***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: TNF-α ( Tumor necrosis factor-alpha ) is involved in many immunological and inflammatory processes , and might be expected to play an important role in the development of BMT-related complications . Triple therapy ( pentoxifylline , ciprofloxacin and prednisone ) with known anti-TNF activity was tested in 37 patients undergoing a hematopoietic progenitor transplant ( HPT ) . A control group of 16 patients with similar characteristics was selected among consecutive patients receiving a HTP in a neighboring center who did not receive anti-TNF prophylaxis . Major transplant-related complications were registered ( VOD , acute GVHD , infectious episodes , renal failure and mucositis ) and survival status . TNF plasma concentrations were determined by ELISA , and pentoxifylline plasma concentrations were determined by HPLC . Among patients treated with pentoxifylline ( PTX ) , ciprofloxacin and steroids , no difference in the mean survival time was observed compared with the control group . The incidence of procedure-related death up to day + 35 was 11 % in the study group and 6 % in the control group . In spite of a tendency to a lower incidence of mucositis there was a higher incidence of infections ( positive blood cultures ) in the study group ( 49 % ) than in the control group ( 16.7 % ) ( P = 0.16 ) . This difference achieved statistical significance in patients receiving an allogeneic HPT ( P = 0.05 ) . It is likely that the use of steroids in the early period after transplant increases infectious episodes and makes control of GVHD difficult . The combined administration of steroids with pentoxifylline and ciprofloxacin has not proved beneficial in preventing mucositis , renal failure , VOD or GVHD , or in improving patient survival Mucosal toxicity is dose limiting for etoposide . This may be related to the direct effects of etoposide on the mucosa . Twelve patients receiving etoposide 1800 mg/m2 as part of a myeloablative pre-transplant regimen were r and omized to receive propantheline 30 mg or placebo orally every 6 h for six doses . Mucositis was less frequent ( 2 of 6 vs 5 of 6 ) and less severe ( p = 0.05 ) in the propantheline arm . There were no differences in tumor response or survival between the two groups . Propantheline is an anticholinergic that causes xerostomia by decreasing salivation . Propantheline may reduce the salivary excretion of etoposide and could reduce its toxic effects on the mucosa . Propantheline is effective in reducing the incidence and severity of mucositis in patients receiving high-dose etoposide We studied the effects of pilocarpine hydrochloride , a para-sympathomimetic agent , on major salivary gl and output and subjective responses in 31 patients with salivary hypofunction .  Pilocarpine hydrochloride ( 5-mg capsules , three times daily ) was given for 5 months and a placebo was r and omly assigned for 1 month in a double-blind fashion . Objective measurements of major salivary gl and output , subjective impressions of oral moisture , treatment-related side effects , and a number of physiologic measures were assessed monthly . Pilocarpine significantly increased salivary output in 21 of the 31 patients . Subjective improvement in the feeling of oral dryness , speaking , chewing , and swallowing were reported by 27 individuals . Side effects , while common , generally were mild and tolerable . There were no significant alterations in cardiovascular or other physiologic measures . We conclude that pilocarpine is an effective and safe treatment for salivary gl and hypofunction and xerostomia in selected patients . The increase in major gl and output provides beneficial natural secretions and relief of oral dryness Summary : Pilocarpine hydrochloride has been reported to increase salivation and decrease oral mucositis in patients receiving head and neck radiotherapy , but there is only one report of its use in a cancer chemotherapy patient population . This prospect i ve , double-blinded , r and omized , placebo-controlled trial was undertaken to determine the efficacy of pilocarpine for the moderation of oral mucositis during autologous blood stem cell transplantation . Subjects were r and omized to receive a 5 mg tablet of pilocarpine , or a placebo , during and following chemotherapy . Subjects were seen every other day and evaluated for gingival , oral , and oropharyngeal mucositis ; nutrition ; oral hygiene ; eating ; speaking ; sleeping ; pain at rest and /or with swallowing ; and mouth dryness . We recorded the mean and highest scores and duration of problems , along with white blood cell counts and differentials , and the use of systemic narcotics for oral mucosal pain .  