***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: Objective : To evaluate the effect of oral administration of selenium and zinc tablets in patients with cancer of the digestive tract during chemotherapy . Design : A case – control , r and omized study . Setting : Medical Oncology , II University of Naples , Naples , Italy . Subjects : A total of 60 patients ( median age 55 y , range 46–61 y ) with diagnosis of gut cancer were r and omized in 1999 . Patients were treated for 60 days with chemotherapy .  Interventions : Trace elements were measured by atomic absorption spectroscopy .  The nutritional status of the patients was assessed by biochemical and bio-impedance analysis ( BIA ) parameters in basal condition and after 60 days of treatment . Oral administration of selenium and zinc in oral tablet form for 50 days was Se 200 μg/day ( 50 μg/tablet ) and Zn 21 mg/day ( 7 mg/tablet ) . Results : Both in the basal condition and at 60 days all patients were malnourished . Selenium and zinc concentrations were significantly lower ( P<0.01 ) whereas copper concentration was significantly higher ( P<0.01 ) in cancer patients than in control subjects . However , 21/30 ( 70 % ) of those treated with Se and Zn did not showed a further worsening of nutritional status and experienced a significant decrease of asthenia with an increase of appetite . On the other h and , 24/30 ( 80 % ) untreated patients had a significant decline of all parameters studied after 60 days ( prealbumin , cholesterol , transferrin , P<0.05 vs 0 time ; total proteins , albumin/globulin ratio , P<0.01 vs 0 time ; fat-free mass , fat mass , Na+/K+ ratio , body mass index P<0.05 vs 0 time ; fat free mass/fat mass , total body water , extra cellular/intra cellular water , basal metabolic rate : P<0.01 vs 0 time ) . Conclusions : Data indicate that Se and Zn supplementation may improve the clinical course of general conditions in patients with gut cancer . These effects of Se and Zn require confirmation in an independent trial of appropriate design before new public health recommendations regarding Se and Zn supplementation can be made . European Journal of Clinical Nutrition ( 2001 ) 55 , A national cooperative group trial was conducted in 153 patients with chronic myelogenous leukemia ( CML ) in chronic phase treated with oral pulse busulfan  to determine if oral vitamin A can increase the time to blast crisis and enhance survival of patients . Patients diagnosed within 1 year and in the chronic phase of CML were r and omized to receive oral pulse busulfan or the alkylator plus continuous oral vitamin A. Distributions of clinical progression and overall survival were estimated using the method of Kaplan and Meier . Associations of these endpoints with treatment and other patient characteristics were analyzed using the proportional hazards regression method of Cox . Both regimes were well tolerated . Patients in the busulfan plus vitamin A arm had somewhat longer duration s of clinical progression-free survival ( median 46 months ) and overall survival ( 51 months ) compared to those in the busulfan arm ( medians 38 and 44 months ) . However , the differences were not statistically significant ( one-tailed P = 0.11 for clinical progression-free survival , 0.081 for survival ) . After adjustment for significant factors identified in an additional exploratory multivariate analysis , risk of clinical progression or death was 53 % ( P = 0.022 ) greater and risk of death 60 % ( P = 0.014 ) greater among busulfan patients . Given the relatively large though non-significant difference between treatment arms , the limited statistical power of the study , and the likelihood that oral vitamin A may not be the most effective means of delivering retinoid therapy , we conclude that further investigation of retinoids in chronic phase CML is warranted Two groups of children with acute lymphoblastic leukemia or non-Hodgkin lymphoma , treated with anthracyclines ( ANT ) , were studied : group I , consisting of 10 patients , with coenzyme Q10 ( CoQ ) therapy ;  group II , consisting of 10 patients without CoQ therapy . The ANT cumulative dose was 240 + /- 20.0 mg/m2 in group I and 252.0 + /- 20.1 mg/m2 in group II . Echocardiographic study was performed at the beginning , at the cumulative dose of 180 mg/m2 and at the end of therapy with ANT .  