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: The aim of this study was to evaluate a low-dose regimen of megestrol acetate ( MA ; 320 mg/day ) on appetite in advanced cancer patients . Out- patients with far-advanced non-hormone responsive tumours and loss of appetite were r and omised in a phase III trial , with two consecutive phases : a 14-day double-blind placebo controlled phase ( phase A ) and a 76-day open phase ( phase B ) . During phase A , patients were treated with MA , two 160 mg tablets/day , or placebo . In phase B , the MA dose was titrated to clinical response in both groups . Appetite , food intake , body weight , performance status , mood and quality of life were evaluated with st and ardised measures ; patients ' global judgement about treatment efficacy was also requested . Of 42 patients entering the study , 33 ( 17 MA and 16 placebo ) were evaluable for efficacy . The appetite score improved significantly with MA after 7 days ( P = 0.0023 ) , and this effect was still significant at 14 days ( P = 0.0064 ) . Patients judged the treatment with MA effective in 88.2 % of cases ( 14th day ) , whilst placebo was considered effective by 25 % ( P = 0.0003 ) . None of the other measures showed significant changes during treatment . The remarkable effect on appetite evident after 7 days , without serious side-effects , shows that MA can produce significant subjective effects at a low-dose even in patients with far-advanced disease Patients with breast cancer treated with adjuvant chemotherapy  experience not only fatigue and menopausal symptoms but also documented cognitive dysfunction and reduced capacity to carry out activities of daily living . The role of epoetin alfa in improving cognition and functional capacity was assessed in a large r and omized trial through patient self-reported outcomes . Patients with breast cancer ( N = 354 , adjuvant and metastatic ) undergoing chemotherapy  were r and omized in a 1:1 ratio to receive epoetin alfa ( 40,000 IU once weekly ) or the st and ard of care ( SOC ) . Change in patient-reported Health Utilities Index Mark 3 ( HUI3 ) from baseline to week 12 was compared between the epoetin alfa and SOC groups . In addition , correlations between the disease-nonspecific HUI3 utility scale and the cancer-specific quality of life instrument Functional Assessment of Cancer Therapy-Anemia ( FACT-An ) and Fatigue subscales were assessed . Epoetin alfa treatment significantly improved HUI3 scores compared with patients receiving SOC ( P = 0.036 ) . Three subscales within HUI3 were also significantly better for epoetin alfa-treated patients ( emotion , P = 0.048 ; ambulation , P = 0.048 ; and cognition , P = 0.02 ) . Moreover , a strong correlation ( P = 0.0001 ) exists between the disease-nonspecific utility scale HUI3 and the disease-specific FACT-An and FACT-Fatigue scales in terms of overall scores and score changes . The findings of the study demonstrate for the first time in patients with breast cancer that epoetin alfa significantly enhances functional well-being , which translates into significantly better utility scores . In addition , epoetin alfa also significantly improved cognitive function of women undergoing chemotherapy , and this could have an important impact on their lives from a societal perspective BACKGROUND Bojungikki-tang ( Bu-Zhong-Yi-Qi-Tang in Chinese or Hochu-ekki-to in Japanese ) is a widely used herbal prescription in traditional medicine in China , Japan , and Korea . The aim of this study was to investigate the effectiveness of Bojungikki-tang for cancer-related fatigue . METHODS A total of 40 patients with cancer-related fatigue were r and omized into an experimental or a waiting list control group . Patients in the experimental group were treated with Bojungikki-tang ( TJ-41 ) and patients in the waiting list group remained without any intervention for 2 weeks . RESULTS The experimental group showed statistically significant improvements in fatigue level assessed by the Visual Analogue Scale of Global Fatigue ( VAS-F ) measuring the severity of fatigue ( experimental vs control : -1.1 ± 2.1 vs 0.1 ± 0.9 , P < .05 ) and results of Functional Assessment of Cancer