***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 
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    Input: BACKGROUND Accelerated partial breast irradiation ( APBI ) represents a valid option for selected early breast cancer ( BC ) . We recently published the 5-year results of the APBI-IMRT-Florence phase 3 r and omised trial ( NCT02104895 ) , showing a very low rate of disease failure , with acute and early-late toxicity in favour of APBI . We present the early and 2-year follow-up health-related quality of life ( HRQoL ) results . METHODS Eligible patients were women aged more than 40 years with early BC suitable for breast-conserving surgery .  APBI consisted of 30 Gy in five fractions delivered with IMRT technique . St and ard whole breast irradiation ( WBI ) consisted of 50 Gy in 25 fractions plus a 10 Gy in five fractions boost on tumour bed . A total of 520 patients were enrolled in the phase 3 trial . Overall , 205 patients ( 105 APBI and 100 WBI )  fully completed all the given question naires and were therefore included in the present analysis . As HRQoL assessment , patients were asked to complete the European Organisation for Research and Treatment of Cancer QLQ-C30 , and the BR23 question naires at the beginning ( T0 ) , at the end ( T1 ) and after 2 years from radiation ( T2 ) . FINDINGS No significant difference between the two arms at QLQ-C30 and BR23 scores emerged at T0 . Global health status ( p = 0.0001 ) , and most scores of the functional and symptom scales of QLQ-C30 at T1 showed significant differences in favour of the APBI arm . Concerning the BR23 functional and symptom scales , the body image perception , future perspective and breast and arm symptoms were significantly better in the  APBI  group . Similar significant results emerged at T2 : significant differences in favour of APBI  emerged for GHS ( p = 0.0001 ) , and most functional and symptom QLQ-C30 scales . According to QLQ-BR23 module , among the functional scales , the body image perception and the future perspective were significantly better in the APBI group ( p = 0.0001 ) , whereas among the symptom scales significant difference emerged by breast and arm symptoms with better outcomes in APBI arm ( p < 0.01 ) . INTERPRETATION Early BC treated with APBI showed an improved short-term , and 2-year follow-up HRQoL outcome as compared with WBI . Early BC treated with APBI showed an improved short-term , and 2-year follow-up HRQoL outcome as compared with WBI . APBI should be strongly considered in the treatment choice for selected low-risk patients . Mature local control results from ongoing adequately powered r and omised trials are awaited BACKGROUND Temozolomide chemotherapy versus radiotherapy in patients with a high-risk low- grade glioma has been shown to have no significant effect on progression-free survival . If these treatments have a different effect on health-related quality of life ( HRQOL ) , it might affect the choice of therapy . We postulated that temozolomide compromises HRQOL and global cognitive functioning to a lesser extent than does radiotherapy . METHODS We did a prospect i ve , phase 3 , r and omised controlled trial at 78 medical centres and large hospitals in 19 countries . We enrolled adult patients ( aged ≥18 years ) with histologically confirmed diffuse ( WHO grade II ) astrocytoma , oligodendroglioma , or mixed oligoastrocytoma , with a WHO performance status of 2 or lower , without previous chemotherapy or radiotherapy , who needed active treatment other than surgery . We r and omly assigned eligible patients ( 1:1 ) using a minimisation technique , stratified by WHO performance status ( 0 - 1 vs 2 ) , age ( < 40 years vs ≥40 years ) , presence of contrast enhancement on MRI , chromosome 1p status ( deleted vs non-deleted vs indeterminate ) , and the treating medical centre , to receive either radiotherapy ( 50·4 Gy in 28 fractions of 1·8 Gy for 5 days per week up to 6·5 weeks ) or temozolomide chemotherapy ( 75 mg/m2 daily , for 21 of 28 days [ one cycle ] for 12 cycles ) . The primary endpoint was progression-free survival ( results published separately ) ; here , we report the results for two key secondary endpoints : HRQOL ( assessed using the European Organisation for Research and Treatment of Cancer 's [ EORTC ] QLQ-C30 [ version 