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: Fifty-five patients with high- grade advanced gastric cancer in whom the presence of stage IV was confirmed by preoperative diagnostic imaging were treated with PMUE therapy by a combined use of cisplatin ( CDDP ) 75 mg/m2 , mitomycin C ( MMC ) 10 mg/body , etoposide 150 mg/body , and UFT ( a combination of 1-(2-tetrahydrofuryl)-5-fluorouracil and uracil in a molar ratio of 1∶4 ) 400 mg/day . CDDP and MMC was administered intravenously on the first day , followed by etoposide 50 mg/day on the 3rd , 4th , and 5th days . All the patients had measurable lesions that were evaluated by computed tomography scanning before and after the treatments . These patients were allocated r and omly to two groups . Of these cases , 29 belonged to the neoadjuvant chemotherapy ( NAC ) group to whom PMUE therapy was given preoperatively ; the remaining 26 patients underwent operation first and received PMUE thereafter ( control group ) . Background factors did not differ significantly between the two groups . The response rate was higher in the NAC group than in the control group ( 62 % in the former versus 35 % in the latter ) . The resectability rates were 79 % and 88 % in the NAC and control groups , respectively . However , the rate of potentially curable cases was higher in the NAC group than in the control group ( 38 % in the former versus 15 % in the latter ) . Among the nonresection cases , the prognosis was highly unfavorable in both groups . In the resection cases , however , the survival rate was significantly better in the NAC group than in the control group . These results may indicate that in patients with high- grade , advanced gastric cancer initial chemotherapy ( neoadjuvant chemotherapy ) and then surgery should be considered . RésuméCinquante-cinq cas de cancer gastrique avancé , à potentiel très malin ( stade IV à l'imagerie préopératoire ) , ont été traités par une chimiothérapie PMUE comprenant une combinaison de CDDP , 75 mg/m2 , MMC , 10 mg/Kg poids corporel , d'etopocide , 150 mg/Kg poids corporel et d'UFT , 400 mg/jour . Le CDDP et le MMC ont été donnés par voie intraveineuse à Jl , suivis d'etoposide , 50 mg/jour aux jours 3 , 4 et 5 . Tous les patients avaient des lésions qui ont pu être évaluées par la tomodensitométrie avant et après le traitement . Ces patients ont été r and omisés en deux groupes : 29 ont eu une chimiothérapie néoadjuvante ( CNA ) par le PMUE en préopératoire , alors que les 26 autres ont d'abord été opérés , et ensuite ont reçu une chimiothérapie PMUE ( groupe contrôle ) . Les caractéristiques des deux groupes ne différaient pas de façon significative . Le taux de réponse était plus haut dans le groupe CNA par rapport au groupe contrôle ( 62 % contre 35 % ) . Le taux de résecabilité était respectivement , de 79 et 88 % dans les deux groupes . Le taux de cas potentiellement curables , cependant , était plus élevé dans le groupe CNA par rapport au groupe contrôle ( 38 % contre 15 % ) . Dans les cas de cancer gastrique non réséqués , le pronostic était extrêmement mauvais , quel que soit le groupe . Dans les cancers réséqués , la survie était significativement plus élevée dans le groupe CNA comparé au groupe contrôle . Ces résultats indiquent que chez les patients ayant un cancer gastrique avancé à potentiel très malin , une chimiothérapie néoadjuvante ( d'emblée ) , suivie de chirurgie , peut être le meilleur choix thérapeutique . ResumenCincuenta y cinco casos de cáncer gástrico avanzado , en los cuales se había confirmado el Estado IV mediante imágenes diagnósticas preoperatorias , recibieron quimioterapia PMVE con el uso combinado de cisplatino ( CDDP ) 75 mg/m2 , MMC 10 mg/cuerpo , Ectoposide 150 mg/cuerpo y VHF 400 mg/día . El CDDP y el MMC fueron administrados por vía intravenosa en el primer día , seguidos de Ectoposide 50 mg/día en los días 3 , 4 y 5 . Todos los pacientes exhibían lesiones medibles , las cuales fueron valoradas