human
***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 The aim of the study was to analyse the toxicity and health related quality of life ( HRQoL ) of breast cancer patients treated with FAC ( 5-fluorouracil , doxorubicin , cyclophosphamide ) and TAC ( docetaxel , doxorubicin , cyclophosphamide ) with and without primary prophylactic G-CSF ( PPG ) .  PATIENTS AND METHODS This was a phase III study to compare FAC and TAC as adjuvant treatment of high-risk node-negative breast cancer patients . After the entry of the first 237 patients , the protocol was amended to include PPG in the TAC arm due to the high incidence of febrile neutropenia . A total of 1047 evaluable patients from 49 centres in Spain , two in Pol and and four in Germany were included in the trial .  Side-effects and the scores of the EORTC QLQ-C30 and QLQ BR-23 question naires were compared in the three groups ( FAC , TAC pre-amendment and TAC post-amendment ) . RESULTS The addition of PPG to TAC significantly reduced the incidence of neutropenic fever , grade 2 - 4 anaemia , asthenia , anorexia , nail disorders , stomatitis , myalgia and dysgeusia . Patient QoL decreased during chemotherapy , more with TAC than FAC , but returned to baseline values afterwards . The addition of PPG to TAC significantly reduced the percentage of patients with clinical ly relevant Global Health Status deterioration ( 10 or more points over baseline value ) at the end of chemotherapy ( 64 % versus 46 % , P<0.03 ) . CONCLUSIONS The addition of PPG significantly reduces the incidence of neutropenic fever associated with TAC chemotherapy as well as that of some TAC-induced haematological and extrahaematological side-effects . The HRQoL of patients treated with TAC is worse than that of those treated with FAC but improves with the addition of PPG , particularly in the final part of chemotherapy treatment BACKGROUND renal cell carcinoma ( RCC ) is a potential target for anti-angiogenic drugs because of its high vascularization . Neovastat ( AE-941 ) is an inhibitor of angiogenesis with a mechanism of action that could prove beneficial in the treatment of RCC . Patients and design A phase II trial was conducted to identify the long-term safety profile of Neovastat in advanced cancer patients and to obtain preliminary information on its efficacy in solid tumors refractory to st and ard treatments . Neovastat ( 60 or 240 ml/day ) was administered orally ( b.i.d . ) to 144 patients with solid tumors refractory to st and ard therapies or for whom no st and ard treatments were available . RESULTS A survival analysis was conducted on 22 patients with a primary diagnosis of refractory RCC to determine whether the dose of Neovastat had any effect . A significant relationship between dose and survival was observed ; the median survival time was significantly longer ( 16.3 versus 7.1 months ; P = 0.01 ) in patients treated with Neovastat 240 ml/day ( n = 14 ) compared with patients receiving 60 ml/day ( n = 8) . No dose-limiting toxicity was reported . The most frequent adverse event was taste alteration ( 13.6 % ) . CONCLUSIONS Neovastat is well tolerated by advanced cancer patients at doses of 60 and 240 ml/day . The higher dose of Neovastat administered in this trial is associated with a survival benefit in RCC , which is not explained by differences in major prognostic factors AMD473 is a novel sterically hindered platinum cytotoxic with demonstrated ability to overcome acquired resistance to cisplatin in vitro and in human tumour xenografts . A single-agent dose escalating Phase I study was performed . AMD473 was initially administered intravenously as a 1 h infusion every 21 days to patients with advanced solid tumours . In total , 42 patients received a total of 147 cycles ( median 3 , range 1–8 ) of treatment at doses of 12 , 24 , 48 , 96 , 110 , 120 , 130 , and 150 mg m−2 . Dosing intervals of 21 and 28 days were explored at the recommended dose . Neutropenia and thrombocytopenia proved dose limiting . Other toxicities included moderate nausea , vomiting , anorexia , and a transient metallic taste . There was no significant alopecia . The maximum tolerated dose was 150 mg m−2 . Plasma pharmacokinetics were linear . Two patients with heavily pretreated ovarian cancer  showed partial response . Five patients ( mesothelioma , ovary , nonsmall cell lung , and melanoma )  showed prolonged stable disease  . AMD473 demonstrates encouraging activity in patients , including those with prior platinum exposure . Toxicity is predictable with linear pharmacokinetics , as was predicted by pre clinical studies . A dose of 120 mg m−2 every 21 days is recommended for Phase II evaluation although there is evidence that chemo-naive patients and those of good performance status may tolerate a higher dose In the treatment of dysgeusia , the use of zinc has been frequently tried , with equivocal results . The aim of the present r and omized clinical trial , which involved a sufficiently large sample , was therefore to determine the efficacy of zinc treatment . Fifty patients with idiopathic dysgeusia were carefully selected .  