Therapy-General ( FACT-G ) , Functional Assessment of Cancer Therapy-Fatigue ( FACT-F ) , and Trial Outcome Index-Fatigue ( TOI-F ) also showed significant improvements ( FACT-G , 3.7 ± 9.9 vs -2.4 ± 9.5 , P < .05 ; FACT-F , F , 8.0 ± 13.6 vs -2.2 ± 14.1 , P < .05 ; TOI-F , 6.5 ± 9.2 vs -0.5 ± 10.9 , P < .05 ) . CONCLUSIONS The results of this study indicate that Bojungikki-tang may have beneficial effects on cancer-related fatigue and quality of lives in cancer patients . More rigorous trials are needed to confirm the efficacy of Bojungikki-tang BACKGROUND Extracellular adenosine 5'-triphosphate ( ATP ) is involved in the regulation of a variety of biologic processes , including neurotransmission , muscle contraction , and liver glucose metabolism , via purinergic receptors . In nonr and omized studies involving patients with different tumor types including non-small-cell lung cancer ( NSCLC ) , ATP infusion appeared to inhibit loss of weight and deterioration of quality of life ( QOL ) and performance status . We conducted a r and omized clinical trial to evaluate the effects of ATP in patients with advanced NSCLC ( stage IIIB or IV ) . METHODS Fifty-eight patients were r and omly assigned to receive either 10 intravenous 30-hour ATP infusions , with the infusions given at 2- to 4-week intervals , or no ATP . Outcome parameters were assessed every 4 weeks until 28 weeks . Between-group differences were tested for statistical significance by use of repeated- measures analysis , and reported P values are two-sided . RESULTS Twenty-eight patients were allocated to receive ATP treatment and 30 received no ATP .  Mean weight changes per 4-week period were -1.0 kg ( 95 % confidence interval [ CI ] = -1.5 to -0.5 ) in the control group and 0.2 kg ( 95 % CI = -0.2 to + 0.6 ) in the ATP group ( P = .002 ) . Serum albumin concentration declined by -1.2 g/L ( 95 % CI= -2.0 to -0.4 ) per 4 weeks in the control group but remained stable ( 0.0 g/L ; 95 % CI = -0.3 to + 0.3 ) in the ATP group ( P = .006 ) . Elbow flexor muscle strength declined by -5.5 % ( 95 % CI = -9.6 % to -1 . 4 % ) per 4 weeks in the control group but remained stable ( 0.0 % ; 95 % CI= -1.4 % to + 1.4 % ) in the ATP group ( P = .01 ) . A similar pattern was observed for knee extensor muscles ( P = .02 ) . The effects of  ATP  on body weight , muscle strength , and albumin concentration were especially marked in cachectic patients ( P = .0002 , P = .0001 , and P = . 0001 , respectively , for ATP versus no ATP ) . QOL score changes per 4-week period in the ATP group showed overall less deterioration than in the control group-physical scores ( -0.2 % versus -2.4 % ; P = . 0002 ) ; functional scores ( + 0.4 % versus -5.5 % ; P = .02 ) ; psychologic scores ( -0.7 % versus -2.4 % ; P = .11 ) ; overall QOL score ( + 0.1 % versus -3.5 % ; P = .0001 ) . CONCLUSIONS This r and omized trial demonstrates that ATP has beneficial effects on weight , muscle strength , and QOL in patients with advanced NSCLC Limited research is available regarding the efficacy of psychostimulants in treating cognitive function in primary brain tumor patients . An open-label , r and omized , pilot trial examined both the general and differential efficacy of 4 weeks of methylpheni date ( MPH ) and modafinil ( MOD ) in 24 brain tumor patients . Participants completed cognitive tests and self-report measures of fatigue , sleep disturbance , mood and quality of life at baseline and after 4 weeks . Following stimulant treatment , there was evidence of a beneficial effect on test performance in speed of processing and executive function requiring divided attention . Patients with the greatest deficit in executive function at baseline appeared to derive the greatest benefit following stimulant therapy . Inconsistent , differential effects were found on a measure of attention in favor of MPH and on a measure of processing speed in favor of MOD . There was also evidence of a general beneficial effect on patient-reported measures of fatigue , mood , and quality of life , with no statistically significant differences between treatment arms in these measures over time . The results from this small pilot study should be interpreted