por escanografía computadorizada antes y después del tratamiento . Los pacientes fueron ubicados al azar en dos grupos ; 29 quedaron en el grupo de la quimioterapia neoadyuvante ( QNA ) en el cual la quimioterapia PMVE fue practicada preoperatoriamente , y los 26 pacientes restantes fueron sometidos primero a operación y luego a quimioterapia PMVE , constituyendose en el grupo de control . Los antecedentes médicos no eran significativamente diferentes en los dos grupos . La respuesta fue mayor en el grupo de QNA en comparación con el grupo control ( 62 % vs 35 % ) . La tasa de resecabilidad fue de 79 % y 88 % en el grupo QNA y en el grupo de control , respectivamente . Sin embargo , la rata de casos potencialmente curables fue más alta en el grupo de QNA , en comparación con el grupo control ( 38 % vs 15 % ) . En los casos no resecados , sin embargo , la tasa de sobrevida fue significativamente superior en el grupo de QNA en comparación con el grupo control . Tales resulados pueden significar que en pacientes con cáncer gástrico de alto grado y en estado avanzado se debe considerar primero la quimioterapia como paso inicial ( quimioterapia neodyuvante ) , y luego la cirugía INTRODUCTION Surgical resection is the only curative treatment for gastric cancer . However , the overall prognosis of gastric adenocarcinoma is poor and advanced disease may even make surgical treatment impossible . It has been theoretically proposed that administration of chemotherapy before surgical resection may down-stage the disease state and facilitate resectability especially in locally-advanced tumors . AIM We wanted to assess the effect of administration of neoadjuvant chemotherapy on tumor resectability in patients with locally-advances gastric adenocarcinoma . MATERIAL S AND METHODS During a r and omized-controlled trial , we divided 60 patients with locally-advanced gastric adenocarcinoma into two groups of neoadjuvant chemotherapy and surgery ( case ) versus surgery alone ( control ) . Because of patient dropouts , we analyzed the results for 22 and 29 patients in case and control groups respectively . The study period was March 21 , 2011 to March 20 , 2014 . A non-r and omized set of 23 patients were also added to the control group ( Multi-center analysis ) . The analysis was repeated for non-r and omized patients ( 22 case patients versus 52 control patients ) . RESULTS The mean age of patients in case and control groups was 58.3 ± 9.1 and 59.7 ± 8.7 years of age respectively ( p > 0.05 ) . Male to female ratio was 15/7 and 41/11 in case and control groups respectively ( p > 0.05 ) . In R and omized patients , 19 patients ( 86.4 % ) were resectable in case group ; while 16 patients ( 55.2 % ) were resectable in control group ( p < 0.05 ) . Multicenter analysis also revealed resectability in 19 patients ( 86.4 % ) and 31 patients ( 59.6 % ) of case and control groups respectively ( p < 0.05 ) . CONCLUSION We conclude that neoadjuvant chemotherapy could increase tumor resectability rate in patients with locally-advanced gastric adenocarcinoma . However , further studies are necessary to confirm the effect of this modality on patients ' overall survival OBJECTIVE To evaluate the clinical efficacy and the toxicity of neoadjuvant chemotherapy with paclitaxel and FOLFOX4 ( 5-fluorouracil/leucovorin combined and oxaliplatin ) regimen for advanced gastric cancer . METHODS Seventy-eight patients with cTNM stage III or IV ( M0 ) gastric cancer were enrolled and 39 were r and omized into the treatment arm ( n=39 , paclitaxel combined with FOLFOX4 regimen neoadjuvant chemotherapy every two weeks in each cycle ) and control group ( n=39 ) . Clinical response was evaluated with RECIST criteria after 3 cycles . Patients in experimental group received surgery after 2 - 4 weeks and postoperative chemotherapy of 3 cycles of the original regimen . When disease progressed , postoperative chemotherapy regimen was changed into ECF regimen . The control