Zinc gluconate ( 140 mg/day ; n = 26 ) or placebo ( lactose ; n = 24 ) was r and omly assigned to the patients . The patients on zinc improved in terms of gustatory function ( p < 0.001 ) and rated the dysgeusia as being less severe ( p < 0.05 ) . Similarly , signs of depression in the zinc group were less severe ( Beck Depression Inventory , p < 0.05 ; mood scale , p < 0.05 ) . With the exception of the salivary calcium level , which was higher in the zinc patients ( p < 0.05 ) , no other significant group differences were found . In conclusion , zinc appears to improve general gustatory function and , consequently , general mood scores in dysgeusia patients PURPOSE This prospect i ve , longitudinal study was aim ed to describe the prevalence , severity , and pattern of symptoms over the course of radiation therapy in persons with nasopharyngeal carcinoma and to explore symptom severity by treatment modality . DESCRIPTION OF STUDY Thirty-seven patients completed this study , and 46 % received chemotherapy before radiation therapy .  A self-reported radiation symptom checklist and an objective mucositis assessment tool were used weekly to document oropharyngeal , skin , nose or ear , or more general side effects , and mucositis . RESULTS Oropharyngeal problems were the most severe complaints during radiation therapy . All patients experienced dry mouth , taste change , difficulty in swallowing , difficulty in opening their mouths , hoarseness , sore throat , and observable mucositis . Most reported moderate-to-severe dry mouth , difficulty in swallowing , and sore throat from weeks 3 through 7 . Skin problems were not prominent until week 4 . Patients also lost an average of 3.9 kg during the therapy . Sequential chemotherapy and radiation therapy was associated with more severe oropharyngeal problems than radiation therapy alone , but no significant differences in other problems were found . CLINICAL IMPLICATION S Despite recognition of the oropharyngeal side effects associated with irradiation , effective management protocol s for such symptoms have not been implemented in the studied institution . The frequency and intensity of the symptoms reported indicate an urgent need for increased vigilance about radiation-related side effects and pain management . As well , patient education about expected side effects may help mitigate the anxiety that patients experience when these symptoms occur INTRODUCTION Stage II nasopharyngeal carcinoma ( NPC ) treated with conventionally fractionated radiotherapy results in loco-regional control of around 80 % . This report aims to document the outcome of Stage II NPC patients treated with external beam radiotherapy delivered using an accelerated concomitant boost ( C-Boost ) schedule . METHODS AND MATERIAL S Twenty-five 1997 AJCC Stage II NPC patients were enrolled and analyzed in this preliminary report . The primary tumor and clinical ly involved nodes received a total dose of 72 Gy in 42 fractions . C-Boost for gross disease consisted of 18 Gy in 12 fractions commencing on day 19 and was delivered at least 6 hours after the first dose . Patients were assessed for response , survival , and toxicity . RESULTS With a median follow-up of 24 months , only one patient had pathologically confirmed local recurrence , necessitating IMRT . Two developed distant metastases for which they received chemotherapy . One died from systemic disease after refusing treatment for persistent neck lymphadenopathy . Two-year loco-regional control rates , overall survival and disease-free survival rates were 96 % , 96 % , and 88 % , respectively . All patients experienced some degree of acute and /or late toxicity . However , the toxicity profile was comparable to that seen following st and ard fractionation . Acute or late toxicities directly attributable to C-Boost