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: Ninety-three cancer patients about to undergo radiotherapy were studied . These patients were affected by cancer of the head and neck , breast cancer , and abdominopelvic cancer . They were r and omly distributed into control and experimental groups . The patients from the control group were allowed to eat ad libitum , whereas those from the experimental group followed a strict nutritional protocol that covered their needs while satisfying their particular tastes and habits . Data were collected the day before radiotherapy commenced and the day treatment ended . Anthropometric , analytical , and clinical parameters were determined . The results showed the benefit of dietetic treatment in experimental patients with head and neck or abdominopelvic cancer BACKGROUND A r and omized controlled trial previously conducted in radiation oncology patients demonstrated that nutrition intervention had a beneficial impact on body weight , nutritional status , and quality of life compared with st and ard practice , but it did not report on dietary intake data . OBJECTIVE To determine the impact of nutrition intervention compared with st and ard practice on dietary intake in out patients receiving radiotherapy . DESIGN Prospect i ve , r and omized , controlled trial . SUBJECTS Sixty consecutive radiation oncology out patients ( 51 men and nine women ; age 61.9+/-14 years [ mean+/-st and ard deviation ] ) . SETTING Australian private radiotherapy facility . INTERVENTION Patients were r and omly assigned to receive either nutrition intervention ( n=29 ) ( nutrition counseling following the American Dietetic Association [ ADA ] medical nutrition therapy [ MNT ] protocol for radiation oncology ) or st and ard practice ( n=31 ) ( general nutrition talk and booklet ) . MAIN OUTCOME MEASURE Dietary intake ( protein , energy , fiber ) assessed at baseline and at 4 , 8 , and 12 weeks after starting radiotherapy . STATISTICAL ANALYSES Repeated- measures analysis of variance done on an intention to treat basis . RESULTS The nutrition intervention group had a higher mean total energy ( P=0.029 ) and protein intake ( P<0.001 ) compared with the st and ard practice group . Mean intake per kilogram of body weight for the nutrition intervention group ranged from 28 to 31 kcal/kg/day compared with 25 to 29 kcal/kg/day for the st and ard practice group ( P=0.022 ) . The nutrition intervention group had a higher mean protein intake ( 1.1 to 1.3 g/kg/day ) compared with the st and ard practice group ( 1.0 to 1.1 g/kg/day ) ( P=0.001 ) . Although the change in fiber intake between the groups was not significant , there was a trend in the anticipated direction ( P=0.083 ) . CONCLUSIONS Intensive nutrition intervention following the ADA MNT protocol results in improved dietary intake compared with st and ard practice and seems to beneficially impact nutrition-related outcomes previously observed in oncology out patients receiving radiotherapy . The ADA MNT protocol for radiation oncology is a useful guide to the level of nutrition support required The authors prospect ively assessed the independent association between weight loss and deterioration in quality of life ( QOL ) in patients treated by radiotherapy for head and neck cancer . In 533 head and neck cancer patients treated by curative radiotherapy  , changes in weight and QOL were assessed between baseline ( before radiotherapy ) and follow-up ( 12 wk after the start of radiotherapy ) . Patients were categorized into 4 weight loss categories : 0 % , 0.1%–5.0 % , 5.1%–10.0 % , and > 10 % weight loss . The association between weight loss and change in QOL was analyzed by linear regression analysis , adjusted for sociodemographic and tumor-related characteristics , and additionally for disease specific symptoms and tube feeding . Thirty percent of patients lost 0.1%–5.0 % weight , 26 % lost 5.1%–10.0 % weight , and 24 % lost > 10 % weight . Adjusted regression analyses showed a significant association between weight loss and deterioration of global QOL , physical functioning , social functioning , social eating , and social contact . After additional adjustment for disease-specific symptoms and tube feeding , weight loss ( > 10 % ) remained significantly associated with global QOL , social eating , and social contact ( P < 0.05 ) . More than 10 % weight loss during and directly after radiotherapy has a significant impact on social eating , social contact , and QOL in head and neck cancer patients