group of 39 patients received surgery within 2 weeks and postoperative chemotherapy of 6 cycles of paclitaxel combined with FOLFOX4 regimen . RESULTS The clinical response rate was 66.7 % in the treatment arm . The R0 resection rate ( 59.0 % ) was significantly higher than that in the control group ( P=0.025 ) and the number of lymph node metastasis in the treatment arm(3.23±2.80 ) was significantly lower than that in the control group ( 5.79±2.69 , P=0.001 ) . There were no significant differences in postoperative complication rate ( 5.1 % vs. 2.6 % ) and the number of lymph node dissection ( 19.69±2.95 vs. 20.59±3.22 ) between the two groups ( P>0.05 ) . The median survival time and 2-year survival rate in the treatment arm [ ( 27.10±2.32 ) months and 59.0 % ] was significantly higher than that in the control group[(18.20±1.30 ) months and 28.2 % ] ( P=0.001 , P=0.006 ) . Cox regression multivariable analysis showed that tumor differentiation , R0 resection , lymph node metastasis were independent prognostic factors . Adverse reaction of chemotherapy , mainly hematological adverse reactions , and peripheral nerve toxicity , were tolerable . No significant differences were noted between the two groups in adverse reactions ( P>0.05 ) . CONCLUSIONS The efficacy of paclitaxel combined with FOLFOX4 as neoadjuvant chemotherapy is high . Patients tolerance and compliance are satisfactory . It can improve in patients with advanced gastric cancer the R0 resection rate , reduce lymph node metastasis and improve survival The aim of this study is to evaluate the effects of preoperative chemotherapy with fluorouracili polyphase liposome composita pro orale ( FPLC ) on the tumour cells and the survival rate of the patients with gastric cardia cancer . Sixty patients with gastric cardia cancer were r and omly divided into two groups . Thirty patients were treated with FPLC prior to surgical resection , the other 30 , as controls , did not receive the preoperative chemotherapy . Pathological responses of the tumours to the FPLC chemotherapy were determined by gross and microscopic assessment s of tumour size , tumour emboli , cell degeneration and necrosis . Expressions of nm23 and CD44 were detected by flow cytometry . All patients were followed up to 5 years . In the FPLC-treated patients , the tumour size ( p<0 . 01 ) , the number of tumour emboli ( p=0.04 ) and the intensity of CD44 expression ( p<0.001 ) , were significantly reduced , while cell degeneration ( p<0.001 ) , necrosis ( p<0.01 ) and the expression of nm23 ( p<0.001 ) were increased , when compared with those observations seen in the controls . The postoperative 5-year survival rate was 40 % in the FPLC-treated group and 23 % in the controls ( p=0.17 ) . Preoperative FPLC chemotherapy might improve the survival rate of patients with gastric cardia cancer by inhibiting tumour proliferative , invasive and metastatic activities , and stimulating the patient 's immune system We performed a multicenter clinical trial of preoperative chemotherapy for gastric cancer . Patients aged 75 years or less with advanced gastric cancer were enrolled and r and omized into the following groups : Group I , which received oral 5'-DFUR ( 610 mg/m2/day x 10 days or over ) preoperatively , and Group II , which received no treatment preoperatively . Patients in both groups also received intravenous MMC 1 and 2 days after surgery and were orally administered 5'-DFUR for two years postoperatively . There were 171 patients ( Group I : 91 , Group II : 80 ) enrolled and analyzed , and the  5-year survival rate  was 63.4 % in Group I and 64.9 % in Group II ( p = 0.698 ) . Among patients classified as having curability B , the 5-year survival rate of each group was 51.8 % and 36.8 % , respectively ( p = 0.426 ) . However , the 5-year survival rate of patients showing good compliance with oral 5'-DFUR therapy was significantly higher than that of patients with poor compliance ( 53.3 