were not observed . CONCLUSION This C-Boost radiotherapy regimen administers a substantially higher biologically effective dose compared with conventional radiation schedules . Preliminary locoregional control and survival rates are promising with no significant acute and /or late toxicities PURPOSE Smell and taste changes during chemotherapy are significant complaints of cancer patients . Loss of olfactory/gustatory function can lead to malnutrition , weight loss , and possibly a prolonged morbidity of chemotherapy-induced adverse effects , decreased quality of life , poor compliance , and even decreased therapy response . This prospect i ve study comprehensively investigated , to our knowledge for the first time , smell and taste changes in a cohort of 87 patients undergoing chemotherapy for breast cancer or gynecologic malignancies . PATIENTS AND METHODS Olfactory function was tested using Sniffin ' Sticks ( Burghart ; Wedel , Germany ) and gustatory function was tested using taste strips before , during , and immediately and 3 months after chemotherapy . RESULTS Olfactory and gustatory function significantly decreased during chemotherapy and recovered almost completely 3 months after chemotherapy .  Scores of odor thresholds were affected more than those of discrimination or identification . The olfactory function of older patients was affected more than that of younger patients . There was no difference in the olfactory function during chemotherapy with respect to the chemotherapeutic agent or initial diagnosis ( breast or ovarian cancer ) . Regarding taste , scores of salty taste were affected more than scores of sweet , sour , or bitter taste . The gustatory function did not differ significantly during chemotherapy with respect to age or diagnosis but did differ with respect to the chemotherapeutic agent . Taxane-based chemotherapy caused the most severe disorders . CONCLUSION Chemotherapy has a significant but transient effect on olfactory and gustatory function , possibly causing reduced appetite , a low energy intake , and weight loss . Additional spices and flavoring may compensate for this diminished chemosensory function , enhancing patient compliance and quality of life BACKGROUND We aim ed to determine the effect of dietary counseling or oral supplements on outcome for patients with cancer , specifically , nutritional outcome , morbidity , and quality of life ( QOL )  , during and 3 months after radiotherapy . METHODS Seventy-five patients with head and neck cancer who were referred for radiotherapy ( RT ) were r and omized to the following groups : group 1 ( n = 25 ) , patients who received dietary counseling with regular foods ; group 2 ( n = 25 ) , patients who maintained usual diet plus supplements ; and group 3 ( n = 25 ) , patients who maintained intake ad lib .  Nutritional intake ( determined by diet history ) and status ( determined by Ottery 's Subjective Global Assessment ) , and QOL ( determined by the European Organization for the Research and Treatment of Cancer Quality of Life Question naire version 3.0 [ EORTC QLQ-C30 ] ) were evaluated at baseline , at the end of RT , and at 3 months . RESULTS Energy intake after RT increased in both groups 1 and 2 ( p < or = .05 ) . Protein intake also increased in both groups 1 and 2 ( p < or = .006 ) . Both energy and protein intake decreased significantly in group 3 ( p < .01 ) . At 3 months , group 1 maintained intakes , whereas groups 2 and 3 returned to or below baseline levels . After RT , > 90 % of patients experienced RT toxicity ; this was not significantly different between groups , with a trend for reduced symptomatology in group 1 versus group 2/group 3 ( p < .07 ) . At 3 months , the reduction of incidence/severity of grade 1 + 2 anorexia , nausea/vomiting , xerostomia , and dysgeusia was different : 90 % of the patients improved in group 1 versus 67 % in group 2 versus 51 % in group 3 ( p < .0001 ) . After RT , QOL function scores improved ( p < .003 ) proportionally with improved nutritional intake and status in group 1/group 2 ( p < .05 ) and worsened in group 3 ( p < .05 ) ; at 3 months , patients in group 1 maintained or improved overall QOL , whereas patients in groups 2 and 3 maintained or w 
    Output:
    
agent
Attempts to prevent dysgeusia through the prophylactic use of zinc sulfate or amifostine have been of limited benefit .
Nutritional counseling may be helpful to some patients in minimizing the symptoms of dysgeusia .