The aim of this study was to assess the effect of ( preventive ) rehabilitation on swallowing and mouth opening  after concomitant chemoradiotherapy ( CCRT ) . Forty-nine patients with advanced oral cavity , oropharynx , hypopharynx and larynx , or nasopharynx cancer treated with CCRT  were r and omized into a st and ard ( S ) or an experimental ( E ) preventive rehabilitation arm . Structured multidimensional assessment ( i.e. ,  videofluoroscopy , mouth-opening measurement , structured question naires ) was performed before and 10 weeks after CCRT . In both S and E arms , feasibility was good ( all patients could execute the exercises within a week ) and compliance was satisfactory ( mean days practice d per week was 4 ) . Nevertheless , mouth opening , oral intake , and weight decreased significantly . Compared to similar CCRT studies at our institute , however , fewer patients were still tube-dependent after CCRT . Furthermore , some functional outcomes seemed less affected than those of studies in the literature that did not incorporate rehabilitation exercises . Patients in the E arm practice d significantly fewer days in total and per week , but they obtained results comparable to the S arm patients . Preventive rehabilitation ( regardless of the approach , i.e. , experimental or st and ard ) in head and neck cancer patients , despite advanced stage and burdensome treatment , is feasible , and compared with historical controls , it seems helpful in reducing the extent and /or severity of various functional short-term effects of CCRT Clinical research shows that nutritional intervention is necessary to prevent malnutrition in head and neck cancer patients undergoing radiotherapy . The objective of the present study was to assess the value of individually adjusted counselling by a dietitian compared to st and ard nutritional care ( SC ) . A prospect i ve study , conducted between 2005 and 2007 , compared individual dietary counselling ( IDC , optimal energy and protein requirement ) to SC by an oncology nurse ( st and ard nutritional counselling ) . Endpoints were weight loss , BMI and malnutrition ( 5 % weight loss/month ) before , during and after the treatment . Thirty-eight patients were included evenly distributed over two groups . A significant decrease in weight loss was found 2 months after the treatment ( P = 0.03 ) for IDC compared with SC . Malnutrition in patients with IDC decreased over time , while malnutrition increased in patients with SC ( P = 0.02 ) . Therefore , early and intensive individualised dietary counselling by a dietitian produces clinical ly relevant effects in terms of decreasing weight loss and malnutrition compared with SC in patients with head and neck cancer undergoing radiotherapy BACKGROUND We aim ed to determine the effect of dietary counseling or oral supplements on outcome for patients with cancer , specifically , nutritional outcome , morbidity , and quality of life ( QOL )  , during and 3 months after radiotherapy . METHODS Seventy-five patients with head and neck cancer who were referred for radiotherapy ( RT ) were r and omized to the following groups : group 1 ( n = 25 ) , patients who received dietary counseling with regular foods ; group 2 ( n = 25 ) , patients who maintained usual diet plus supplements ; and group 3 ( n = 25 ) , patients who maintained intake ad lib .  Nutritional intake ( determined by diet history ) and status ( determined by Ottery 's Subjective Global Assessment ) , and QOL ( determined by the European Organization for the Research and Treatment of Cancer Quality of Life Question naire version 3.0 [ EORTC QLQ-C30 ] ) were evaluated at baseline , at the end of RT , and at 3 months . RESULTS Energy intake after RT increased in both groups 1 and 2 ( p < or = .05 ) . Protein intake also increased in both groups 1 and 2 ( p < or = .006 ) . Both energy and protein intake decreased significantly in group 3 ( p < .01 ) . At 3 months , group 1 maintained intakes , whereas groups 2 and 3 returned to or below baseline levels . After RT , > 90 % of patients experienced RT toxicity ; this was not significantly different between groups , with a trend for reduced symptomatology in group 1 versus group 2/group 3 ( p < .07 ) . At 3 months , the reduction of incidence/severity of grade 1 + 2 anorexia , nausea/vomiting , xerostomia , and dysgeusia was different : 90 % of the patients improved in group 1 versus 67 % in group 2 versus 51 % in group 3 ( p < .0001 ) . After RT , QOL function scores improved ( p < .003 ) proportionally with improved nutritional intake and status in group 1/group 2 ( p < .05 ) and worsened in group 3 ( p < .05 ) ; at 3 months , patients in group 1 maintained or improved overall QOL , whereas patients in groups 2 and 3 maintained or worsened overall QOL . CONCLUSIONS During RT , nutritional interventions positively influenced outcomes , and counseling was of similar/higher benefit ; in the medium term , only counseling exerted a significant impact on patient outcomes BACKGROUND AND PURPOSE Concomitant radio-chemotherapy is the gold st and ard treatment for unresectable head and neck carcinomas . Placement of prophylactic gastrostomy has been proposed to provide adequate nutrition during the therapeutic sequence . The objectives of this study were to assess the impact of prophylactic gastrostomy on the 6-month quality of life , and to determine the factors related to this quality of life . MATERIAL S AND METHODS Design . r and omized , controlled , open study ( " systematic percutaneous gastrostomy " versus " no systematic gastrostomy " ) . Patients . squamous cell head and neck carcinoma ( stages III and IV , UICC 1997 ) . Setting . oncological departments of French university teaching hospitals . Treatment . optimal concomitant radio-chemotherapy . Evaluations . T0 baseline evaluation , T1 during the treatment , T2 end of the treatment , and T3 6-month post- inclusion . Primary endpoint . 6-month quality of life ( Qol ) assessed using SF36 , EORTC QLQ-C30 , EORTC QLQ H&N35 question naires . RESULTS The Qol changes from baseline included a decline ( T1 and T2 ) followed by an improvement ( T3 ) . Qol at 6 months was significantly higher in the group receiving systematic prophylactic gastrostomy ( p=10(-3 ) ) . Higher initial BMI and lower initial Karnofsky index were significant factors related to a higher 6-month Qol . CONCLUSIONS The study results suggest that prophylactic gastrostomy improves post-treatment quality of life for unresectable head and neck cancer patients , after adjusting for other potential predictive quality of life factors Malnutrition occurs frequently in patients with cancer of the gastrointestinal ( GI ) or head and neck area and can lead to negative outcomes . The aim of this study is to determine the impact of early and intensive nutrition intervention ( NI ) on body weight , body composition , nutritional status , global quality of life ( QoL ) and physical function compared to usual practice in oncology out patients receiving radiotherapy to the GI or head and neck area . Out patients commencing at least 20 fractions of radiotherapy to the GI or head and neck area were  r  and omised to receive intensive , individualised nutrition counselling by a dietitian using a st and ard protocol and oral supplements if required , or the usual practice of the centre ( general advice and nutrition booklet ) . Outcome parameters were measured at baseline and 4 , 8 and 12 weeks after commencing radiotherapy using valid and reliable tools . A total of 60 patients ( 51 M : 9F ; mean age 61.9±14.0 years ) were r and omised to receive either NI ( n=29 ) or usual care ( UC ) ( n=31 ) . The NI group had statistically smaller deteriorations in weight ( P<0.001 ) , nutritional status ( P=0.020 ) and global QoL ( P=0.009 ) compared with those receiving UC . Clinical ly , but not statistically significant differences in fat-free mass were observed between the groups ( P=0.195 ) . Early and intensive NI appears beneficial in terms of minimising weight loss , deterioration in nutritional status , global QoL and physical function in oncology out patients receiving radiotherapy to the GI or head and neck area . Weight maintenance in this population leads to beneficial outcomes and suggests that this , rather than weight gain , may be a more appropriate aim of NI Fifty ambulatory patients with head and neck cancer treated by definitive radiation therapy at the Fox Chase Cancer Center were prospect ively studied to determine the effect of oral nutritional supplements on both nutritional status and treatment response . Nutritional supplements maintained serum albumin during and post treatment . Nutritional supplements were shown to increase total protein and total calorie intake rather than displace these nutrients in usual food intake . Equal weight loss occurred in both the supplemented and non-supplemented groups during the observation period of 6 months , with the same or greater amount of weight loss registered 10 weeks after the start of 