Percentage left ventricular fractional shortening ( % LVFS ) decreased from baseline ( 40.36 + /- 4.6 ) to end value ( 35.82 + /- 5.02 ) ( P < 0.05 ) in group I ; % LVFS decreased from baseline ( 39.89 + /- 4.37 ) to end value ( 33.43 + /- 3.46 ) ( P < 0.002 ) in group II . Interventricular septum wall thickening decreased only in group II from baseline ( 46.10 + /- 10.1 ) to end therapy ( 27.00 + /- 18.54 ) ( P < 0.01 ) . Septum wall motion abnormalities were detected only in 2 patients of group II . These data demonstrate a protective effect of CoQ on cardiac function during therapy with ANT Ratios of urinary 8‐hydroxy‐2′‐deoxyguanosine to urinary creatinine ( 8‐OHdG/creatinine ) have been considered as a good biological indicator of DNA oxidation . Urinary 8‐OHdG/creatinine levels of lung cancer patients were evaluated by enzyme‐linked immunosorbent assay using a monoclonal antibody N45.1 during radiotherapy and chemotherapy . An increase in urinary 8‐OHdG/creatinine was found in non‐small‐cell carcinoma ( non‐SCC ) patients during the course of radiotherapy .  SCC patients showed higher levels of urinary 8‐OHdG/creatinine than the controls . Furthermore , SCC patients with complete or partial response to the chemotherapy showed a significant decrease in urinary 8‐OHdG/creatinine while patients with no change or progressive disease showed an increase Oxaliplatin is effective in the treatment of metastatic colorectal cancer ( MCRC ) patients ; however , severe neurotoxicity develops frequently . To assess the efficacy of oral glutamine for preventing neuropathy induced by oxaliplatin , a pilot study was performed . A total of 86 patients with MCRC treated at Taipei Veterans General Hospital were enrolled .  Oxaliplatin ( 85 mg/m(2 ) , days 1 and 15 ) plus weekly bolus 5-fluorouracil ( 5-FU ; 500 mg/m(2 ) ) and folinic acid ( FA ; 20 mg/m(2 ) ) on days 1 , 8 , and 15 were given every 28 days as first-line treatment . Patients were r and omized to receive ( glutamine group ; n = 42 ) or not receive ( control group ; n = 44 ) glutamine ( 15 g twice a day for seven consecutive days every 2 weeks starting on the day of oxaliplatin infusion ) . Efficacy of chemotherapy , neurological toxicity , and electrophysiological alterations were assessed . A lower percentage of grade 1 - 2 peripheral neuropathy was observed in the glutamine group ( 16.7 % versus 38.6 % ) after two cycles of treatment , and a significantly lower incidence of grade 3 - 4 neuropathy was noted in the glutamine group after four cycles ( 4.8 % versus 18.2 % ) and six cycles ( 11.9 % versus 31.8 % ) . By adding glutamine , interference with activities of daily living was lower ( 16.7 % versus 40.9 % ) , and need for oxaliplatin dose reduction was lower ( 7.1 % versus 27.3 % ) . There were no significant between-group differences in response to chemotherapy ( 52.4 % versus 47.8 % ) , electrophysiological abnormalities , grade 3 - 4 non-neurological toxicities ( 26.2 % versus 22.8 % ) , or survival . These data indi-cate that oral glutamine significantly reduces the incidence and severity of peripheral neuropathy of MCRC patients receiving oxaliplatin without affecting response to chemotherapy and survival Summary A significant myeloprotective effect of melatonin in mice treated with etoposide , cyclophosphamide or carboplatin has been reported . The present study was design ed to evaluate if the same effect could be observed in patients receiving chemotherapy . Twenty previously untreated patients with inoperable lung cancer received two cycles of carboplatin ( given at area under the curve 5 by the Calvert formula ) on day 1 and etoposide ( 150 mg m–2 i.v . ) on days 1–3 every 4 weeks . Melatonin 40 mg or placebo ( double-blind ) was given orally in the evening for 21 consecutive days , starting 2 days before chemotherapy .  