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: EORTC protocol 22791 compared once daily fractionation ( CF ) of 70 Gy in 35 - 40 fractions in 7 - 8 weeks , to pure hyperfractionation ( HF ) of 80.5 Gy in 70 fractions in 7 weeks using 2 fractions of 1.15 Gy per day , in T2-T3 oropharyngeal carcinoma ( excluding base of tongue ) , N0,N1 of less than 3 cm . From 1980 to 1987 , 356 patients were entered . In the final analysis ( June 1990 ) , the local control was significantly higher ( p = 0.02 log-rank ) after HF compared with CF . At 5 years , 59 % of patients are local disease-free in the HF arm compared to 40 % in the CF arm . The superiority of HF was demonstrated in patients staged T3N0,T3N1 but not in T2 . The Cox model confirmed that the treatment regimen was an independent significant prognostic factor for locoregional control ( p = 0.007 log-rank ) . This improvement of locoregional control was responsible for a trend to an improved survival ( p = 0.08 log-rank ) . There was no difference in late normal tissue damage between the two treatment modalities A r and omized trial was conducted at the Institut Gustave-Roussy ( IGR ) between 1972 and 1980 comparing tumorectomy and breast irradiation with modified radical mastectomy . One hundred and seventy-nine patients with an infiltrating breast carcinoma up to 20 mm in diameter at macroscopic examination were included : 88 had conservative management , and 91 a mastectomy .  All patients had a low-axillary dissection  with immediate histological examination . For the patients with positive axillary nodes , a complete axillary dissection was undertaken . Overall survival , distant metastasis , contralateral breast cancer and locoregional recurrence rates were not significantly different between the two treatment groups Experimental evidence suggests that the hypoxic fraction in a solid tumor may increase its malignant potential and reduce its sensitivity towards non-surgical treatment modalities ( e.g. st and ard irradiation , certain anticancer agents ) . However , the clinical importance of tumor hypoxia remains uncertain since valid methods for the routine measurement of intratumoral O2-tensions in patients have so far been lacking . A clinical ly applicable st and ardized procedure has been established which enables the determination of intratumoral oxygen tensions in advanced cervical cancers by use of a computerized polarographic needle electrode histography system . Tumor oxygenation as measured by this method represents a novel tumor feature which can be individually determined for each tumor and which is independent from other known oncological parameters . The results of an interim analysis of an open prospect i ve clinical trial to evaluate the prognostic significance of tumor oxygenation based on the survival data of the first 31 patients are presented . Fifteen patients have been treated by primary radiation , 11 patients received multimodality therapy including irradiation .  After a median follow-up of 19 months ( range 5 - 31 months ) , Kaplan-Meier-life table analysis showed significantly lower survival and recurrence-free survival for patients with a median pO2 of < or = 10 mmHg compared to those with better oxygenated tumors ( median pO2 > 10 mmHg ) . The Cox proportional hazards model revealed that the median pO2 and the clinical stage according to the FIGO are independent , highly significant predictors of survival and recurrence-free survival . We conclude from these preliminary results that tumor oxygenation as determined with this st and ardized procedure appears to be a new independent prognostic factor influencing survival in advanced cancer of the uterine cervix Factors influencing time to loco-regional recurrence were identified in a multivariate regression analysis of data from a series of 468 radically operated patients ( 260 Dukes ' B and 208 Dukes ' C ) with carcinoma of the rectum and the rectosigmoid . A number of clinical and pathological characteristics were prospect ively collected and recorded . In addition , carcinoembryonic antigen ( CEA ) was measured within 1 week before surgery . The endpoint used was recurrence below the level of the umbilicus . All patients were followed for at least 5 years or until time of death . The two Dukes ' stages B and C were analysed in two separate analyses using the Cox proportional hazards model . In patients with Dukes ' B tumours , an increased risk of loco-regional recurrence was associated with perineural invasion , tumour located less than 10 cm from the anal verge , patient aged above 70 years , and small tumour size . In patients with Dukes ' C tumours , the