with caution , but appear to warrant additional research , in larger study sample s , targeting fatigue , processing speed and executive function , and exploring different doses of stimulants . Future studies may also wish to explore the specific patient factors that may be associated with responsiveness to psychostimulant treatment PURPOSE To investigate the effect of recombinant human erythropoietin ( epoetin beta ) on anemia , transfusion need , and quality of life ( QOL ) in severely anemic patients with low- grade non-Hodgkin 's lymphoma ( NHL ) , chronic lymphocytic leukemia ( CLL ) , or multiple myeloma ( MM ) . PATIENTS AND METHODS Transfusion-dependent patients with NHL ( n = 106 ) , CLL ( n = 126 ) , or MM ( n = 117 ) and a low serum erythropoietin concentration were r and omized to receive epoetin beta 150 IU/kg or placebo subcutaneously three times a week for 16 weeks . Primary efficacy criteria were transfusion-free and transfusion- and severe anemia-free survival ( hemoglobin [ Hb ] > 8.5 g/dL ) between weeks 5 to 16 . Response was defined as an increase in Hb > or = 2 g/dL with elimination of transfusion need . QOL was assessed by the Functional Assessment of Cancer Therapy scale . RESULTS Transfusion-free ( P = .0012 ) survival and transfusion- and severe anemia-free survival ( P = .0001 ) were significantly greater in the epoetin beta group versus placebo ( Wald chi(2 ) test ) , giving a relative risk reduction of 43 % and 51 % , respectively . The response rate was 67 % and 27 % in the epoetin beta versus the placebo group , respectively ( P < .0001 ) . After 12 and 16 weeks of treatment , QOL significantly improved in the epoetin beta group compared with placebo ( P < .05 ) ; this improvement correlated with an increase in Hb concentration ( > or = 2 g/dL ) . A target Hb that could be generally recommended could not be identified . CONCLUSION Many severely anemic and transfusion-dependent patients with advanced MM , NHL , and CLL and a low performance status benefited from epoetin therapy , with elimination of severe anemia and transfusion need , and improvement in QOL Cancer and its treatment can induce subjective and objective evidence of diminished functional capacity encompassing physical fatigue and cognitive impairment . Dexmethylpheni date ( D-MPH ; the D-isomer of methylpheni date ) was evaluated for treatment of chemotherapy-related fatigue and cognitive impairment . A r and omized , double-blind , placebo-controlled , parallel-group study evaluated the potential therapeutic effect and safety of D-MPH in the treatment of patients with chemotherapy-related fatigue . Change from baseline in the Functional Assessment of Chronic Illness Therapy-Fatigue Subscale ( FACIT-F ) total score at Week 8 was the primary outcome measure . One hundred fifty-four patients ( predominantly with breast and ovarian cancers ) were r and omized and treated . Compared with placebo , D-MPH-treated subjects demonstrated a significant improvement in fatigue symptoms at Week 8 in the FACIT-F ( P=0.02 ) and the Clinical Global Impression-Severity scores ( P=0.02 ) , without clinical ly relevant changes in hemoglobin levels . Cognitive function was not significantly improved . There was a higher rate of study drug-related adverse events ( AEs ) ( 48 of 76 [ 63 % ] vs. 22 of 78 [ 28 % ] ) and a higher discontinuation rate because of AEs ( 8 of 76 [ 11 % ] vs. 1 of 78 [ 1.3 % ] ) in D-MPH-treated subjects compared with placebo-treated subjects . The most commonly reported AEs independent of study drug relationship in D-MPH-treated subjects were headache , nausea , and dry mouth , and in placebo-treated subjects were headache , diarrhea , and insomnia .  D-MPH produced significant improvement in fatigue in subjects previously treated with cytotoxic chemotherapy . Further studies with D-MPH or other agents to explore treatment response in chemotherapy-associated fatigue should be considered Sleep disorders are a substantial problem for cancer survivors , with prevalence estimates ranging from 23 % to 61 % . Although numerous prescription hypnotics are available , few are approved for long-term use or have demonstrated benefit in this 