Patients were r and omized to receive melatonin either with the first or the second cycle . Complete blood cell count with differential was done three times per week for 3 weeks . The median age of the cohort was 60 years ( range 42–69 ) , 16 patients had non-small cell and four patients small-cell lung cancer , 12 stage III and eight stage IV disease . In a multivariate analysis including age , sex , diagnosis , stage , performance status , doses of carboplatin and etoposide , and concomitant treatment with melatonin or placebo , the haematological parameters – depth and duration of toxicity for haemoglobin , platelets and neutrophils ( ANC ) – were not significantly different between cycles with/without melatonin .  The mean ANC nadir and the mean number of days with ANC < 0.5 × 109 l–1 were 0.5 × 109 l–1 and 2.5 days , respectively , with/without melatonin . We concluded that , in patients with lung cancer , melatonin given orally at a dose of 40 mg per day for 21 days in the evening , does not protect against the myelotoxic effect of carboplatin and etoposide PURPOSE Glutathione has been shown to be an effective chemoprotector against cisplatin-induced side effects in patients with ovarian cancer . In view of this fact , we performed a r and omized clinical pilot-trial in the management of other solid tumors in order to compare application of Glutathione to intensive hydration in patients undergoing chemotherapy with a regimen including cisplatin .  PATIENTS AND METHODS Twenty patients suffering from advanced non small cell lung cancer ( n = 6 ) or head- and neck cancer ( n = 14 ) were enrolled in the study . All patients received 80 mg/m2 cisplatin along with etoposide or 5-fluorouracil every 4 weeks . Patients r and omized to application of Glutathione ( n = 11 ) received 5 g of Glutathione immediately before application of cisplatin followed by 2000 ml of normal saline . Patients in the control group ( n = 9 ) received 2000 ml electrolyte infusion before and 2000 ml of normal saline with forced diuresis after cisplatin . RESULTS The intensity of hematologic toxicity was significantly less pronounced in patients treated with Glutathione than in the control group ( hemoglobin : 10.7 vs 9.5 mg% respectively , p = 0.039 ; white blood cell count 3.3 vs 2.2 x 103/microliter respectively , p = 0.004 ; platelets 167 vs 95 x 103/microliter respectively , p = 0.02 ) , whereas in terms of non-hematologic toxicity no difference was observed . Objective remission occurred in 6 out of 11 evaluable patients from the group receiving Glutathione ( 55 % ; complete remission : 9 % ; partial remission : 46 % ) , and in 4 out of 8 evaluable patients from the control group ( partial remission : 50 % ) . However , there was no statistical difference in terms of response and overall survival ( 13.5 months vs. 10.5 months ) between the two groups . CONCLUSIONS Application of Cisplatin and Glutathione seems to be safe and feasible and the antitumoral efficacy of cisplatin is apparently not impaired by the concomitant use of Glutathione in patients with solid tumors Aim A r and omized , open label with blind assessment , controlled trial was performed to assess efficacy and adverse-event profile of vitamin E , given as supplementation for prophylaxis against cisplatin-induced peripheral neuropathy ( CIPN ) . Patients and methods A total of 30 patients scheduled to receive six courses of cumulative cisplatin-based regimens were r and omly allocated to treatment and control groups and were then studied by means of neurological examination and electrophysiological study . Patients assigned to group I ( n=14 ) orally received vitamin E at a daily dose of 600 mg/day during chemotherapy and 3 months after its cessation were compared to patients of group II ( n=16 ) , who received no vitamin E supplementation and served as controls . The severity of neurotoxicity was summarized by means of a modified Peripheral Neuropathy ( P 
    Output:
    
This review provides the first systematic ally review ed evidence that antioxidant supplementation during chemotherapy holds potential for reducing dose-limiting toxicities .