necessity to resect neighbour organs , perineural and venous invasion , tumour located less than 10 cm from the anal verge , and large tumour size were all associated with a poor loco-regional outcome . Postoperative radiotherapy was not a significant prognosticator for loco-regional control . An up date of the 5-year results of the r and omised study of post-operative radiotherapy ( 50 Gy with 2 Gy per fraction in an overall treatment time of 7 weeks ) showed no survival benefit from adjuvant radiotherapy in either Dukes ' category and no statistically significant improvement in the 5-year loco-regional control rate . However , when the comparison was restricted to a group of high-risk patients there was a statistically significant benefit from radiotherapy with respect to loco-regional control ( P = 0.03 ) but not with respect to survival ( P = 0.23 ) . The potential advantage , in terms of the required number of patients , of restricting clinical trials of intensified loco-regional therapies to the high-risk patients , is illustrated PURPOSE This study describes the acute response of oral and pharyngeal mucosa to chemo-IMRT schedules using different doses per fraction . MATERIAL S AND METHODS Patients , treated in prospect i ve trials of concomitant chemo-IMRT with 2.17 Gy , 2.25 Gy and 2.4 Gy per fraction and identical dose of cisplatin , were included in this study .  Acute toxicity was recorded prospect ively using the CTCAE v2.0 . We describe the incidence and prevalence of grade 3 oral mucositis and dysphagia over time and report the influence of overall treatment time ( OTT ) . The association between the lengths of pharyngeal mucosa receiving 50 Gy ( L50 ) and 60 Gy ( L60 ) and grade 3 dysphagia was tested . RESULTS The incidence and the peak prevalence of grade 3 dysphagia were significantly higher in patients receiving 2.4 Gy per fraction . The peak prevalence of grade 3 dysphagia was higher and the recovery was slower in patients with lower OTT ( median 38 days vs. 42 days ) treatment . There was a significant correlation between L50 , L60 and grade 3 dysphagia . A L50 and L60 greater than 8 cm result ed in greater than 60 % and 70 % incidence of grade 3 dysphagia , respectively . CONCLUSION The length of pharyngeal mucosa receiving doses close to the prescription dose correlates with grade 3 dysphagia . It was observed that incidence of grade 3 dysphagia was lower and recovery from it was quicker in patients with greater OTT BACKGROUND AND AIM Numerous consensus reports recommend that postmastectomy radiotherapy ( RT ) in addition to systemic therapy is indicated in high-risk patients with 4 + positive nodes , but not in patients with 1 - 3 positive nodes . A subgroup analysis of the DBCG 82 b&c trials was performed to evaluate the loco-regional recurrence rate and survival in relation to number of positive nodes . MATERIAL S AND METHODS In the DBCG 82 b&c trials 3083 pre- and postmenopausal high-risk women were r and omized to postoperative RT in addition to adjuvant systemic therapy . Since many patients had relatively few lymph nodes removed ( median 7 ) , the present analysis was limited to 1152 node positive patients with 8 or more nodes removed . RESULTS The overall 15-year survival rate in the subgroup was 39 % and 29 % ( p=0.015 ) after RT and no RT , respectively . RT reduced the 15-year loco-regional failure rate from 51 % to 10 % ( p<0.001 ) in 4 + positive node patients and from 27 % to 4 % ( p<0.001 ) in patients with 1 - 3 positive nodes . Similarly , the 15-year survival benefit after RT was significantly improved in both patients with 1 - 3 positive nodes ( 57 % vs 48 % , p=0.03 ) and in patients with 4 + positive nodes ( 21 % vs 12 % , p=0.03 ) . CONCLUSION The survival benefit after postmastectomy RT was substantial and similar in patients with 1 - 3 and 4 + positive lymph nodes . Furthermore , it was not strictly associated with the risk of loco-regional recurrence , which was most pronounced in patients with 4 + positive nodes . The indication for RT seems therefore to be at least equally beneficial in patients with 1 - 3 positive nodes , and future consensus should be modified accordingly BACKGROUND AND PURPOSE During the first decade of the 21st century a number of important European r and omized studies were published . In order to help shape clinical practice based on best scientific evidence from the literature , the International Conference on ' Multidisciplinary Rectal Cancer Treatment : Looking for an European Consensus ' ( EURECA-CC2 ) was organized in Italy under the endorsement of European Society of Medical Oncology ( ESMO ) , European Society of