Conclusions Dysgeusia is a common oral side effect of cancer therapy ( radiotherapy , chemotherapy , or combined modality therapy ) and often impacts negatively on quality of life .
From the current literature , there does not appear to be a predictable way of preventing or treating dysgeusia
***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 The aim of the study was to analyse the toxicity and health related quality of life ( HRQoL ) of breast cancer patients treated with FAC ( 5-fluorouracil , doxorubicin , cyclophosphamide ) and TAC ( docetaxel , doxorubicin , cyclophosphamide ) with and without primary prophylactic G-CSF ( PPG ) .  PATIENTS AND METHODS This was a phase III study to compare FAC and TAC as adjuvant treatment of high-risk node-negative breast cancer patients . After the entry of the first 237 patients , the protocol was amended to include PPG in the TAC arm due to the high incidence of febrile neutropenia . A total of 1047 evaluable patients from 49 centres in Spain , two in Pol and and four in Germany were included in the trial .  Side-effects and the scores of the EORTC QLQ-C30 and QLQ BR-23 question naires were compared in the three groups ( FAC , TAC pre-amendment and TAC post-amendment ) . RESULTS The addition of PPG to TAC significantly reduced the incidence of neutropenic fever , grade 2 - 4 anaemia , asthenia , anorexia , nail disorders , stomatitis , myalgia and dysgeusia . Patient QoL decreased during chemotherapy , more with TAC than FAC , but returned to baseline values afterwards . The addition of PPG to TAC significantly reduced the percentage of patients with clinical ly relevant Global Health Status deterioration ( 10 or more points over baseline value ) at the end of chemotherapy ( 64 % versus 46 % , P<0.03 ) . CONCLUSIONS The addition of PPG significantly reduces the incidence of neutropenic fever associated with TAC chemotherapy as well as that of some TAC-induced haematological and extrahaematological side-effects . The HRQoL of patients treated with TAC is worse than that of those treated with FAC but improves with the addition of PPG , particularly in the final part of chemotherapy treatment BACKGROUND renal cell carcinoma ( RCC ) is a potential target for anti-angiogenic drugs because of its high vascularization . Neovastat ( AE-941 ) is an inhibitor of angiogenesis with a mechanism of action that could prove beneficial in the treatment of RCC . Patients and design A phase II trial was conducted to identify the long-term safety profile of Neovastat in advanced cancer patients and to obtain preliminary information on its efficacy in solid tumors refractory to st and ard treatments . Neovastat ( 60 or 240 ml/day ) was administered orally ( b.i.d . ) to 144 patients with solid tumors refractory to st and ard therapies or for whom no st and ard treatments were available . RESULTS A survival analysis was conducted on 22 patients with a primary diagnosis of refractory RCC to determine whether the dose of Neovastat had any effect . A significant relationship between dose and survival was observed ; the median survival time was significantly longer ( 16.3 versus 7.1 months ; P = 0.01 ) in patients treated with Neovastat 240 ml/day ( n = 14 ) compared with patients receiving 60 ml/day ( n = 8) . No dose-limiting toxicity was reported . The most frequent adverse event was taste alteration ( 13.6 % ) . CONCLUSIONS Neovastat is well tolerated by advanced cancer patients at doses of 60 and 240 ml/day . The higher dose of Neovastat administered in this trial is associated with a survival benefit in RCC , which is not explained by differences in major prognostic factors AMD473 is a novel sterically hindered platinum cytotoxic with demonstrated ability to overcome acquired resistance to cisplatin in vitro and in human tumour xenografts . A single-agent dose escalating Phase I study was performed . AMD473 was initially administered intravenously as a 1 h infusion every 21 days to patients with advanced solid tumours . In total , 42 patients received a total of 147 cycles ( median 3 , range 1–8 ) of treatment at doses of 12 , 24 , 48 , 96 , 110 , 120 , 130 , and 150 mg m−2 . Dosing intervals of 21 and 28 days were explored at the recommended dose . Neutropenia and thrombocytopenia proved dose limiting . Other toxicities included moderate nausea , vomiting , anorexia , and a transient metallic taste . There was no significant alopecia . The maximum tolerated dose was 150 mg m−2 . Plasma pharmacokinetics were