    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: The aim of this study was to evaluate a low-dose regimen of megestrol acetate ( MA ; 320 mg/day ) on appetite in advanced cancer patients . Out- patients with far-advanced non-hormone responsive tumours and loss of appetite were r and omised in a phase III trial , with two consecutive phases : a 14-day double-blind placebo controlled phase ( phase A ) and a 76-day open phase ( phase B ) . During phase A , patients were treated with MA , two 160 mg tablets/day , or placebo . In phase B , the MA dose was titrated to clinical response in both groups . Appetite , food intake , body weight , performance status , mood and quality of life were evaluated with st and ardised measures ; patients ' global judgement about treatment efficacy was also requested . Of 42 patients entering the study , 33 ( 17 MA and 16 placebo ) were evaluable for efficacy . The appetite score improved significantly with MA after 7 days ( P = 0.0023 ) , and this effect was still significant at 14 days ( P = 0.0064 ) . Patients judged the treatment with MA effective in 88.2 % of cases ( 14th day ) , whilst placebo was considered effective by 25 % ( P = 0.0003 ) . None of the other measures showed significant changes during treatment . The remarkable effect on appetite evident after 7 days , without serious side-effects , shows that MA can produce significant subjective effects at a low-dose even in patients with far-advanced disease Patients with breast cancer treated with adjuvant chemotherapy  experience not only fatigue and menopausal symptoms but also documented cognitive dysfunction and reduced capacity to carry out activities of daily living . The role of epoetin alfa in improving cognition and functional capacity was assessed in a large r and omized trial through patient self-reported outcomes . Patients with breast cancer ( N = 354 , adjuvant and metastatic ) undergoing chemotherapy  were r and omized in a 1:1 ratio to receive epoetin alfa ( 40,000 IU once weekly ) or the st and ard of care ( SOC ) . Change in patient-reported Health Utilities Index Mark 3 ( HUI3 ) from baseline to week 12 was compared between the epoetin alfa and SOC groups . In addition , correlations between the disease-nonspecific HUI3 utility scale and the cancer-specific quality of life instrument Functional Assessment of Cancer Therapy-Anemia ( FACT-An ) and Fatigue subscales were assessed . Epoetin alfa treatment significantly improved HUI3 scores compared with patients receiving SOC ( P = 0.036 ) . Three subscales within HUI3 were also significantly better for epoetin alfa-treated patients ( emotion , P = 0.048 ; ambulation , P = 0.048 ; and cognition , P = 0.02 ) . Moreover , a strong correlation ( P = 0.0001 ) exists between the disease-nonspecific utility scale HUI3 and the disease-specific FACT-An and FACT-Fatigue scales in terms of overall scores and score changes . The findings of the study demonstrate for the first time in patients with breast cancer that epoetin alfa significantly enhances functional well-being , which translates into significantly better utility scores . In addition , epoetin alfa also significantly improved cognitive function of women undergoing chemotherapy , and this could have an important impact on their lives from a societal perspective BACKGROUND Bojungikki-tang ( Bu-Zhong-Yi-Qi-Tang in Chinese or Hochu-ekki-to in Japanese ) is a widely used herbal prescription in traditional medicine in China , Japan , and Korea . The aim of this study was to investigate the effectiveness of Bojungikki-tang for cancer-related fatigue . METHODS A total of 40 patients with cancer-related fatigue were r and omized into an experimental or a waiting list control group . Patients in the experimental group were treated with Bojungikki-tang ( TJ-41 ) and patients in the waiting list group remained without any intervention for 2 weeks . RESULTS The experimental group showed statistically significant improvements in fatigue level assessed by the Visual Analogue Scale of Global Fatigue ( VAS-F ) measuring the severity of fatigue ( experimental vs control : -1.1 ± 2.1 vs 0.1 ± 0.9 , P < .05 ) and results of Functional Assessment of Cancer