Surgical Oncology ( ESSO ) , and European Society of Therapeutic Radiation Oncology ( ESTRO ) . METHODS Consensus was achieved using the Delphi method . The document was available to all Committee members as a web-based document customized for the consensus process . Eight chapters were identified : epidemiology , diagnostics , pathology , surgery , radiotherapy and chemotherapy , treatment toxicity and quality of life , follow-up , and research questions . Each chapter was subdivided by a topic , and a series of statements were developed . Each member commented and voted , sentence by sentence thrice . Sentences upon which an agreement was not reached after voting round # 2 were openly debated during a Consensus Conference in Perugia ( Italy ) from 11 December to 13 December 2008 . A h and -held televoting system collected the opinions of both the Committee members and the audience after each debate . The Executive Committee scored percentage consensus based on three categories : " large consensus " , " moderate consensus " , and " minimum consensus " . RESULTS The total number of the voted sentences was 207 . Of the 207 , 86 % achieved large consensus , 13 % achieved moderate consensus , and only 3 ( 1 % ) result ed in minimum consensus . No statement was disagreed by more than 50 % of the members . All chapters were voted on by at least 75 % of the members , and the majority was voted on by > 85 % . CONCLUSIONS This Consensus Conference represents an expertise opinion process that may help shape future programs , investigational protocol s , and guidelines for staging and treatment of rectal cancer throughout Europe PURPOSE To test for association between single nucleotide polymorphisms at the TGFβ1 locus and the risk of late normal tissue injury following whole breast radiotherapy . METHODS A retrospective study compared the number of variant alleles at -509 and codons 10 and 25 of the  TGFβ1 locus in women followed up in two prospect i ve clinical trials who developed either marked radiotherapy adverse effects or no adverse effects after matching on fractionation schedule , breast size , surgical deficit , chemotherapy and length of follow up . RESULTS Median follow up in the two trials was 7.4 ( maximum 15 ) years and 5.3 ( maximum 5.3 ) years . 1237/1716 ( 72 % ) women with photographic assessment s of radiotherapy adverse effects  were alive and well , and 147/1237 ( 12 % ) potential cases with the most marked change in photographic change in breast appearance were matched to potential controls recording no change . In an unmatched analysis of 82 cases and 108 controls , no significant difference in the number of genetic variants was observed . CONCLUSIONS No association was detected between sequence variations at the TGFβ1 locus and the risk of late adverse effects of breast radiotherapy BACKGROUND AND PURPOSE The " Registry for the evaluation of side effects after radiation in childhood and adolescence " ( risk ) was introduced to characterize adverse effects of  radiotherapy  in childhood and adolescence prospect ively . The aim of this analysis was to characterize the pattern of acute side effects . MATERIAL S AND METHODS Since 2001 , patients receiving radiotherapy in one of the German pediatric therapy trials have been registered in RiSK with detailed information regarding radiation doses to organs at risk and characterization of acute toxicities . RESULTS From 2001 to May 2009 , 690 patients have been characterized for acute toxicity in primary therapy . Acute toxicity ≥ grade 1 was observed in 506 patients . In patients irradiated in their lung and liver , patients with grade 1 or 2 acute toxicities showed higher organ volumes exposed to radiation doses < 20 Gray ( Gy ) compared to patients without toxicities . For the salivary gl and s , there was a positive correlation between the acute toxicity grade and the maximum radiation dose to the organ ; the lower GI tract showed a similar trend . The impact of different chemotherapy regimens on these acute side effects remains unclear . Age did not have any 
    Output:
    
agent
Both journals are anchored in large scientific societies and serve basically the same medical , physical and biological community and at the same scientific level ; the two journals are in the most recent Impact Factor list ranked almost back to back , indicating an equal importance and contribution to science .
Radiotherapy and Oncology is more than a scientific journal , it also serves other purpose s such as facilitate education through ( educational ) review s and improving the st and ard of care by bringing forward guidelines for conduct of radiotherapy .