linear . Two patients with heavily pretreated ovarian cancer  showed partial response . Five patients ( mesothelioma , ovary , nonsmall cell lung , and melanoma )  showed prolonged stable disease  . AMD473 demonstrates encouraging activity in patients , including those with prior platinum exposure . Toxicity is predictable with linear pharmacokinetics , as was predicted by pre clinical studies . A dose of 120 mg m−2 every 21 days is recommended for Phase II evaluation although there is evidence that chemo-naive patients and those of good performance status may tolerate a higher dose In the treatment of dysgeusia , the use of zinc has been frequently tried , with equivocal results . The aim of the present r and omized clinical trial , which involved a sufficiently large sample , was therefore to determine the efficacy of zinc treatment . Fifty patients with idiopathic dysgeusia were carefully selected .  Zinc gluconate ( 140 mg/day ; n = 26 ) or placebo ( lactose ; n = 24 ) was r and omly assigned to the patients . The patients on zinc improved in terms of gustatory function ( p < 0.001 ) and rated the dysgeusia as being less severe ( p < 0.05 ) . Similarly , signs of depression in the zinc group were less severe ( Beck Depression Inventory , p < 0.05 ; mood scale , p < 0.05 ) . With the exception of the salivary calcium level , which was higher in the zinc patients ( p < 0.05 ) , no other significant group differences were found . In conclusion , zinc appears to improve general gustatory function and , consequently , general mood scores in dysgeusia patients PURPOSE This prospect i ve , longitudinal study was aim ed to describe the prevalence , severity , and pattern of symptoms over the course of radiation therapy in persons with nasopharyngeal carcinoma and to explore symptom severity by treatment modality . DESCRIPTION OF STUDY Thirty-seven patients completed this study , and 46 % received chemotherapy before radiation therapy .  A self-reported radiation symptom checklist and an objective mucositis assessment tool were used weekly to document oropharyngeal , skin , nose or ear , or more general side effects , and mucositis . RESULTS Oropharyngeal problems were the most severe complaints during radiation therapy . All patients experienced dry mouth , taste change , difficulty in swallowing , difficulty in opening their mouths , hoarseness , sore throat , and observable mucositis . Most reported moderate-to-severe dry mouth , difficulty in swallowing , and sore throat from weeks 3 through 7 . Skin problems were not prominent until week 4 . Patients also lost an average of 3.9 kg during the therapy . Sequential chemotherapy and radiation therapy was associated with more severe oropharyngeal problems than radiation therapy alone , but no significant differences in other problems were found . CLINICAL IMPLICATION S Despite recognition of the oropharyngeal side effects associated with irradiation , effective management protocol s for such symptoms have not been implemented in the studied institution . The frequency and intensity of the symptoms reported indicate an urgent need for increased vigilance about radiation-related side effects and pain management . As well , patient education about expected side effects may help mitigate the anxiety that patients experience when these symptoms occur INTRODUCTION Stage II nasopharyngeal carcinoma ( NPC ) treated with conventionally fractionated radiotherapy results in loco-regional control of around 80 % . This report aims to document the outcome of Stage II NPC patients treated with external beam radiotherapy delivered using an accelerated concomitant boost ( C-Boost ) schedule . METHODS AND MATERIAL S Twenty-five 1997 AJCC Stage II NPC patients were enrolled and analyzed in this preliminary report . The primary tumor and clinical ly involved nodes received a total dose of 72 Gy in 42 fractions . C-Boost for gross disease consisted of 18 Gy in 12 fractions commencing on day 19 and was delivered at least 6 hours after the first dose . Patients were assessed for response , survival , and toxicity . RESULTS With a median follow-up of 24 months , only one patient had pathologically confirmed local recurrence , necessitating IMRT . Two developed distant metastases for which they received chemotherapy . One died from systemic disease after refusing treatment for persistent neck lymphadenopathy . Two-year loco-regional control rates , overall survival and disease-free survival rates were 96 % , 96 % , and 