3 ] and the EORTC Brain Cancer Module [ QLQ-BN20 ] ) and global cognitive functioning ( assessed using the Mini-Mental State Examination [ MMSE ] ) . We did analyses on the intention-to-treat population . This study is closed and is registered at EudraCT , number 2004 - 002714 - 11 , and at Clinical Trials.gov , number NCT00182819 . FINDINGS Between Dec 6 , 2005 , and Dec 21 , 2012 , we r and omly assigned 477 eligible patients  to either radiotherapy ( n=240 ) or temozolomide chemotherapy ( n=237 ) . The difference in HRQOL between the two treatment groups was not significant during the 36 months ' follow-up ( mean between group difference [ averaged over all timepoints ] 0·06 , 95 % CI -4·64 to 4·75 , p=0·98 ) . At baseline , 32 ( 13 % ) of 239 patients who received radiotherapy and 32 ( 14 % ) of 236 patients who received temozolomide chemotherapy  had impaired cognitive function , according to the MMSE scores . After r and omisation , five ( 8 % ) of 63 patients who received radiotherapy and three ( 6 % ) of 54 patients who received temozolomide chemotherapy and who could be followed up for 36 months had impaired cognitive function , according to the MMSE scores . No significant difference was recorded between the groups for the change in MMSE scores during the 36 months of follow-up . INTERPRETATION The effect of temozolomide chemotherapy or radiotherapy  on HRQOL or global cognitive functioning did not differ in patients with low- grade glioma . These results do not support the choice of temozolomide alone over radiotherapy alone in patients with high-risk low- grade glioma . FUNDING Merck Sharp & Dohme-Merck & Co , National Cancer Institute , Swiss Cancer League , National Institute for Health Research , Cancer Research UK , Canadian Cancer Society Research Institute , National Health and Medical Research Council , European Organisation for Research and Treatment of Cancer Cancer Research Fund CONTEXT Intensity-modulated radiation therapy ( IMRT ) , three-dimensional conformal radiation therapy ( 3DCRT ) , and proton-beam therapy ( PBT ) are chemoradiotherapy modalities for treating locally advanced non-small-cell lung cancer . Although therapy is carefully planned to maximize treatment benefit while minimizing risk for adverse side effects , most patients develop radiation-induced symptom burden . OBJECTIVES To demonstrate the MD And erson Symptom Inventory 's ability to detect fine differences in symptom development among these modalities . METHODS This was a longitudinal observational study . Patients with unresectable primary or recurrent non-small-cell lung cancer ( n = 82 ) underwent 3DCRT , IMRT , or PBT .  Patients rated MD And erson Symptom Inventory symptoms weekly for up to 12 weeks . We used mixed-effect modeling to estimate development of symptoms and functional interference . RESULTS The PBT group received a significantly higher radiation target dose than did the IMRT and 3DCRT groups ( P < 0.001 ) . Fatigue was the most severe symptom over time for all groups . Controlling for patient and clinical factors ( age , sex , race , cancer stage , performance status , body mass index , previous cancer therapy , total radiation dose ) , we found that pain , as a major esophagitis-related symptom , increased more during therapy ( P = 0.019 ) and decreased more after ( P = 0.013 ) therapy in the 3DCRT and IMRT groups than in the PBT group . Compared with the PBT group , the 3DCRT and IMRT groups reported greater decrease in systemic symptoms ( fatigue , drowsiness , lack of appetite , disturbed sleep ) after therapy ( P = 0.016 ) . CONCLUSION Patients receiving PBT reported significantly less severe symptoms than did patients receiving IMRT or 3DCRT . These results should be confirmed in a r and omized study with comparable tumor burden among therapies AIMS Although clinical experience with proton beam radiotherapy ( PBT ) for most tumours is limited , there is relatively longst and ing experience for uveal melanomas . Because of potential to reduce ocular toxicities , PBT is an attractive option for these tumours . However , summative data remain scarce . We systematic ally review ed clinical outcomes of uveal melanoma patients treated with PBT  , to comprehensively assess outcomes such as tumour control , survival , enucleation rates , toxicity