Finally , the journal also tries to maintain a communication platform between the science produced by the membership of ESTRO and therefore it brings papers frommembers in the different European countries , sometimes at the expense of ultimate scientific quality , but with the underst and ing that it is important that the entire ESTRO membership gets access and opportunity to publish in a high ranked journal .
***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: EORTC protocol 22791 compared once daily fractionation ( CF ) of 70 Gy in 35 - 40 fractions in 7 - 8 weeks , to pure hyperfractionation ( HF ) of 80.5 Gy in 70 fractions in 7 weeks using 2 fractions of 1.15 Gy per day , in T2-T3 oropharyngeal carcinoma ( excluding base of tongue ) , N0,N1 of less than 3 cm . From 1980 to 1987 , 356 patients were entered . In the final analysis ( June 1990 ) , the local control was significantly higher ( p = 0.02 log-rank ) after HF compared with CF . At 5 years , 59 % of patients are local disease-free in the HF arm compared to 40 % in the CF arm . The superiority of HF was demonstrated in patients staged T3N0,T3N1 but not in T2 . The Cox model confirmed that the treatment regimen was an independent significant prognostic factor for locoregional control ( p = 0.007 log-rank ) . This improvement of locoregional control was responsible for a trend to an improved survival ( p = 0.08 log-rank ) . There was no difference in late normal tissue damage between the two treatment modalities A r and omized trial was conducted at the Institut Gustave-Roussy ( IGR ) between 1972 and 1980 comparing tumorectomy and breast irradiation with modified radical mastectomy . One hundred and seventy-nine patients with an infiltrating breast carcinoma up to 20 mm in diameter at macroscopic examination were included : 88 had conservative management , and 91 a mastectomy .  All patients had a low-axillary dissection  with immediate histological examination . For the patients with positive axillary nodes , a complete axillary dissection was undertaken . Overall survival , distant metastasis , contralateral breast cancer and locoregional recurrence rates were not significantly different between the two treatment groups Experimental evidence suggests that the hypoxic fraction in a solid tumor may increase its malignant potential and reduce its sensitivity towards non-surgical treatment modalities ( e.g. st and ard irradiation , certain anticancer agents ) . However , the clinical importance of tumor hypoxia remains uncertain since valid methods for the routine measurement of intratumoral O2-tensions in patients have so far been lacking . A clinical ly applicable st and ardized procedure has been established which enables the determination of intratumoral oxygen tensions in advanced cervical cancers by use of a computerized polarographic needle electrode histography system . Tumor oxygenation as measured by this method represents a novel tumor feature which can be individually determined for each tumor and which is independent from other known oncological parameters . The results of an interim analysis of an open prospect i ve clinical trial to evaluate the prognostic significance of tumor oxygenation based on the survival data of the first 31 patients are presented . Fifteen patients have been treated by primary radiation , 11 patients received multimodality therapy including irradiation .  After a median follow-up of 19 months ( range 5 - 31 months ) , Kaplan-Meier-life table analysis showed significantly lower survival and recurrence-free survival for patients with a median pO2 of < or = 10 mmHg compared to those with better oxygenated tumors ( median pO2 > 10 mmHg ) . The Cox proportional hazards model revealed that the median pO2 and the clinical stage according to the FIGO are independent , highly significant predictors of survival and recurrence-free survival . We conclude from these preliminary results that tumor oxygenation as determined with this st and ardized procedure appears to be a new independent prognostic factor influencing survival in advanced cancer of the uterine cervix Factors influencing time to loco-regional recurrence were identified in a multivariate regression analysis of data from a series of 468 radically operated patients ( 260 Dukes ' B and 208 Dukes ' C ) with carcinoma of the rectum and the rectosigmoid . A number of clinical and pathological characteristics were prospect ively collected and recorded . In addition , carcinoembryonic antigen ( CEA ) was measured within 1 week before surgery . The endpoint used was recurrence below the level of the