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: Objectives Chemotherapy-induced peripheral neuropathy ( CIPN ) can produce severe neurological deficits and neuropathic pain and is a potential reason for terminating or suspending chemotherapy treatments . Specific and effective curative treatments are lacking . Methods A pilot study was conducted to evaluate the therapeutic effect of acupuncture  on CIPN as measured by changes in nerve conduction studies ( NCS ) in six patients treated with acupuncture for 10 weeks in addition to best medical care and five control patients who received the best medical care but no specific treatment for CIPN .  Results In five of the six patients treated with acupuncture , NCS improved after treatment . In the control group , three of five patients did not show any difference in NCS , one patient improved and one showed impaired NCS . Conclusion The data suggest that acupuncture has a positive effect on CIPN . The encouraging results of this pilot study justify a r and omised controlled trial of acupuncture in CIPN on the basis of NCS 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 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 BACKGROUND Diabetes is the most important cause of peripheral neuropathy ( DPN ) . No definitive treatment for DPN has been established , and very few data on the role of exercise training on DPN have been reported . AIM OF THE STUDY We sought to examine the effects of long-term exercise training on the development of DPN in both Types 1 and 2 diabetic patients . PARTICIPANTS AND METHODS Seventy-eight diabetic patients without signs and symptoms of peripheral DPN were enrolled , r and omized , and subdivided in two groups : 31 diabetic participants [ 15 f , 16 m ; 49+/-15.5 years old ; body mass index ( BMI ) = 27.9+/-4.7 ] , who performed a prescribed and supervised 4 h/week brisk walking on a treadmill at 50 % to 85 % of the heart rate reserve ( exercise group : EXE ) , and a  control group of 47 diabetic participants ( CON ; 24 f , 23 m ; 52.9+/-13.4 years old ; BMI = 30.9+/-8.4 ) .  Vibration perception threshold ( VPT ) , nerve distal latency ( DL ) , nerve conduction velocity ( NCV ) , and nerve action potential amplitude ( NAPA ) in the lower limbs were measured . RESULTS We found significant differences on Delta ( delta ) in NCV for both peroneal and sural motor nerve between the EXE and CON groups during the study period ( P<.001 , for both ) . The percentage of diabetic patients that developed motor neuropathy and sensory neuropathy during the 4 years of the study was significantly higher in the CON than the EXE group ( 17 % vs. 0.0 % , P<.05 , and 29.8 % vs. 6.45 % , P<.05 , respectively ) . In addition , the percentage of diabetic patients who developed increased VPT ( 25 V ) during the study was significantly higher in the CON than the EXE group ( 21.3 % vs. 12.9 % , P<.05 ) . Change on Hallux VPT from baseline to the end of the study was significantly different between the EXE and CON groups ( P<.05 ) ; no significant change in Malleolus VPT between the two groups occurred . CONCLUSIONS This study suggests , for the first time , that long-term aerobic exercise training can prevent the onset or modify the natural history of DPN Acetyl-L-carnitine ( ALC ) improves  non-oncological neuropathies .  We tested oral ALC ( 1 g tid ) for 8 weeks in 25 patients with neuropathy grade 3 ( common toxicity criteria --CTC ) during paclitaxel or cisplatin therapy , or grade 2 persisting for at least three months after discontinuing the drugs . An independent neurologist assessed patients before and after ALC . All patients except one reported symptomatic relief , and only two described grade 1 nausea . The sensory neuropathy grade improved in 15 of 25 ( 60 % ) , and motor neuropathy in 11 of 14 patients ( 79 % ) . Total neuropathy score ( TNS ) that included neurophysiological measures improved in 23 ( 92 % ) . Amelioration of sensory amplitude and conduction velocity ( sural and peroneal nerves ) was measured in 22 and 21 patients , respectively . Symptomatic improvement persisted in 12 of 13 evaluable patients at median 13 months after ALC . In view of its effect in improving established paclitaxel- and cisplatin-neuropathy , we recommend ALC testing in preventing progression or revert symptoms during neurotoxic chemotherapy CONTEXT AND OBJECTIVE Oxaliplatin is one of the chemotherapy regimens most used for treating colorectal cancer . One of the main limitations to its use is induction of peripheral neuropathy . Previous studies have shown that vitamin E can reduce the incidence of peripheral neuropathy by 50 % . This study aim ed to assess the effectiveness of vitamin E for prevention of oxaliplatin-induced peripheral neuropathy . DESIGN AND SETTING Prospect i ve , phase II , r and omized pilot study developed at a university hospital in the Greater ABC region . METHODS Patients were r and omized five days before starting oxaliplatin treatment , to receive either vitamin E or placebo until the end of the chemotherapy regimen . The outcome was evaluated using the Common Terminology Criteria for Adverse Events ( CTCAE ) , version 3 , and specific gradation scales for oxaliplatin-induced peripheral neuropathy .  Patients with colorectal and gastric cancer who had been scheduled to receive oxaliplatin-based chemotherapy were included . Both groups received calcium and magnesium supplementation before and after oxaliplatin infusions . RESULTS Eighteen patients were r and omized to the vitamin E group and 16 to the placebo group .  