We enrolled and r and omized 36 subjects , and there were no statistically or clinical ly significant differences for the primary outcome of severity of mucositis and no clinical ly significant differences in any of the other outcome measures . Pilocarpine has no benefit for the moderation of the incidence , severity , or duration of mucositis in patients receiving autologous blood stem cell transplantation 5-Fluorouracil ( 5FU ) is the most effective drug in gastrointestinal cancer . Mucositis and bone marrow toxicity are the two major limiting side effects . In our effort to reduce mucositis we administered Allopurinol mouthwash in 42 patients who had experienced oral mucositis during prior treatment with 5FU .  In all patients significant reduction of oral toxicity was noticed as well as prolonged pain relief An unblinded , historical controlled study of 49 bone marrow transplant ( BMT ) patients was carried out in our institution to assess the effect of oral pentoxifylline ( PTX ) on BMT regimen related toxicity ( RRT ) .  Twenty-eight consecutively treated BMT patients ( 17 allogeneic , 11 autologous ) were entered into the PTX treatment group and treated with oral PTX 400 mg at intervals of 4 h from day -10 until day + 35 or discharge , whichever came sooner . These were compared with a control group of 21 BMT patients ( 14 allogeneic , 7 autologous ) . Patient groups were very similar with respect to age , sex , conditioning regimen , graft-versus-host disease ( GVHD ) prophylaxis and baseline liver and renal function .  Compliance with the drug was 85 % . Despite this , no significant difference in days of mucositis or hyperalimentation , incidence or severity of renal or hepatic dysfunction , hypertension , GVHD , weight gain > 5 % , day 100 mortality or length of hospitalization was observed . Median follow-up is > 2 years in both groups and no difference in relapse or survival was observed . We were unable to confirm an effect of oral PTX on BMT related morbidity or mortality Oral mucositis is a dose-limiting toxicity of high-dose  etoposide  regimens . Since etoposide is excreted in saliva , we tested the hypothesis that the induction of xerostomia would reduce the severity of the mucositis . We design ed a phase II trial of propantheline in patients receiving high-dose ICE ( ifosfamide 20 mg/m2 , carboplatin 1.8 g/m2 , etoposide 3 g/m2 in divided doses over 6 days ) chemotherapy plus autologous hematopoietic stem cell support .  We treated 31 consecutive patients and grade d the oral mucositis according to WHO criteria . Mild ( WHO grade 0 , I , II ) mucositis occurred in 28 of 31 ( 90 % ) ( 95 % CI 74–98 % ) patients ; severe ( WHO grade III , IV ) mucositis occurred in three of 31 patients ( 10 % ) ( 95 % CI 2–25 % ) patients . In contrast , a published reference group treated with the same doses and schedule of ICE reported mild mucositis in 10 of 46 ( 22 % ) ( 95 % CI 11–36 % ) patients and severe mucositis in 36 of 46 ( 78 % ) ( 95 % CI 64–89 % ) . Propantheline therapy had no protective effect on esophagitis and enteritis associated with high-dose ICE . Minor toxicities were constipation and asymptomatic tachycardia ; major toxicities were palpitations in one patient and urinary retention in one patient . We conclude that anticholinergic therapy dramatically reduced the oral mucositis associated with high-dose etoposide and should be considered as a supportive care measure for patients receiving etoposide-containing regimens The aim of this study was to determine the impact of bethanechol administration concomitant to radiotherapy ( RT ) on oral mucositis , c and idiasis and taste loss . We performed a secondary analysis of a previously conducted prospect i ve r and omized trial which evaluated the effect of bethanechol on salivary gl and dysfunction before , during , and after RT for head and neck cancer ( HNC ) , in comparison to artificial saliva . Mucositis , c and idiasis and taste loss were analyzed in 36 patients .  