    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: Fifty-five patients with high- grade advanced gastric cancer in whom the presence of stage IV was confirmed by preoperative diagnostic imaging were treated with PMUE therapy by a combined use of cisplatin ( CDDP ) 75 mg/m2 , mitomycin C ( MMC ) 10 mg/body , etoposide 150 mg/body , and UFT ( a combination of 1-(2-tetrahydrofuryl)-5-fluorouracil and uracil in a molar ratio of 1∶4 ) 400 mg/day . CDDP and MMC was administered intravenously on the first day , followed by etoposide 50 mg/day on the 3rd , 4th , and 5th days . All the patients had measurable lesions that were evaluated by computed tomography scanning before and after the treatments . These patients were allocated r and omly to two groups . Of these cases , 29 belonged to the neoadjuvant chemotherapy ( NAC ) group to whom PMUE therapy was given preoperatively ; the remaining 26 patients underwent operation first and received PMUE thereafter ( control group ) . Background factors did not differ significantly between the two groups . The response rate was higher in the NAC group than in the control group ( 62 % in the former versus 35 % in the latter ) . The resectability rates were 79 % and 88 % in the NAC and control groups , respectively . However , the rate of potentially curable cases was higher in the NAC group than in the control group ( 38 % in the former versus 15 % in the latter ) . Among the nonresection cases , the prognosis was highly unfavorable in both groups . In the resection cases , however , the survival rate was significantly better in the NAC group than in the control group . These results may indicate that in patients with high- grade , advanced gastric cancer initial chemotherapy ( neoadjuvant chemotherapy ) and then surgery should be considered . RésuméCinquante-cinq cas de cancer gastrique avancé , à potentiel très malin ( stade IV à l'imagerie préopératoire ) , ont été traités par une chimiothérapie PMUE comprenant une combinaison de CDDP , 75 mg/m2 , MMC , 10 mg/Kg poids corporel , d'etopocide , 150 mg/Kg poids corporel et d'UFT , 400 mg/jour . Le CDDP et le MMC ont été donnés par voie intraveineuse à Jl , suivis d'etoposide , 50 mg/jour aux jours 3 , 4 et 5 . Tous les patients avaient des lésions qui ont pu être évaluées par la tomodensitométrie avant et après le traitement . Ces patients ont été r and omisés en deux groupes : 29 ont eu une chimiothérapie néoadjuvante ( CNA ) par le PMUE en préopératoire , alors que les 26 autres ont d'abord été opérés , et ensuite ont reçu une chimiothérapie PMUE ( groupe contrôle ) . Les caractéristiques des deux groupes ne différaient pas de façon significative . Le taux de réponse était plus haut dans le groupe CNA par rapport au groupe contrôle ( 62 % contre 35 % ) . Le taux de résecabilité était respectivement , de 79 et 88 % dans les deux groupes . Le taux de cas potentiellement curables , cependant , était plus élevé dans le groupe CNA par rapport au groupe contrôle ( 38 % contre 15 % ) . Dans les cas de cancer gastrique non réséqués , le pronostic était extrêmement mauvais , quel que soit le groupe . Dans les cancers réséqués , la survie était significativement plus élevée dans le groupe CNA comparé au groupe contrôle . Ces résultats indiquent que chez les patients ayant un cancer gastrique avancé à potentiel très malin , une chimiothérapie néoadjuvante ( d'emblée ) , suivie de chirurgie , peut être le meilleur choix thérapeutique . ResumenCincuenta y cinco casos de cáncer gástrico avanzado , en los cuales se había confirmado el Estado IV mediante imágenes diagnósticas preoperatorias , recibieron quimioterapia PMVE con el uso combinado de cisplatino ( CDDP ) 75 mg/m2 , MMC 10 mg/cuerpo , Ectoposide 150 mg/cuerpo y VHF 400 mg/día . El CDDP y el MMC fueron administrados por vía intravenosa en el primer día , seguidos de Ectoposide 50 mg/día en los días 3 , 4 y 5 . Todos los pacientes exhibían lesiones medibles , las cuales fueron valoradas por