Cumulative incidence of 83 % with peripheral neuropathy grade s 1/2 was observed in the vitamin E group , versus 68 % in the placebo group ( P = 0.45 ) . A trend towards more diarrhea was observed among patients who received vitamin E ( 55.6 % vs. 18.8 % ; P = 0.06 ) . There were no other significant differences in toxicity between the groups . CONCLUSIONS No significant decrease in the incidence of acute oxaliplatin-induced peripheral neuropathy was demonstrated through vitamin E use Objective . Oxaliplatin-induced peripheral neurotoxicity continues to be a kind of frequent dose-limiting toxicity for many cancer patients . This study evaluated the preventive effects of Guilongtongluofang on peripheral neurotoxicity induced by oxaliplatin in patients with colorectal tumor . Patients and Methods . From May 2007 to May 2011 , we conducted a r and omized , double-blind , placebo-controlled trial . 120 patients of colorectal cancer treated with adjuvant oxaliplatin-based chemotherapy  were r and omly enrolled into the trial group and the control group . The trial group received Guilongtongluofang ( at a dose of 200 mL once a day ) from 3 days prior to chemotherapy . The control group received a placebo from 3 days prior to chemotherapy . Every 2-week cycle , neurotoxicity was evaluated using numeric rating scale for pain intensity and experienced relief . The primary endpoint was efficacy measurement which included oxaliplatin-induced neurotoxicity and tumor response . The differences of side effects between the two groups were also analyzed . Results . The percentage of grade s 1 - 2 neurotoxicity was significantly lower in the trial group than that in the control group ( 13.3 % versus 20.0 % ; P < 0.05 ) after two cycles of treatment . The difference of the percentage of neurotoxicity between the two groups was significant after six cycles ( 51.7 % versus 70.0 % ; P < 0.05 ) . Significant difference for the mean time to the development of grade 1 + neurotoxicity was found between the two groups ( 9.4 w in the trial group versus 6.5 w in the control group , P < 0.05 ) . The cumulative incidence of grade 1 or more sensory neurotoxicity was significantly lower in the trial group than that in the control group ( P < 0.05 ) . No significant differences of tumor response rate were found between the two groups the trial group and the control group . No significant difference was found between the trial group and the control group ( all P > 0.05 ) . Conclusion . This study provides evidence that Guilongtongluofang is a promising drug for the prevention of oxaliplatin-induced neurotoxicity in patients with colorectal cancer , and it does not reduce the efficacy of oxaliplatin 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 
    Output:
    
agent
***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: Objectives Chemotherapy-induced peripheral neuropathy ( CIPN ) can produce severe neurological deficits and neuropathic pain and is a potential reason for terminating or suspending chemotherapy treatments . Specific and effective curative treatments are lacking . Methods A pilot study was conducted to evaluate the therapeutic effect of acupuncture  on CIPN as measured by changes in nerve conduction studies ( NCS ) in six patients treated with acupuncture for 10 weeks in addition to best medical care and five control patients who received the best medical care but no specific treatment for CIPN .  Results In five of the six patients treated with acupuncture , NCS improved after treatment . In the control group , three of five patients did not show any difference in NCS , one patient improved and one showed impaired NCS . Conclusion The data suggest that acupuncture has a positive effect on CIPN . The encouraging results of this pilot study justify a r and omised controlled trial of acupuncture in CIPN on the basis of NCS 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 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 BACKGROUND Diabetes is the most important cause of peripheral neuropathy ( DPN ) . No definitive treatment for DPN has been established , and very few data on the role of exercise training on DPN have been reported . AIM OF THE STUDY We sought to examine the effects of long-term exercise training on the development of DPN in both Types 1 and 2 diabetic patients . PARTICIPANTS AND METHODS Seventy-eight diabetic patients without signs and symptoms of peripheral DPN were enrolled , r and omized , and subdivided in two groups : 31 diabetic participants [ 15 f , 16 m ; 49+/-15.5 years old ; body mass index ( BMI ) = 27.9+/-4.7 ] , who performed a prescribed and supervised 4 h/week brisk walking on a treadmill at 50 % to 85 % of the heart rate reserve ( exercise group : EXE ) , and a  control group of 47 diabetic participants ( CON ; 24 f , 23 m ; 52.9+/-13.4 years old ; BMI = 30.9+/-8.4 ) .  Vibration perception threshold ( VPT ) , nerve distal latency ( DL ) , nerve conduction velocity ( NCV ) , and nerve action potential amplitude ( NAPA ) in the lower limbs were measured . RESULTS We found significant differences on Delta ( delta ) in NCV for both peroneal and sural motor nerve between the EXE and CON groups during the study period ( P<.001 , for both ) . The percentage of diabetic patients that developed motor neuropathy and sensory neuropathy during the 4 years of the study was significantly higher in the CON than the EXE group ( 17 % vs. 0.0 % , P<.05 , and 29.8 % vs. 6.45 % , P<.05 , respectively ) . In addition , the percentage of diabetic patients who developed increased VPT ( 25 V ) during the study was significantly higher in the CON than the EXE group ( 21.3 % vs. 12.9 % , P<.05 ) . Change on Hallux VPT from baseline to the end of the study was significantly different between the EXE and CON groups ( P<.05 ) ; no significant change in Malleolus VPT between the two groups occurred . CONCLUSIONS This study suggests , for the first time , that long-term aerobic exercise training can prevent the onset or modify the natural history of DPN Acetyl-L-carnitine ( ALC ) improves  non-oncological neuropathies .  