Therapy-General ( FACT-G ) , Functional Assessment of Cancer Therapy-Fatigue ( FACT-F ) , and Trial Outcome Index-Fatigue ( TOI-F ) also showed significant improvements ( FACT-G , 3.7 ± 9.9 vs -2.4 ± 9.5 , P < .05 ; FACT-F , F , 8.0 ± 13.6 vs -2.2 ± 14.1 , P < .05 ; TOI-F , 6.5 ± 9.2 vs -0.5 ± 10.9 , P < .05 ) . CONCLUSIONS The results of this study indicate that Bojungikki-tang may have beneficial effects on cancer-related fatigue and quality of lives in cancer patients . More rigorous trials are needed to confirm the efficacy of Bojungikki-tang BACKGROUND Extracellular adenosine 5'-triphosphate ( ATP ) is involved in the regulation of a variety of biologic processes , including neurotransmission , muscle contraction , and liver glucose metabolism , via purinergic receptors . In nonr and omized studies involving patients with different tumor types including non-small-cell lung cancer ( NSCLC ) , ATP infusion appeared to inhibit loss of weight and deterioration of quality of life ( QOL ) and performance status . We conducted a r and omized clinical trial to evaluate the effects of ATP in patients with advanced NSCLC ( stage IIIB or IV ) . METHODS Fifty-eight patients were r and omly assigned to receive either 10 intravenous 30-hour ATP infusions , with the infusions given at 2- to 4-week intervals , or no ATP . Outcome parameters were assessed every 4 weeks until 28 weeks . Between-group differences were tested for statistical significance by use of repeated- measures analysis , and reported P values are two-sided . RESULTS Twenty-eight patients were allocated to receive ATP treatment and 30 received no ATP .  Mean weight changes per 4-week period were -1.0 kg ( 95 % confidence interval [ CI ] = -1.5 to -0.5 ) in the control group and 0.2 kg ( 95 % CI = -0.2 to + 0.6 ) in the ATP group ( P = .002 ) . Serum albumin concentration declined by -1.2 g/L ( 95 % CI= -2.0 to -0.4 ) per 4 weeks in the control group but remained stable ( 0.0 g/L ; 95 % CI = -0.3 to + 0.3 ) in the ATP group ( P = .006 ) . Elbow flexor muscle strength declined by -5.5 % ( 95 % CI = -9.6 % to -1 . 4 % ) per 4 weeks in the control group but remained stable ( 0.0 % ; 95 % CI= -1.4 % to + 1.4 % ) in the ATP group ( P = .01 ) . A similar pattern was observed for knee extensor muscles ( P = .02 ) . The effects of  ATP  on body weight , muscle strength , and albumin concentration were especially marked in cachectic patients ( P = .0002 , P = .0001 , and P = . 0001 , respectively , for ATP versus no ATP ) . QOL score changes per 4-week period in the ATP group showed overall less deterioration than in the control group-physical scores ( -0.2 % versus -2.4 % ; P = . 0002 ) ; functional scores ( + 0.4 % versus -5.5 % ; P = .02 ) ; psychologic scores ( -0.7 % versus -2.4 % ; P = .11 ) ; overall QOL score ( + 0.1 % versus -3.5 % ; P = .0001 ) . CONCLUSIONS This r and omized trial demonstrates that ATP has beneficial effects on weight , muscle strength , and QOL in patients with advanced NSCLC Limited research is available regarding the efficacy of psychostimulants in treating cognitive function in primary brain tumor patients . An open-label , r and omized , pilot trial examined both the general and differential efficacy of 4 weeks of methylpheni date ( MPH ) and modafinil ( MOD ) in 24 brain tumor patients . Participants completed cognitive tests and self-report measures of fatigue , sleep disturbance , mood and quality of life at baseline and after 4 weeks . Following stimulant treatment , there was evidence of a beneficial effect on test performance in speed of processing and executive function requiring divided attention . Patients with the greatest deficit in executive function at baseline appeared to derive the greatest benefit following stimulant therapy . Inconsistent , differential effects were found on a measure of attention in favor of MPH and on a measure of processing speed in favor of MOD . There was also evidence of a general beneficial effect on patient-reported measures of fatigue , mood , and quality of life , with no statistically significant differences between treatment arms in these measures over time . The results from this small pilot study should be interpreted