escanografía computadorizada antes y después del tratamiento . Los pacientes fueron ubicados al azar en dos grupos ; 29 quedaron en el grupo de la quimioterapia neoadyuvante ( QNA ) en el cual la quimioterapia PMVE fue practicada preoperatoriamente , y los 26 pacientes restantes fueron sometidos primero a operación y luego a quimioterapia PMVE , constituyendose en el grupo de control . Los antecedentes médicos no eran significativamente diferentes en los dos grupos . La respuesta fue mayor en el grupo de QNA en comparación con el grupo control ( 62 % vs 35 % ) . La tasa de resecabilidad fue de 79 % y 88 % en el grupo QNA y en el grupo de control , respectivamente . Sin embargo , la rata de casos potencialmente curables fue más alta en el grupo de QNA , en comparación con el grupo control ( 38 % vs 15 % ) . En los casos no resecados , sin embargo , la tasa de sobrevida fue significativamente superior en el grupo de QNA en comparación con el grupo control . Tales resulados pueden significar que en pacientes con cáncer gástrico de alto grado y en estado avanzado se debe considerar primero la quimioterapia como paso inicial ( quimioterapia neodyuvante ) , y luego la cirugía INTRODUCTION Surgical resection is the only curative treatment for gastric cancer . However , the overall prognosis of gastric adenocarcinoma is poor and advanced disease may even make surgical treatment impossible . It has been theoretically proposed that administration of chemotherapy before surgical resection may down-stage the disease state and facilitate resectability especially in locally-advanced tumors . AIM We wanted to assess the effect of administration of neoadjuvant chemotherapy on tumor resectability in patients with locally-advances gastric adenocarcinoma . MATERIAL S AND METHODS During a r and omized-controlled trial , we divided 60 patients with locally-advanced gastric adenocarcinoma into two groups of neoadjuvant chemotherapy and surgery ( case ) versus surgery alone ( control ) . Because of patient dropouts , we analyzed the results for 22 and 29 patients in case and control groups respectively . The study period was March 21 , 2011 to March 20 , 2014 . A non-r and omized set of 23 patients were also added to the control group ( Multi-center analysis ) . The analysis was repeated for non-r and omized patients ( 22 case patients versus 52 control patients ) . RESULTS The mean age of patients in case and control groups was 58.3 ± 9.1 and 59.7 ± 8.7 years of age respectively ( p > 0.05 ) . Male to female ratio was 15/7 and 41/11 in case and control groups respectively ( p > 0.05 ) . In R and omized patients , 19 patients ( 86.4 % ) were resectable in case group ; while 16 patients ( 55.2 % ) were resectable in control group ( p < 0.05 ) . Multicenter analysis also revealed resectability in 19 patients ( 86.4 % ) and 31 patients ( 59.6 % ) of case and control groups respectively ( p < 0.05 ) . CONCLUSION We conclude that neoadjuvant chemotherapy could increase tumor resectability rate in patients with locally-advanced gastric adenocarcinoma . However , further studies are necessary to confirm the effect of this modality on patients ' overall survival OBJECTIVE To evaluate the clinical efficacy and the toxicity of neoadjuvant chemotherapy with paclitaxel and FOLFOX4 ( 5-fluorouracil/leucovorin combined and oxaliplatin ) regimen for advanced gastric cancer . METHODS Seventy-eight patients with cTNM stage III or IV ( M0 ) gastric cancer were enrolled and 39 were r and omized into the treatment arm ( n=39 , paclitaxel combined with FOLFOX4 regimen neoadjuvant chemotherapy every two weeks in each cycle ) and control group ( n=39 ) . Clinical response was evaluated with RECIST criteria after 3 cycles . Patients in experimental group received surgery after 2 - 4 weeks and postoperative chemotherapy of 3 cycles of the original regimen . When disease progressed , postoperative chemotherapy regimen was changed into ECF regimen . The control group