We tested oral ALC ( 1 g tid ) for 8 weeks in 25 patients with neuropathy grade 3 ( common toxicity criteria --CTC ) during paclitaxel or cisplatin therapy , or grade 2 persisting for at least three months after discontinuing the drugs . An independent neurologist assessed patients before and after ALC . All patients except one reported symptomatic relief , and only two described grade 1 nausea . The sensory neuropathy grade improved in 15 of 25 ( 60 % ) , and motor neuropathy in 11 of 14 patients ( 79 % ) . Total neuropathy score ( TNS ) that included neurophysiological measures improved in 23 ( 92 % ) . Amelioration of sensory amplitude and conduction velocity ( sural and peroneal nerves ) was measured in 22 and 21 patients , respectively . Symptomatic improvement persisted in 12 of 13 evaluable patients at median 13 months after ALC . In view of its effect in improving established paclitaxel- and cisplatin-neuropathy , we recommend ALC testing in preventing progression or revert symptoms during neurotoxic chemotherapy CONTEXT AND OBJECTIVE Oxaliplatin is one of the chemotherapy regimens most used for treating colorectal cancer . One of the main limitations to its use is induction of peripheral neuropathy . Previous studies have shown that vitamin E can reduce the incidence of peripheral neuropathy by 50 % . This study aim ed to assess the effectiveness of vitamin E for prevention of oxaliplatin-induced peripheral neuropathy . DESIGN AND SETTING Prospect i ve , phase II , r and omized pilot study developed at a university hospital in the Greater ABC region . METHODS Patients were r and omized five days before starting oxaliplatin treatment , to receive either vitamin E or placebo until the end of the chemotherapy regimen . The outcome was evaluated using the Common Terminology Criteria for Adverse Events ( CTCAE ) , version 3 , and specific gradation scales for oxaliplatin-induced peripheral neuropathy .  Patients with colorectal and gastric cancer who had been scheduled to receive oxaliplatin-based chemotherapy were included . Both groups received calcium and magnesium supplementation before and after oxaliplatin infusions . RESULTS Eighteen patients were r and omized to the vitamin E group and 16 to the placebo group .  Cumulative incidence of 83 % with peripheral neuropathy grade s 1/2 was observed in the vitamin E group , versus 68 % in the placebo group ( P = 0.45 ) . A trend towards more diarrhea was observed among patients who received vitamin E ( 55.6 % vs. 18.8 % ; P = 0.06 ) . There were no other significant differences in toxicity between the groups . CONCLUSIONS No significant decrease in the incidence of acute oxaliplatin-induced peripheral neuropathy was demonstrated through vitamin E use Objective . Oxaliplatin-induced peripheral neurotoxicity continues to be a kind of frequent dose-limiting toxicity for many cancer patients . This study evaluated the preventive effects of Guilongtongluofang on peripheral neurotoxicity induced by oxaliplatin in patients with colorectal tumor . Patients and Methods . From May 2007 to May 2011 , we conducted a r and omized , double-blind , placebo-controlled trial . 120 patients of colorectal cancer treated with adjuvant oxaliplatin-based chemotherapy  were r and omly enrolled into the trial group and the control group . The trial group received Guilongtongluofang ( at a dose of 200 mL once a day ) from 3 days prior to chemotherapy . The control group received a placebo from 3 days prior to chemotherapy . Every 2-week cycle , neurotoxicity was evaluated using numeric rating scale for pain intensity and experienced relief . The primary endpoint was efficacy measurement which included oxaliplatin-induced neurotoxicity and tumor response . The differences of side effects between the two groups were also analyzed . Results . The percentage of grade s 1 - 2 neurotoxicity was significantly lower in the trial group than that in the control group ( 13.3 % versus 20.0 % ; P < 0.05 ) after two cycles of treatment . The difference of the percentage of neurotoxicity between the two groups was significant after six cycles ( 51.7 % versus 70.0 % ; P < 0.05 ) . Significant difference for the mean time to the development of grade 1 + neurotoxicity was found between the two groups ( 9.4 w in the trial group versus 6.5 w in the control group , P < 0.05 ) . The cumulative incidence of grade 1 or more sensory neurotoxicity was significantly lower in the trial group than that in the control group ( P < 0.05 ) . No significant differences of tumor response rate were found between the two groups the trial group and the control group . No significant difference was found between the trial group and the control group ( all P > 0.05 ) . Conclusion . This study provides evidence that Guilongtongluofang is a promising drug for the prevention of oxaliplatin-induced neurotoxicity in patients with colorectal cancer , and it does not reduce the efficacy of oxaliplatin 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 
    Output:
    