***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 Peripheral sensory neurotoxicity is a frequent and potentially debilitating side effect of oxaliplatin treatment . Calcium and magnesium ( Ca/Mg ) infusions are frequently used to prevent this toxicity . However , concerns about a negative impact of Ca/Mg infusions on outcome have been raised . We retrospectively assessed the effect of Ca/Mg infusions on the incidence of neurotoxicity and on clinical outcome in advanced colorectal cancer ( ACC ) patients treated in the phase III CAIRO2 study . MATERIAL S AND METHODS Seven hundred and fifty five previously untreated ACC patients were r and omised between treatment with  capecitabine , oxaliplatin and bevacizumab or the same combination with the addition of cetuximab . Patients were retrospectively divided into two groups : patients in the Ca/Mg(+ ) group received Ca/Mg at least during their first treatment cycle , and patients in the Ca/Mg(- ) group did not . RESULTS Seven hundred and thirty two patients were evaluable for this analysis . The Ca/Mg(+ ) group consisted of 551 patients , the Ca/Mg(- ) group consisted of 181 patients . The incidence of all grade neurotoxicity in the Ca/Mg(+ ) group and the Ca/Mg(- ) group was 85 % and 92 % , respectively ( p = 0.02 ) , and the incidence of grade ≥ 2 neurotoxicity was 40 % and 45 % , respectively ( p = 0.22 ) . The median PFS in the Ca/Mg(+ ) versus Ca/Mg(- ) group was 10.1 versus 10.7 months ( p = 0.92 ) , the median OS was 19.8 versus 20.7 months ( p = 0.10 ) , and the response rate was 43.1 % versus 50 % ( p = 0.11 ) , respectively . CONCLUSIONS In this largest retrospective analysis to date we observed that Ca/Mg infusions significantly reduced all grade oxaliplatin-related neurotoxicity . Ca/Mg infusions did not affect the clinical efficacy of treatment Meta-analytic investigations sometimes use assessment s of research quality according to a formal protocol as a tool for improving research synthesis . We asked whether a particular  quality scoring system could have a direct use in adjusting the summary estimates of a treatment difference . In an empirical study of the relation of quality scores to treatment differences in published meta-analyses of 7 groups of controlled r and omized clinical trials comprising 107 primary studies , we found no relation between treatment difference and overall quality score . We also found no relation between quality score and variation in treatment difference . The level of quality scores has increased at a rate of 9 % per decade for three decades , averaging 0.51 on a scale of 0 to 1 for the 1980s , and leaving much room for improvement . Nevertheless , attention to quality of studies by editors , review ers , and authors may be raising both the level of research done and quality of the reports BACKGROUND Oxaliplatin , a platinum compound , has been commonly used around the world for treating advanced colorectal cancer . The generally recommended dose and schedule of oxaliplatin monotherapy is 130 mg/m(2 ) every 3 weeks . This trial was conducted to evaluate the safety and pharmacokinetics of oxaliplatin monotherapy in Japanese patients with solid tumors . METHODS Oxaliplatin was administered as a 2-h intravenous infusion every 3 weeks at a dose of 90 and 130 mg/m(2 ) . Blood was collected to determine the total platinum and the ultrafiltrate platinum concentrations in plasma in all cycles . RESULTS Nine patients were enrolled ; three were given oxaliplatin monotherapy at 90 mg/m(2 ) and six received 130 mg/m(2 ) . All tumors were colorectal cancer . The major adverse reactions included myelosuppressive , neurological and gastrointestinal toxicities , although most were grade s 1 and 2 at both dose levels . Peripheral sensory neuropathy of without movement disturbance ( grade 1 or 2 ) was observed in all patients at both dose levels . The 130 mg/m(2 ) dose level was not found to be the maximum tolerated dose , but was judged to be the recommended dose . No objective responses were seen and five cases of no change were observed . A bi-exponential open model best described the disappearance of platinum in the plasma , and a tri-exponential open model best described the disappearance of ultrafilterable platinum in the plasma at both