of 39 patients received surgery within 2 weeks and postoperative chemotherapy of 6 cycles of paclitaxel combined with FOLFOX4 regimen . RESULTS The clinical response rate was 66.7 % in the treatment arm . The R0 resection rate ( 59.0 % ) was significantly higher than that in the control group ( P=0.025 ) and the number of lymph node metastasis in the treatment arm(3.23±2.80 ) was significantly lower than that in the control group ( 5.79±2.69 , P=0.001 ) . There were no significant differences in postoperative complication rate ( 5.1 % vs. 2.6 % ) and the number of lymph node dissection ( 19.69±2.95 vs. 20.59±3.22 ) between the two groups ( P>0.05 ) . The median survival time and 2-year survival rate in the treatment arm [ ( 27.10±2.32 ) months and 59.0 % ] was significantly higher than that in the control group[(18.20±1.30 ) months and 28.2 % ] ( P=0.001 , P=0.006 ) . Cox regression multivariable analysis showed that tumor differentiation , R0 resection , lymph node metastasis were independent prognostic factors . Adverse reaction of chemotherapy , mainly hematological adverse reactions , and peripheral nerve toxicity , were tolerable . No significant differences were noted between the two groups in adverse reactions ( P>0.05 ) . CONCLUSIONS The efficacy of paclitaxel combined with FOLFOX4 as neoadjuvant chemotherapy is high . Patients tolerance and compliance are satisfactory . It can improve in patients with advanced gastric cancer the R0 resection rate , reduce lymph node metastasis and improve survival The aim of this study is to evaluate the effects of preoperative chemotherapy with fluorouracili polyphase liposome composita pro orale ( FPLC ) on the tumour cells and the survival rate of the patients with gastric cardia cancer . Sixty patients with gastric cardia cancer were r and omly divided into two groups . Thirty patients were treated with FPLC prior to surgical resection , the other 30 , as controls , did not receive the preoperative chemotherapy . Pathological responses of the tumours to the FPLC chemotherapy were determined by gross and microscopic assessment s of tumour size , tumour emboli , cell degeneration and necrosis . Expressions of nm23 and CD44 were detected by flow cytometry . All patients were followed up to 5 years . In the FPLC-treated patients , the tumour size ( p<0 . 01 ) , the number of tumour emboli ( p=0.04 ) and the intensity of CD44 expression ( p<0.001 ) , were significantly reduced , while cell degeneration ( p<0.001 ) , necrosis ( p<0.01 ) and the expression of nm23 ( p<0.001 ) were increased , when compared with those observations seen in the controls . The postoperative 5-year survival rate was 40 % in the FPLC-treated group and 23 % in the controls ( p=0.17 ) . Preoperative FPLC chemotherapy might improve the survival rate of patients with gastric cardia cancer by inhibiting tumour proliferative , invasive and metastatic activities , and stimulating the patient 's immune system We performed a multicenter clinical trial of preoperative chemotherapy for gastric cancer . Patients aged 75 years or less with advanced gastric cancer were enrolled and r and omized into the following groups : Group I , which received oral 5'-DFUR ( 610 mg/m2/day x 10 days or over ) preoperatively , and Group II , which received no treatment preoperatively . Patients in both groups also received intravenous MMC 1 and 2 days after surgery and were orally administered 5'-DFUR for two years postoperatively . There were 171 patients ( Group I : 91 , Group II : 80 ) enrolled and analyzed , and the  5-year survival rate  was 63.4 % in Group I and 64.9 % in Group II ( p = 0.698 ) . Among patients classified as having curability B , the 5-year survival rate of each group was 51.8 % and 36.8 % , respectively ( p = 0.426 ) . However , the 5-year survival rate of patients showing good compliance with oral 5'-DFUR therapy was significantly higher than that of patients with poor compliance ( 53.3 
    Output:
    