Mucositis was scored using the World Health Organization ( WHO ) method ; c and idiasis was diagnosed by means of clinical examination , whereas taste loss was assessed by the patients ' subjective report of absence of taste . No significant differences were observed between groups in relation to frequency and severity of mucositis or frequency of c and idiasis and taste loss . In conclusion , bethanechol does not appear to reduce the incidence of mucositis , c and idiasis , and taste loss when administered during RT This study aim ed to investigate the effect of oral pilocarpine ( OP ) in reducing the incidence of  chemotherapy-induced oral mucositis . 32 adult cancer patients completed a total of 82 courses of chemotherapy  in which either OP or placebo was given prophylactically in a double-blind cross-over design to prevent mucositis . Mucositis was documented in 20 out of 41 courses in which patients were given placebo , whereas mucositis was documented in only six out of 41 courses when patients were given OP ( P<0.005 ) . OP treatment was found to significantly reduce the mucositis score when assessed by the method of Donnelly and colleagues ( Donnelly JP , Muus P , Schattenberg A , De Witte T , Horrevorts A , De Pauw BE . Bone Marrow Transplant 1992 , 9 , 409 - 413 ) . Using this score , all patients scored a total of 52 when they were given the placebo versus eleven when they were treated with OP ( P<0.001 ) . A similar reduction in mucositis score was noticed using the World Health Organization ( WHO ) mucositis score ; the total patient score was 25 for the placebo-treated group versus 6 for the OP group ( P<0.001 ) . We therefore conclude that oral pilocarpine is highly effective in the prevention of oral mucositis when given prophylactically to adult patients receiving a variety of cancer chemotherapy regimens Oral mucositis is a frequent side effect of cancer therapy . No effective method of prophylaxis is currently available . We conducted a r and omized , double-blind , placebo-controlled , crossover trial of pentoxifylline to evaluate its potential in preventing mucositis in cancer patients receiving chemotherapy . Ten cancer patients were r and omized for treatment with a 15-day course of 400 mg of pentoxifylline  given orally four times daily . Concurrent chemotherapy consisted of bolus cisplatin and infusional 5-fluorouracil .  Mucositis was evaluated with the use of the Oral Assessment Guide developed at the University of Nebraska . Patients completing two cycles of chemotherapy -- one with pentoxifylline and one with placebo -- were evaluated for prophylaxis efficacy . Comparison of the oral assessment scores of the two cycles with a two-sided Student 's t test failed to demonstrate a cytoprotective effect for pentoxifylline over placebo . We conclude that pentoxifylline as given in this study is ineffective for preventing mucositis in patients receiving cisplatin and 5-FU To prepare and evaluate an allopurinol mouth rinse for prophylaxis of fluorouracil-induced mucositis , 33 patients with malignant disorders , who were going to receive 5-fluorouracil containing chemotherapy , were enrolled in a placebo-controlled double-blinded r and omized clinical trial . Allopurinol mouthwash ( 1 mg/ml ) or placebo was administered 1 , 2 and 3 h after chemotherapy and three consecutive nights . A question naire consisting of demographic parameters , medical status , quality of life survey and mucosal injury scoring table ( based on World Health Organization scales for mucositis ) was completed for each patient at Day 1 , 3 and 7 after chemotherapy . In allopurinol group nine participants ( 60.0 % ) were female and in placebo group , 10 ( 66.7 % ) ( P = 0.705 ) . Mean ages were 56.9 + /- 10.3 and 49.5 + /- 13.8 years in allopurinol and placebo groups respectively ( P = 0.107 ) . The analysis showed that the higher education level and the use of dentures significantly reduced the occurrence of mucositis , and allopurinol mouth rinse ( 1 mg/ml ) was ineffective in the prophylaxis of fluorouracil-indu 
    Output:
    
Conclusions None of the agents review ed was determined to be effective for the prevention or treatment of OM .