dose levels . No racial difference was suggested in the pharmacokinetics of oxaliplatin . CONCLUSIONS The oxaliplatin monotherapy dose schedule of 130 mg/m(2 ) every 3 weeks , recommended worldwide , is acceptable for Japanese patients Aim : Oxaliplatin‐related neurotoxicity is frequently dose‐limiting . Following retrospective studies suggesting neuroprotective effects of calcium and magnesium ( Ca and Mg ) , we conducted a prospect i ve study using nerve conduction studies ( NCS ) to evaluate the effectiveness of such infusions in oxaliplatin‐related neuropathy Background Whether the administration of calcium ( Ca ) and magnesium ( Mg ) can reduce oxaliplatin-related neurotoxicity remains controversial . In addition , little is known about the effects of Ca/Mg on the blood level of platinum or objective tumor progression . Patients and methods Patients receiving modified FOLFOX6 for metastatic colorectal cancer were double-blinded and r and omized to receive additional treatment with Ca/Mg or placebo before and after the administration of oxaliplatin . The plasma and ultrafiltrable concentrations of platinum during the first and fifth cycles of treatment were determined using inductively coupled plasma spectrometry . Results Patients were r and omized to receive Ca/Mg ( Ca/Mg group , n = 17 ) or placebo ( placebo group , n = 16 ) before and after the administration of oxaliplatin ( 85 mg/m2 ) . The incidence of neurotoxicity after six cycles was not significantly different between the two groups . Blood concentrations of platinum at each time and the area under the curve were also not significantly different between the two groups . Furthermore , the response rate ( RR ) and disease control rate ( DCR ) did not differ significantly between the two groups ( Ca/Mg group : RR 36 % , DCR 73 % . Placebo group : RR 40 % , DCR 70 % , P > 0.99 ) . The median progression-free survival time was 9.2 months in the Ca/Mg group and 8.1 months in the control group ; these survival times were not significantly different ( P = 0.56 ) . Conclusion These data are insufficient to conclude with any certainty that the administration of Ca/Mg is not neuroprotective ; however , the administration of Ca/Mg may not have any influence on antitumor activity and the blood concentration profile of platinum in patients receiving oxaliplatin-based chemotherapy BACKGROUND The st and ard adjuvant treatment of colon cancer is fluorouracil plus leucovorin ( FL ) . Oxaliplatin improves the efficacy of this combination in patients with metastatic colorectal cancer . We evaluated the efficacy of treatment with FL plus oxaliplatin in the postoperative adjuvant setting . METHODS We r and omly assigned 2246 patients who had undergone curative resection for stage II or III colon cancer to receive FL alone or with oxaliplatin for six months . The primary end point was disease-free survival . RESULTS A total of 1123 patients were r and omly assigned to each group . After a median follow-up of 37.9 months , 237 patients in the group given FL plus oxaliplatin had had a cancer-related event , as compared with 293 patients in the FL group ( 21.1 percent vs. 26.1 percent ; hazard ratio for recurrence , 0.77 ; P=0.002 ) . The rate of disease-free survival at three years was 78.2 percent ( 95 percent confidence interval , 75.6 to 80.7 ) in the group given FL plus oxaliplatin and 72.9 percent ( 95 percent confidence interval , 70.2 to 75.7 ) in the FL group ( P=0.002 by the stratified log-rank test ) . In the group given FL plus oxaliplatin , the incidence of febrile neutropenia was 1.8 percent , the incidence of gastrointestinal adverse effects was low , and the incidence of grade 3 sensory neuropathy was 12.4 percent during treatment , decreasing to 1.1 percent at one year of follow-up . Six patients in each group died during treatment ( death rate , 0.5 percent ) . CONCLUSIONS Adding oxaliplatin to a regimen of fluorouracil and leucovorin improves the adjuvant treatment of colon cancer OBJECTIVE To assess the efficacy of calcium-magnesium ( Ca/Mg ) infusion and glutathione ( GSH ) for preventing the neurotoxicity induced by oxaliplatin . METHODS This is a r and omized , double blind , placebo controlled clinical trail . The patients receiving FOLFOX4 chemotherapy for their