    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: Ninety-three cancer patients about to undergo radiotherapy were studied . These patients were affected by cancer of the head and neck , breast cancer , and abdominopelvic cancer . They were r and omly distributed into control and experimental groups . The patients from the control group were allowed to eat ad libitum , whereas those from the experimental group followed a strict nutritional protocol that covered their needs while satisfying their particular tastes and habits . Data were collected the day before radiotherapy commenced and the day treatment ended . Anthropometric , analytical , and clinical parameters were determined . The results showed the benefit of dietetic treatment in experimental patients with head and neck or abdominopelvic cancer BACKGROUND A r and omized controlled trial previously conducted in radiation oncology patients demonstrated that nutrition intervention had a beneficial impact on body weight , nutritional status , and quality of life compared with st and ard practice , but it did not report on dietary intake data . OBJECTIVE To determine the impact of nutrition intervention compared with st and ard practice on dietary intake in out patients receiving radiotherapy . DESIGN Prospect i ve , r and omized , controlled trial . SUBJECTS Sixty consecutive radiation oncology out patients ( 51 men and nine women ; age 61.9+/-14 years [ mean+/-st and ard deviation ] ) . SETTING Australian private radiotherapy facility . INTERVENTION Patients were r and omly assigned to receive either nutrition intervention ( n=29 ) ( nutrition counseling following the American Dietetic Association [ ADA ] medical nutrition therapy [ MNT ] protocol for radiation oncology ) or st and ard practice ( n=31 ) ( general nutrition talk and booklet ) . MAIN OUTCOME MEASURE Dietary intake ( protein , energy , fiber ) assessed at baseline and at 4 , 8 , and 12 weeks after starting radiotherapy . STATISTICAL ANALYSES Repeated- measures analysis of variance done on an intention to treat basis . RESULTS The nutrition intervention group had a higher mean total energy ( P=0.029 ) and protein intake ( P<0.001 ) compared with the st and ard practice group . Mean intake per kilogram of body weight for the nutrition intervention group ranged from 28 to 31 kcal/kg/day compared with 25 to 29 kcal/kg/day for the st and ard practice group ( P=0.022 ) . The nutrition intervention group had a higher mean protein intake ( 1.1 to 1.3 g/kg/day ) compared with the st and ard practice group ( 1.0 to 1.1 g/kg/day ) ( P=0.001 ) . Although the change in fiber intake between the groups was not significant , there was a trend in the anticipated direction ( P=0.083 ) . CONCLUSIONS Intensive nutrition intervention following the ADA MNT protocol results in improved dietary intake compared with st and ard practice and seems to beneficially impact nutrition-related outcomes previously observed in oncology out patients receiving radiotherapy . The ADA MNT protocol for radiation oncology is a useful guide to the level of nutrition support required The authors prospect ively assessed the independent association between weight loss and deterioration in quality of life ( QOL ) in patients treated by radiotherapy for head and neck cancer . In 533 head and neck cancer patients treated by curative radiotherapy  , changes in weight and QOL were assessed between baseline ( before radiotherapy ) and follow-up ( 12 wk after the start of radiotherapy ) . Patients were categorized into 4 weight loss categories : 0 % , 0.1%–5.0 % , 5.1%–10.0 % , and > 10 % weight loss . The association between weight loss and change in QOL was analyzed by linear regression analysis , adjusted for sociodemographic and tumor-related characteristics , and additionally for disease specific symptoms and tube feeding . Thirty percent of patients lost 0.1%–5.0 % weight , 26 % lost 5.1%–10.0 % weight , and 24 % lost > 10 % weight . Adjusted regression analyses showed a significant association between weight loss and deterioration of global QOL , physical functioning , social functioning , social eating , and social contact . After additional adjustment for disease-specific symptoms and tube feeding , weight loss ( > 10 % ) remained significantly associated with global QOL , social eating , and social contact ( P < 0.05 ) . More than 10 % weight loss during and directly after radiotherapy has a significant impact on social eating , social contact , and QOL in head and neck cancer patients The