umbilicus . All patients were followed for at least 5 years or until time of death . The two Dukes ' stages B and C were analysed in two separate analyses using the Cox proportional hazards model . In patients with Dukes ' B tumours , an increased risk of loco-regional recurrence was associated with perineural invasion , tumour located less than 10 cm from the anal verge , patient aged above 70 years , and small tumour size . In patients with Dukes ' C tumours , the necessity to resect neighbour organs , perineural and venous invasion , tumour located less than 10 cm from the anal verge , and large tumour size were all associated with a poor loco-regional outcome . Postoperative radiotherapy was not a significant prognosticator for loco-regional control . An up date of the 5-year results of the r and omised study of post-operative radiotherapy ( 50 Gy with 2 Gy per fraction in an overall treatment time of 7 weeks ) showed no survival benefit from adjuvant radiotherapy in either Dukes ' category and no statistically significant improvement in the 5-year loco-regional control rate . However , when the comparison was restricted to a group of high-risk patients there was a statistically significant benefit from radiotherapy with respect to loco-regional control ( P = 0.03 ) but not with respect to survival ( P = 0.23 ) . The potential advantage , in terms of the required number of patients , of restricting clinical trials of intensified loco-regional therapies to the high-risk patients , is illustrated PURPOSE This study describes the acute response of oral and pharyngeal mucosa to chemo-IMRT schedules using different doses per fraction . MATERIAL S AND METHODS Patients , treated in prospect i ve trials of concomitant chemo-IMRT with 2.17 Gy , 2.25 Gy and 2.4 Gy per fraction and identical dose of cisplatin , were included in this study .  Acute toxicity was recorded prospect ively using the CTCAE v2.0 . We describe the incidence and prevalence of grade 3 oral mucositis and dysphagia over time and report the influence of overall treatment time ( OTT ) . The association between the lengths of pharyngeal mucosa receiving 50 Gy ( L50 ) and 60 Gy ( L60 ) and grade 3 dysphagia was tested . RESULTS The incidence and the peak prevalence of grade 3 dysphagia were significantly higher in patients receiving 2.4 Gy per fraction . The peak prevalence of grade 3 dysphagia was higher and the recovery was slower in patients with lower OTT ( median 38 days vs. 42 days ) treatment . There was a significant correlation between L50 , L60 and grade 3 dysphagia . A L50 and L60 greater than 8 cm result ed in greater than 60 % and 70 % incidence of grade 3 dysphagia , respectively . CONCLUSION The length of pharyngeal mucosa receiving doses close to the prescription dose correlates with grade 3 dysphagia . It was observed that incidence of grade 3 dysphagia was lower and recovery from it was quicker in patients with greater OTT BACKGROUND AND AIM Numerous consensus reports recommend that postmastectomy radiotherapy ( RT ) in addition to systemic therapy is indicated in high-risk patients with 4 + positive nodes , but not in patients with 1 - 3 positive nodes . A subgroup analysis of the DBCG 82 b&c trials was performed to evaluate the loco-regional recurrence rate and survival in relation to number of positive nodes . MATERIAL S AND METHODS In the DBCG 82 b&c trials 3083 pre- and postmenopausal high-risk women were r and omized to postoperative RT in addition to adjuvant systemic therapy . Since many patients had relatively few lymph nodes removed ( median 7 ) , the present analysis was limited to 1152 node positive patients with 8 or more nodes removed . RESULTS The overall 15-year survival rate in the subgroup was 39 % and 29 % ( p=0.015 ) after RT and no RT , respectively . RT reduced the 15-year loco-regional failure rate from 51 % to 10 % ( p<0.001 ) in 4 + positive node patients and from 27 % to 4 % ( p<0.001 ) in patients with 1 - 3 positive nodes . Similarly , the 15-year survival benefit after RT was significantly improved in both patients with 1 - 3 positive nodes ( 57 % vs 48 % , p=0.03 ) and in patients with 4 + positive nodes ( 21 % vs 12 % , p=0.03 ) . CONCLUSION The survival benefit after postmastectomy RT was substantial and similar in patients with 1 - 3 and 4 + positive lymph nodes . Furthermore , it was not strictly associated with the risk of loco-regional recurrence , which was most pronounced in patients with 4 + positive nodes . The indication for RT seems therefore to be at least equally beneficial in patients with 1 - 3 positive nodes , and future