solid tumor were r and omized to receive Ca/Mg , GSH or normal saline with chemotherapy simultaneously . The incidence and severity of oxaliplatin-induced neurotoxicity were observed . The ECOG performance status was recorded and compared among the 3 groups . RESULTS Ninety-three patients admitted in our department from Mar 2006 to Dec 2007 were entered into this study , including 29 patients in the Ca/Mg group , 33 in the GSH group and 31 in the chemotherapy alone group . The incidences of acute neurotoxicity were 82.8 % , 90.9 % and 93.5 % , respectively . At the third cycle , the incidences of grade 1 - 2 chronic neurotoxicity were 37.9 % , 48.5 % and 42.0 % , respectively . No grade 3 neuropathy was observed . After 6 cycles , the incidence of grade 1 - 2 neuropathy was increased to 68.2 % , 88.9 % and 85.2 % , respectively . A lower percentage was observed in Ca/Mg arm without a statistically significant difference , and grade 3 neuropathy occurred in 5 patients . After 9 cycles , the incidence of grade 1 - 2 neuropathy was increased to 81.3 % , 90.0 % and 92.9 % , respectively . Grade 3 neuropathy occurred in another 2 patients . No statistically significant difference was observed among the 3 arms . Changes of patient 's ECOG score after chemotherapy were similar . CONCLUSION This study did n't provide evidence that Ca/Mg infusion and GSH can prevent the oxaliplatin-induced neurotoxicity Oxaliplatin , a platinum-based chemotherapeutic agent , is effective in the treatment of solid tumors , particularly colorectal cancer . During and immediately following oxaliplatin infusion , patients may experience cold-induced paresthesias , throat and jaw tightness , and occasionally focal weakness . We assessed nerve conduction studies and findings on needle electromyography of patients with metastatic colorectal cancer before and during treatment with oxaliplatin . Twenty-two patients had follow-up studies within 48 h following oxaliplatin infusions , and 14 patients had follow-up studies after 3 - 9 treatment cycles . Repetitive compound muscle action potentials and neuromyotonic discharges were observed in the first 24 - 48 h following oxaliplatin infusion , but resolved by 3 weeks . After 8 - 9 treatment cycles , sensory nerve action potential amplitudes declined , without conduction velocity changes or neuromyotonic discharges . The acute neurological symptoms reflect a state of peripheral nerve hyperexcitability that likely represents a transient oxaliplatin-induced channelopathy . Chronic treatment causes an axonal neuropathy similar to other platinum-based chemotherapeutic agents PURPOSE Cumulative sensory neurotoxicity ( sNT ) is the dose-limiting toxicity of oxaliplatin , which commonly leads to early discontinuation of oxaliplatin-based therapy in the palliative and adjuvant setting s. In a nonr and omized , retrospective study , intravenous ( IV ) calcium/magnesium ( Ca/Mg ) was associated with reduced oxaliplatin-induced sNT . METHODS Patients with colon cancer undergoing adjuvant therapy with infusional fluorouracil , leucovorin , and oxaliplatin ( FOLFOX )  were r and omly assigned to Ca/Mg ( 1 g calcium gluconate plus 1 g magnesium sulfate pre- and post-oxaliplatin ) or placebo , in a double-blinded manner . The primary end point was the percentage of patients with grade 2 or greater sNT at any time during or after oxaliplatin-based therapy by National Cancer Institute Common Terminology Criteria for Adverse Events ( NCI CTCAE ; version 3 ) criteria . An oxaliplatin-specific sNT scale and patient question naires were also used to assess sNT . After 104 of 300 planned patients were enrolled , the study was closed . This was due to preliminary reports from another trial that suggested that Ca/Mg decreased treatment efficacy ; these data were subsequently found to be incorrect . RESULTS Overall , 102 patients were available for analysis . Ca/Mg decreased the incidence of chronic , cumulative , grade 2 or greater sNT , as measured by NCI CTCAE ( P = .038 ) and also by the oxaliplatin-specific sNT scale ( P = .018 ) 
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On the other h and , our results support the hypothesis that administrations of Ca/Mg do not impair the efficacy of oxaliplatin-based chemotherapy .