aim of this study was to assess the effect of ( preventive ) rehabilitation on swallowing and mouth opening  after concomitant chemoradiotherapy ( CCRT ) . Forty-nine patients with advanced oral cavity , oropharynx , hypopharynx and larynx , or nasopharynx cancer treated with CCRT  were r and omized into a st and ard ( S ) or an experimental ( E ) preventive rehabilitation arm . Structured multidimensional assessment ( i.e. ,  videofluoroscopy , mouth-opening measurement , structured question naires ) was performed before and 10 weeks after CCRT . In both S and E arms , feasibility was good ( all patients could execute the exercises within a week ) and compliance was satisfactory ( mean days practice d per week was 4 ) . Nevertheless , mouth opening , oral intake , and weight decreased significantly . Compared to similar CCRT studies at our institute , however , fewer patients were still tube-dependent after CCRT . Furthermore , some functional outcomes seemed less affected than those of studies in the literature that did not incorporate rehabilitation exercises . Patients in the E arm practice d significantly fewer days in total and per week , but they obtained results comparable to the S arm patients . Preventive rehabilitation ( regardless of the approach , i.e. , experimental or st and ard ) in head and neck cancer patients , despite advanced stage and burdensome treatment , is feasible , and compared with historical controls , it seems helpful in reducing the extent and /or severity of various functional short-term effects of CCRT Clinical research shows that nutritional intervention is necessary to prevent malnutrition in head and neck cancer patients undergoing radiotherapy . The objective of the present study was to assess the value of individually adjusted counselling by a dietitian compared to st and ard nutritional care ( SC ) . A prospect i ve study , conducted between 2005 and 2007 , compared individual dietary counselling ( IDC , optimal energy and protein requirement ) to SC by an oncology nurse ( st and ard nutritional counselling ) . Endpoints were weight loss , BMI and malnutrition ( 5 % weight loss/month ) before , during and after the treatment . Thirty-eight patients were included evenly distributed over two groups . A significant decrease in weight loss was found 2 months after the treatment ( P = 0.03 ) for IDC compared with SC . Malnutrition in patients with IDC decreased over time , while malnutrition increased in patients with SC ( P = 0.02 ) . Therefore , early and intensive individualised dietary counselling by a dietitian produces clinical ly relevant effects in terms of decreasing weight loss and malnutrition compared with SC in patients with head and neck cancer undergoing radiotherapy BACKGROUND We aim ed to determine the effect of dietary counseling or oral supplements on outcome for patients with cancer , specifically , nutritional outcome , morbidity , and quality of life ( QOL )  , during and 3 months after radiotherapy . METHODS Seventy-five patients with head and neck cancer who were referred for radiotherapy ( RT ) were r and omized to the following groups : group 1 ( n = 25 ) , patients who received dietary counseling with regular foods ; group 2 ( n = 25 ) , patients who maintained usual diet plus supplements ; and group 3 ( n = 25 ) , patients who maintained intake ad lib .  Nutritional intake ( determined by diet history ) and status ( determined by Ottery 's Subjective Global Assessment ) , and QOL ( determined by the European Organization for the Research and Treatment of Cancer Quality of Life Question naire version 3.0 [ EORTC QLQ-C30 ] ) were evaluated at baseline , at the end of RT , and at 3 months . RESULTS Energy intake after RT increased in both groups 1 and 2 ( p < or = .05 ) . Protein intake also increased in both groups 1 and 2 ( p < or = .006 ) . Both energy and protein intake decreased significantly in group 3 ( p < .01 ) . At 3 months , group 1 maintained intakes , whereas groups 2 and 3 returned to or below baseline levels . After RT , > 90 % of patients experienced RT toxicity ; this was not significantly different between groups , with a trend for reduced symptomatology in group 1 versus group 2/group 3 ( p < .07 ) . At 3 months , the reduction of incidence/severity of grade 1 + 2 anorexia , nausea/vomiting , xerostomia , and dysgeusia was different : 90 % of the patients improved in group 1 versus 67 % in group 2 versus 51 % in group 3 ( p < .0001 ) . After RT , QOL function scores improved ( p < .003 ) proportionally with improved nutritional intake and status in group 1/group 2 ( p < .05 ) and worsened in group 3 ( p < .05 ) ; at 3 months , patients in group 1 maintained or improved overall QOL , whereas patients in groups 2 and 3 maintained or worsened overall QOL . CONCLUSIONS During RT , nutritional interventions positively influenced outcomes , and counseling was of similar/higher benefit ; in the medium term , only counseling exerted a significant impact on patient outcomes BACKGROUND AND PURPOSE Concomitant radio-chemotherapy is the gold st and ard treatment for unresectable head and neck carcinomas . Placement of prophylactic gastrostomy has been proposed to provide adequate nutrition during the therapeutic sequence . The objectives of this study were to assess the impact of prophylactic gastrostomy on the 6-month quality of life , and to determine the factors related to this quality of life . MATERIAL S AND METHODS Design . r and omized , controlled , open study ( " systematic percutaneous gastrostomy " versus " no systematic gastrostomy " ) . Patients . squamous cell head and neck carcinoma ( stages III and IV , UICC 1997 ) . Setting . oncological departments of French university teaching hospitals . Treatment . optimal concomitant radio-chemotherapy . Evaluations . T0 baseline evaluation , T1 during the treatment , T2 end of the treatment , and T3 6-month post- inclusion . Primary endpoint . 6-month quality of life ( Qol ) assessed using SF36 , EORTC QLQ-C30 , EORTC QLQ H&N35 question naires . RESULTS The Qol changes from baseline included a decline ( T1 and T2 ) followed by an improvement ( T3 ) . Qol at 6 months was significantly higher in the group receiving systematic prophylactic gastrostomy ( p=10(-3 ) ) . Higher initial BMI and lower initial Karnofsky index were significant factors related to a higher 6-month Qol . CONCLUSIONS The study results suggest that prophylactic gastrostomy improves post-treatment quality of life for unresectable head and neck cancer patients , after adjusting for other potential predictive quality of life factors Malnutrition occurs frequently in patients with cancer of the gastrointestinal ( GI ) or head and neck area and can lead to negative outcomes . The aim of this study is to determine the impact of early and intensive nutrition intervention ( NI ) on body weight , body composition , nutritional status , global quality of life ( QoL ) and physical function compared to usual practice in oncology out patients receiving radiotherapy to the GI or head and neck area . Out patients commencing at least 20 fractions of radiotherapy to the GI or head and neck area were  r  and omised to receive intensive , individualised nutrition counselling by a dietitian using a st and ard protocol and oral supplements if required , or the usual practice of the centre ( general advice and nutrition booklet ) . Outcome parameters were measured at baseline and 4 , 8 and 12 weeks after commencing radiotherapy using valid and reliable tools . A total of 60 patients ( 51 M : 9F ; mean age 61.9±14.0 years ) were r and omised to receive either NI ( n=29 ) or usual care ( UC ) ( n=31 ) . The NI group had statistically smaller deteriorations in weight ( P<0.001 ) , nutritional status ( P=0.020 ) and global QoL ( P=0.009 ) compared with those receiving UC . Clinical ly , but not statistically significant differences in fat-free mass were observed between the groups ( P=0.195 ) . Early and intensive NI appears beneficial in terms of minimising weight loss , deterioration in nutritional status , global QoL and physical function in oncology out patients receiving radiotherapy to the GI or head and neck area . Weight maintenance in this population leads to beneficial outcomes and suggests that this , rather than weight gain , may be a more appropriate aim of NI Fifty ambulatory patients with head and neck cancer treated by definitive radiation therapy at the Fox Chase Cancer Center were prospect ively studied to determine the effect of oral nutritional supplements on both nutritional status and treatment response . Nutritional supplements maintained serum albumin during and post treatment . Nutritional supplements were shown to increase total protein and total calorie intake rather than displace these nutrients in usual food intake . Equal weight loss occurred in both the supplemented and non-supplemented groups during the observation period of 6 months , with the same or greater amount of weight loss registered 10 weeks after the start of 
    Output:
    