and visual acuity preservation . MATERIAL S AND METHODS A systematic search of PubMed , EMBASE , abstract s from meetings of the American Societies for Radiation Oncology and Clinical Oncology , and the Particle Therapy Co-Operative Group was conducted from 2000 to 2015 . Fourteen original investigations from 10 different institutions were analysed . RESULTS Most tumours were choroidal and medium-/large-sized , and received 50 - 70 Cobalt Gray equivalent dose ; more recent data reported lower doses . Five year local control rates exceed 90 % , which persisted at 10 and 15 years . Five-year overall survival rates ranged from 70 to 85 % , 5 year metastasis-free survival and disease-specific survival rates from 75 to 90 % , with more recent series reporting higher values . With the removal of smaller studies , 5 year enucleation rates were consistently between 7 and 10 % . Many patients ( 60 - 70 % ) showed a post-PBT visual acuity decrease , but still retained purpose ful vision ( > 20/200 ) ; more recent , higher-volume series reported superior numbers . Complication rates were quite variable but showed improvements on historical plaque brachytherapy data . Only one r and omised trial directly compared particle therapy ( helium ) with plaque brachytherapy , showing the former to be superior ; this is addressed separately . CONCLUSIONS PBT is an excellent modality to treat uveal melanomas , with high survival outcomes and visual acuity preservation . Although there are low toxicity and enucleation rates , the recent development of supportive therapies for radiation toxicities can further decrease clinical adverse effects PURPOSE To assess clinical outcomes in children with rhabdomyosarcoma ( RMS ) treated with pencil beam scanning ( PBS ) proton therapy ( PT ) . METHODS AND MATERIAL S Eighty-three RMS ( embryonal , n=74 ; 89 % ) patients treated between January 2000 and December 2014 were included . The median age was 4.5years ( range , 0.8 - 15.5 ) . All patients received systemic chemotherapy according to prospect i ve protocol s. Patients had low- , intermediate- , and high-risk disease in 24 % , 63 % , and 13 % of cases , respectively . The median total dose delivered was 54Gy(RBE ) ( range , 41.4 - 64.8 ) . RESULTS After a median follow-up time of 55.5 months ( range , 0.9 - 126.3 ) , local failure occurred in 16 patients . The 5-year local-control survival rate was 78.5 % [ 95 % confidence interval ( CI ) , 69.5 - 88.5 % ] . Significant predictors for local failure were group/stage , tumour location , and size . Fourteen patients ( 16 % ) died , all from tumour progression . The 5-year overall survival was 80.6 % ( 95%CI , 71.8 - 90.0 % ) . The 5-year incidence of grade 3 non-ocular late toxicity was 3.6 % ( 95%CI , 1 - 12 % ) . No grade 4 - 5 late toxicities were observed . One radiation-induced malignancy was observed ( 1.2 % ) . The Quality of Life ( QoL ) scores increased significantly after PT compared to baseline values . CONCLUSIONS PBS PT led to excellent outcome in children with RMS . Late non-ocular toxicity was minimal and QoL good PURPOSE Relative radiation dose exposure to vital organs in the thorax could influence clinical outcomes in esophageal cancer ( EC ) . We assessed whether the type of radiation therapy ( RT ) modality used was associated with postoperative outcomes after neoadjuvant chemoradiation ( nCRT ) . PATIENTS AND METHODS Contemporary data from 580 EC patients treated with nCRT at 3 academic institutions from 2007 to 2013 were review ed .  3D conformal RT ( 3D ) , intensity modulated RT ( IMRT ) and proton beam therapy ( PBT ) were used for 214 ( 37 % ) , 255 ( 44 % ) , and 111 ( 19 % ) patients , respectively . Postoperative outcomes included pulmonary , GI , cardiac , wound healing complications , length of in-hospital stay ( LOS ) , 
    Output:
    
QOL did not deteriorate during PBT for skull base and after PBT for brain tumors , respectively .
PROs were higher for PBT than photon-based radiotherapy for both head/neck and lung cancer .
Patient-reported breast cosmesis was appropriate after PBT and comparable to photon modalities .
Conclusions Based on limited data , PBT provides favorable QOL/PRO profiles for select brain , head/neck , lung , and pediatric cancers ; measures for prostate and breast cancers were more modest .