II ) ( DDP ) , low-dose DDP , mechlorethamine , streptozotocin , actinomycin D , or DTIC . Although results varied according to strength of emetic stimulus received , both nabilone and prochlorperazine appeared to produce antiemetic effects . Eighteen of the 37 patients achieved a complete or partial elimination of symptoms : seven with nabilone alone , three with prochlorperazine alone , and eight with each drug . Nabilone appeared to be the more effective antiemetic for patients who received chemotherapy agents other than high dose DDP ; it was equivalent to prochlorperazine for those who did receive high-dose DDP . Side effects from prochlorperazine were limited to mild drowsiness occurring among 35 % of the patients . The side effects from nabilone were drowsiness and dizziness which occurred frequently and were dose-limiting in 25 % of patients Thirty-two patients were entered into a double blind trial of antiemetic support in patients being treated with cisplatin . Patients were allocated to receive either oral nabilone ( 1 mg 8 hourly ) or intravenous metoclopramide ( 1 mg kg−1 3 hourly ) in r and om order over 4 courses . There was no difference between the two treatments in the overall incidence or severity of vomiting , although a subgroup of patients enjoyed a substantial reduction in episodes of vomiting whilst receiving metoclopramide . Side-effects were predictable from the pharmacology of the drugs Summary Twenty nonseminomatous testicular cancer patients not pretreated with emetogenic chemotherapy  were included in a crossover study of antiemetic therapy . Patients were r and omly assigned to receive either nabilone ( 2 × 2 mg/day ) or alizapride ( 3 × 150 mg/day ) prior to beginning lowdose cisplatin chemotherapy . Patients on nabilone had significantly fewer episodes of emesis than those on alizapride ( medians , 1.1 vs 2.9;p<0.01 ) . Nabilone was superior to alizapride in giving complete relief from nausea ( medians , 65 % vs 30%;p<0.01 ) , and was more effective in shortening the duration of nausea ( medians , 1.3 h vs 5.1 h;p<0.01 ) ; however , it caused more adverse effects . It is concluded that nabilone has greater antiemetic activity than alizapride in young patients receiving low-dose cisplatin chemotherapy . Nabilone dosage should be reduced to decrease the incidence and degree of adverse reactions while leaving the definite antiemetic activity unchanged Delta‐9‐tetrahydrocannabinol ( THC ) and prochlorperazine ( Compazine ) were found to be equally efficacious in reducing nausea and vomiting associated with cancer chemotherapy across a wide range of chemotherapeutic regimens and tumor types . Both drugs were administered orally one hour before chemotherapy , then every four hours for a total of four doses . Compazine was administered in a fixed dose of 10 mg ; THC was administered by body surface area ( BSA ) : BSA < 1.4 m2 = 7.5 mg ; BSA 1.4‐1.8 m2 = 10 mg ; and BSA > 1.8 m2 = 12.5 mg . Two hundred and fourteen subjects ( 75 % of whom had previously received Compazine with varying results ) were evaluated employing a double‐blind , crossover design . Additional parameters evaluated were study drug effects on appetite , food intake , mood , activity , relaxation , interaction , and concentration . There were significant drug effects with THC : less ability to concentrate ( P < 0.01 ) , less social interaction ( P < 0.05 ) , and less activity ( P < 0.05 ) . There were no significant differences between the two drugs in the level of food intake or appetite .  Patients of all ages did equally well on both drugs . Neither past marijuana use nor past Compazine use were related to study drug efficacy . Those patients who correctly identified their THC cycle did better on THC versus those who could not correctly identify which antiemetic they had received ( P < 0.05 ) . There were more drug‐related effects associated with THC , but these did not reduce the patients ' preference for the drug , and were associated with nausea reduction ( P < 0.05 ) Levonantradol is a cannabis derivative . Cannabinoid anti-emetics are being assessed in cancer chemotherapy but have been little used in radiotherapy to date . A pilot study and r and omised trial compared the anti-emetic effect of a st and ard drug ( Chlorpromazine 26 mg ) with Levonantradol at two doses ( 0.5 and 0.75 mg ) in patients receiving palliative single fraction radiotherapy to sites likely to cause nausea and vomiting . Most patients were out- patients . Both drugs were well tolerated . The frequency of vomiting was similar in all three groups in both the pilot study and r and omised trial Eighty evaluable patients receiving chemotherapy were entered on a r and om prospect i ve double-blind study to evaluate the effectiveness of nabilone , a synthetic cannabinoid , compared to prochlorperazine . Most of these patients received cisplatin , a drug that universally produces severe nausea and vomiting , as part of a combination chemotherapy regimen . The patients served as their own controls , receiving either nabilone or prochlorperazine during two consecutive treatment courses with the identical chemotherapy . Side effects consisting of hypotension and lethargy were more pronounced with nabilone .  Toxicity , in general , did not preclude antiemetic treatment and in no way interfered with chemotherapy . Sixty patients ( 75 per cent ) reported nabilone to be more effective than prochlorperazine for relief of nausea and vomiting . Of these 60 patients , 46 required further chemotherapy and continued taking nabilone as the antiemetic of choice In a previous study on the antiemetic effect of nabilone ( N ) in patients with lung cancer receiving chemotherapy ( CT ) , we found that N was only moderately effective and that its side effects limited its use , especially in elderly out patients . We , therefore , performed a new study of N in combination with dexamethasone ( DXM ) , a potent antiemetic in itself , to evaluate whether the addition of DXM to N would improve the antiemetic effect and /or reduce the side effects .  Forty patients with lung cancer were en 
    Output:
    
The superiority of the anti-emetic efficacy of cannabinoids was demonstrated through meta- analysis