88 % , respectively . All patients experienced some degree of acute and /or late toxicity . However , the toxicity profile was comparable to that seen following st and ard fractionation . Acute or late toxicities directly attributable to C-Boost were not observed . CONCLUSION This C-Boost radiotherapy regimen administers a substantially higher biologically effective dose compared with conventional radiation schedules . Preliminary locoregional control and survival rates are promising with no significant acute and /or late toxicities PURPOSE Smell and taste changes during chemotherapy are significant complaints of cancer patients . Loss of olfactory/gustatory function can lead to malnutrition , weight loss , and possibly a prolonged morbidity of chemotherapy-induced adverse effects , decreased quality of life , poor compliance , and even decreased therapy response . This prospect i ve study comprehensively investigated , to our knowledge for the first time , smell and taste changes in a cohort of 87 patients undergoing chemotherapy for breast cancer or gynecologic malignancies . PATIENTS AND METHODS Olfactory function was tested using Sniffin ' Sticks ( Burghart ; Wedel , Germany ) and gustatory function was tested using taste strips before , during , and immediately and 3 months after chemotherapy . RESULTS Olfactory and gustatory function significantly decreased during chemotherapy and recovered almost completely 3 months after chemotherapy .  Scores of odor thresholds were affected more than those of discrimination or identification . The olfactory function of older patients was affected more than that of younger patients . There was no difference in the olfactory function during chemotherapy with respect to the chemotherapeutic agent or initial diagnosis ( breast or ovarian cancer ) . Regarding taste , scores of salty taste were affected more than scores of sweet , sour , or bitter taste . The gustatory function did not differ significantly during chemotherapy with respect to age or diagnosis but did differ with respect to the chemotherapeutic agent . Taxane-based chemotherapy caused the most severe disorders . CONCLUSION Chemotherapy has a significant but transient effect on olfactory and gustatory function , possibly causing reduced appetite , a low energy intake , and weight loss . Additional spices and flavoring may compensate for this diminished chemosensory function , enhancing patient compliance and quality of life BACKGROUND We aim ed to determine the effect of dietary counseling or oral supplements on outcome for patients with cancer , specifically , nutritional outcome , morbidity , and quality of life ( QOL )  , during and 3 months after radiotherapy . METHODS Seventy-five patients with head and neck cancer who were referred for radiotherapy ( RT ) were r and omized to the following groups : group 1 ( n = 25 ) , patients who received dietary counseling with regular foods ; group 2 ( n = 25 ) , patients who maintained usual diet plus supplements ; and group 3 ( n = 25 ) , patients who maintained intake ad lib .  Nutritional intake ( determined by diet history ) and status ( determined by Ottery 's Subjective Global Assessment ) , and QOL ( determined by the European Organization for the Research and Treatment of Cancer Quality of Life Question naire version 3.0 [ EORTC QLQ-C30 ] ) were evaluated at baseline , at the end of RT , and at 3 months . RESULTS Energy intake after RT increased in both groups 1 and 2 ( p < or = .05 ) . Protein intake also increased in both groups 1 and 2 ( p < or = .006 ) . Both energy and protein intake decreased significantly in group 3 ( p < .01 ) . At 3 months , group 1 maintained intakes , whereas groups 2 and 3 returned to or below baseline levels . After RT , > 90 % of patients experienced RT toxicity ; this was not significantly different between groups , with a trend for reduced symptomatology in group 1 versus group 2/group 3 ( p < .07 ) . At 3 months , the reduction of incidence/severity of grade 1 + 2 anorexia , nausea/vomiting , xerostomia , and dysgeusia was different : 90 % of the patients improved in group 1 versus 67 % in group 2 versus 51 % in group 3 ( p < .0001 ) . After RT , QOL function scores improved ( p < .003 ) proportionally with improved nutritional intake and status in group 1/group 2 ( p < .05 ) and worsened in group 3 ( p < .05 ) ; at 3 months , patients in group 1 maintained or improved overall QOL , whereas patients in groups 2 and 3 maintained or w 
    Output:
    