***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: Background Stereotactic Body Radiotherapy ( SBRT ) has excellent control rates for low- and intermediate-risk prostate carcinoma . The role of SBRT for high-risk disease remains less studied . We present long-term results on a cohort of patients with NCCN-defined high-risk disease treated with SBRT .  Methods We retrospectively studied 97 patients treated as part of prospect i ve trial from 2006–2010 with SBRT alone ( n = 52 ) to dose of 35–36.25 Gy in 5 fractions , or pelvic radiation to 45 Gy followed by SBRT boost of 19–21 Gy in 3 fractions ( n = 45 ) . 46 patients received And rogen Deprivation Therapy .  Quality of life and bladder/bowel toxicity was assessed using the Exp and ed Prostate Index Composite ( EPIC ) and RTOG toxicity scale . Results Median followup was 60 months . 6-year biochemical disease-free survival ( bDFS ) was 69 % . On multivariate analysis , only PSA remained significant ( P < 0.01 ) for bDFS . Overall toxicity was mild , with 5 % Grade 2–3 urinary and 7 % Grade 2 bowel toxicity . Use of pelvic radiotherapy was associated with significantly higher bowel toxicity ( P = .001 ) . EPIC scores declined for the first six months and then returned towards baseline . Conclusions SBRT appears to be a safe and effective treatment for high-risk prostate carcinoma . Our data suggests that SBRT alone may be the optimal approach . Further followup and additional studies is required to corroborate our results Background The grading of recommendation , assessment , development and evaluation ( GRADE ) approach is widely implemented in health technology assessment and guideline development organisations throughout the world . GRADE provides a transparent approach to reaching judgements about the quality of evidence on the effects of a health care intervention , but is complex and therefore challenging to apply in a consistent manner . Methods We developed a checklist to guide the research er to extract the data required to make a GRADE assessment . We applied the checklist to 29 meta-analyses of r and omised controlled trials on the effectiveness of health care interventions . Two review ers used the checklist for each paper and used these data to rate the quality of evidence for a particular outcome . Results For most ( 70 % ) checklist items , there was good agreement between review ers . The main problems were for items relating to indirectness where considerable judgement is required . Conclusions There was consistent agreement between review ers on most items in the checklist . The use of this checklist may be an aid to improving the consistency and reproducibility of GRADE assessment s , particularly for inexperienced users or in rapid review s without the re sources to conduct assessment s by two research ers independently 
    Output:
    
In our analysis of all included participants , SRS plus WBRT did not show a survival benefit over WBRT alone .
However , performance status and local control were significantly better in the SRS plus WBRT group .
Furthermore , significantly longer OS was reported in the combined treatment group for recursive partitioning analysis ( RPA ) Class I patients as well as patients with single metastasis .