consensus should be modified accordingly BACKGROUND AND PURPOSE During the first decade of the 21st century a number of important European r and omized studies were published . In order to help shape clinical practice based on best scientific evidence from the literature , the International Conference on ' Multidisciplinary Rectal Cancer Treatment : Looking for an European Consensus ' ( EURECA-CC2 ) was organized in Italy under the endorsement of European Society of Medical Oncology ( ESMO ) , European Society of Surgical Oncology ( ESSO ) , and European Society of Therapeutic Radiation Oncology ( ESTRO ) . METHODS Consensus was achieved using the Delphi method . The document was available to all Committee members as a web-based document customized for the consensus process . Eight chapters were identified : epidemiology , diagnostics , pathology , surgery , radiotherapy and chemotherapy , treatment toxicity and quality of life , follow-up , and research questions . Each chapter was subdivided by a topic , and a series of statements were developed . Each member commented and voted , sentence by sentence thrice . Sentences upon which an agreement was not reached after voting round # 2 were openly debated during a Consensus Conference in Perugia ( Italy ) from 11 December to 13 December 2008 . A h and -held televoting system collected the opinions of both the Committee members and the audience after each debate . The Executive Committee scored percentage consensus based on three categories : " large consensus " , " moderate consensus " , and " minimum consensus " . RESULTS The total number of the voted sentences was 207 . Of the 207 , 86 % achieved large consensus , 13 % achieved moderate consensus , and only 3 ( 1 % ) result ed in minimum consensus . No statement was disagreed by more than 50 % of the members . All chapters were voted on by at least 75 % of the members , and the majority was voted on by > 85 % . CONCLUSIONS This Consensus Conference represents an expertise opinion process that may help shape future programs , investigational protocol s , and guidelines for staging and treatment of rectal cancer throughout Europe PURPOSE To test for association between single nucleotide polymorphisms at the TGFβ1 locus and the risk of late normal tissue injury following whole breast radiotherapy . METHODS A retrospective study compared the number of variant alleles at -509 and codons 10 and 25 of the  TGFβ1 locus in women followed up in two prospect i ve clinical trials who developed either marked radiotherapy adverse effects or no adverse effects after matching on fractionation schedule , breast size , surgical deficit , chemotherapy and length of follow up . RESULTS Median follow up in the two trials was 7.4 ( maximum 15 ) years and 5.3 ( maximum 5.3 ) years . 1237/1716 ( 72 % ) women with photographic assessment s of radiotherapy adverse effects  were alive and well , and 147/1237 ( 12 % ) potential cases with the most marked change in photographic change in breast appearance were matched to potential controls recording no change . In an unmatched analysis of 82 cases and 108 controls , no significant difference in the number of genetic variants was observed . CONCLUSIONS No association was detected between sequence variations at the TGFβ1 locus and the risk of late adverse effects of breast radiotherapy BACKGROUND AND PURPOSE The " Registry for the evaluation of side effects after radiation in childhood and adolescence " ( risk ) was introduced to characterize adverse effects of  radiotherapy  in childhood and adolescence prospect ively . The aim of this analysis was to characterize the pattern of acute side effects . MATERIAL S AND METHODS Since 2001 , patients receiving radiotherapy in one of the German pediatric therapy trials have been registered in RiSK with detailed information regarding radiation doses to organs at risk and characterization of acute toxicities . RESULTS From 2001 to May 2009 , 690 patients have been characterized for acute toxicity in primary therapy . Acute toxicity ≥ grade 1 was observed in 506 patients . In patients irradiated in their lung and liver , patients with grade 1 or 2 acute toxicities showed higher organ volumes exposed to radiation doses < 20 Gray ( Gy ) compared to patients without toxicities . For the salivary gl and s , there was a positive correlation between the acute toxicity grade and the maximum radiation dose to the organ ; the lower GI tract showed a similar trend . The impact of different chemotherapy regimens on these acute side effects remains unclear . Age did not have any 
    Output:
    