with caution , but appear to warrant additional research , in larger study sample s , targeting fatigue , processing speed and executive function , and exploring different doses of stimulants . Future studies may also wish to explore the specific patient factors that may be associated with responsiveness to psychostimulant treatment PURPOSE To investigate the effect of recombinant human erythropoietin ( epoetin beta ) on anemia , transfusion need , and quality of life ( QOL ) in severely anemic patients with low- grade non-Hodgkin 's lymphoma ( NHL ) , chronic lymphocytic leukemia ( CLL ) , or multiple myeloma ( MM ) . PATIENTS AND METHODS Transfusion-dependent patients with NHL ( n = 106 ) , CLL ( n = 126 ) , or MM ( n = 117 ) and a low serum erythropoietin concentration were r and omized to receive epoetin beta 150 IU/kg or placebo subcutaneously three times a week for 16 weeks . Primary efficacy criteria were transfusion-free and transfusion- and severe anemia-free survival ( hemoglobin [ Hb ] > 8.5 g/dL ) between weeks 5 to 16 . Response was defined as an increase in Hb > or = 2 g/dL with elimination of transfusion need . QOL was assessed by the Functional Assessment of Cancer Therapy scale . RESULTS Transfusion-free ( P = .0012 ) survival and transfusion- and severe anemia-free survival ( P = .0001 ) were significantly greater in the epoetin beta group versus placebo ( Wald chi(2 ) test ) , giving a relative risk reduction of 43 % and 51 % , respectively . The response rate was 67 % and 27 % in the epoetin beta versus the placebo group , respectively ( P < .0001 ) . After 12 and 16 weeks of treatment , QOL significantly improved in the epoetin beta group compared with placebo ( P < .05 ) ; this improvement correlated with an increase in Hb concentration ( > or = 2 g/dL ) . A target Hb that could be generally recommended could not be identified . CONCLUSION Many severely anemic and transfusion-dependent patients with advanced MM , NHL , and CLL and a low performance status benefited from epoetin therapy , with elimination of severe anemia and transfusion need , and improvement in QOL Cancer and its treatment can induce subjective and objective evidence of diminished functional capacity encompassing physical fatigue and cognitive impairment . Dexmethylpheni date ( D-MPH ; the D-isomer of methylpheni date ) was evaluated for treatment of chemotherapy-related fatigue and cognitive impairment . A r and omized , double-blind , placebo-controlled , parallel-group study evaluated the potential therapeutic effect and safety of D-MPH in the treatment of patients with chemotherapy-related fatigue . Change from baseline in the Functional Assessment of Chronic Illness Therapy-Fatigue Subscale ( FACIT-F ) total score at Week 8 was the primary outcome measure . One hundred fifty-four patients ( predominantly with breast and ovarian cancers ) were r and omized and treated . Compared with placebo , D-MPH-treated subjects demonstrated a significant improvement in fatigue symptoms at Week 8 in the FACIT-F ( P=0.02 ) and the Clinical Global Impression-Severity scores ( P=0.02 ) , without clinical ly relevant changes in hemoglobin levels . Cognitive function was not significantly improved . There was a higher rate of study drug-related adverse events ( AEs ) ( 48 of 76 [ 63 % ] vs. 22 of 78 [ 28 % ] ) and a higher discontinuation rate because of AEs ( 8 of 76 [ 11 % ] vs. 1 of 78 [ 1.3 % ] ) in D-MPH-treated subjects compared with placebo-treated subjects . The most commonly reported AEs independent of study drug relationship in D-MPH-treated subjects were headache , nausea , and dry mouth , and in placebo-treated subjects were headache , diarrhea , and insomnia .  D-MPH produced significant improvement in fatigue in subjects previously treated with cytotoxic chemotherapy . Further studies with D-MPH or other agents to explore treatment response in chemotherapy-associated fatigue should be considered Sleep disorders are a substantial problem for cancer survivors , with prevalence estimates ranging from 23 % to 61 % . Although numerous prescription hypnotics are available , few are approved for long-term use or have demonstrated benefit in this 
    Output:
    