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: Introduction The treatment of peritoneal carcinomatosis is based on cytoreduction followed by hyperthermic intraperitoneal chemotherapy and combined with adjuvant chemotherapy . In 2003 , a r and omized trial was finished comparing systemic chemotherapy alone with cytoreduction followed by hyperthermic intraperitoneal chemotherapy and systemic chemotherapy . This trial showed a positive result favoring the studied treatment . This trial has now been up date d to a minimal follow-up of 6 years to show long-term results . Patients and Methods For all patients still alive , the follow-up was up date d until 2007 . In the original study , four patients were excluded — two because of no eligible histology/pathology and two because of major protocol violations . After r and omization , four patients in the HIPEC arm and six in the control arm were not treated using the intended therapy , one patient because of withdrawal , one because of a life-threatening other malignant disease and the others because of progressive disease before initiation of the treatment . During the follow-up , one patient was crossed over from the control arm and underwent cytoreduction and HIPEC for recurrent disease , after the assigned treatment was completed . The data from these patients were censored at the moment of the cross-over . Progression-free and disease-specific survival were analyzed using the Kaplan Meyer test and compared using the log rank method . The long-term results were studied in more detail to evaluate efficacy and toxicity . Results At the time of this up date , the median follow-up was almost 8 years ( range 72–115 months ) . In the st and ard arm , 4 patients were still alive , 2 with and 2 without disease ; in the “ HIPEC ’ arm , 5 patients were still alive , 2 with and 3 without disease . The median progression-free survival was 7.7 months in the control arm and 12.6 months in the HIPEC arm ( P = 0.020 ) . The median disease-specific survival was 12.6 months in the control arm and 22.2 months in the HIPEC arm ( P = 0.028 ) . The 5-year survival was 45 % for those patients in whom a R1 resection was achieved . Conclusion With 90 % of all events having taken place up to this time , this r and omized trial shows that cytoreduction followed by HIPEC does significantly add survival time to patients affected by peritoneal carcinomatosis of colorectal origin . For a selected group , there is a possibility of long-term survival Objective To investigate the course of health-related quality of life ( HQL ) over time in patients with peritoneal carcinomatosis ( PC ) after complete cytoreductive surgery ( CRS ) and hyperthermic intraperitoneal chemotherapy ( HIPEC ) .  Methods Prospect i ve , single-center , nonr and omized cohort study using the European Organization for Research and Treatment of Cancer Quality of Life Question naire . Results Ninety patients who underwent CRS and HIPEC for PC in our institution were enrolled in the study . Mean age was 56 years ( range 27–77 years ) ( 61 % female ) . Primary tumor was colorectal in 21 % , ovarian in 19 % , pseudomyxoma peritonei in 16 % , an appendix tumor in 16 % , gastric cancer in 10 % , and peritoneal mesothelioma in 13 % of cases . Mean peritoneal carcinomatosis index was 22 ( range 2–39 ) . Mean global health status score was 69 ± 25 preoperatively and 55 ± 20 , 66 ± 22 , 66 ± 23 , 71 ± 23 , and 78 ± 21 at months 1 , 6 , 12 , 24 , and 36 , respectively . Physical and role function recovered significantly at 6 months and were close to baseline at the 24-month measurement . Emotional function starting from a low baseline recovered to baseline by month 12 . Cognitive and social function had slow recovery on follow-up . Fatigue , diarrhea , dyspnea , and sleep disturbance were symptoms persistent at 6-month follow-up , improving later on in survivors . Conclusions Survivors after CRS and HIPEC have postoperative quality of life similar to preoperatively , with most of the reduced elements recovering after 6–12 months . We conclude that reduced quality of life of patients after CRS and HIPEC should not be used as an argument to deny surgical therapy to these patients Background Inducing oxidative stress under hyperthermic conditions significantly decreases tumor cell growth in a murine model of human colon cancer carcinomatosis . This phase I study examines the safety and pharmacokinetics of induced oxidative stress by the addition of hydrogen peroxide ( H2O2 ) to the perfusate in patients undergoing cytoreduction and hyperthermic intraperitoneal chemotherapy ( HIPEC ) for advanced abdominal-only malignancies . Methods Patients with advanced colon or appendiceal malignancies underwent maximal cytoreduction followed by HIPEC with mitomycin C ( MMC ) . In addition , H2O2 was added to the perfusate at three concentrations ( n = 3/level , 0.05 , 0.075 , 0.1 % ) . A control group consisted of patients perfused with MMC alone ( n = 3 ) . Perfusate , serum MMC , and H2O2 levels were measured , as were tissue levels of MMC . Results Twelve patients were enrolled onto this trial . The median ( range ) peritoneal carcinomatosis index was 13 ( 3–20 ) requiring a median operative time of 6.3 ( 4–8.5 ) h. The median postoperative length of stay was 9 ( 5–34 ) days , with six patients requiring readmission within 30 days . Similar complications were observed at all three H2O2 levels , as well as in the control group . One patient required reexploration for a colon perforation ( control group ) , and three patients developed enterocutaneous fistulas ( 0.075 % H2O2 , 0.1 % H2O2 and control group ) . There were no operative mortalities . Conclusions Hyperthermic intraperitoneal chemotherapy with induced oxidative stress after maximal cytoreduction is well tolerated . On the basis of the encouraging toxicity profile after cytoreduction and HIPEC with induced oxidative stress , a phase II trial to verify activity is indicated Background The purpose of our study was to determine the toxicity and quality of life for patients with peritoneal metastases after cytoreductive surgery ( CS ) plus hyperthermic intraperitoneal chemotherapy ( HIPC ) .  Methods From 2001 to 2005 , 35 consecutive patients with peritoneal metastases enrolled in a prospect i ve trial approved by the University of Minnesota Institutional Review Board . Their primary cancer sites included the appendix ( 19 patients ) , colon ( 7 ) , mesothelioma ( 3 ) , stomach ( 2 ) , small bowel ( 2 ) , gallbladder ( 1 ) , and unknown ( 1 ) . We performed CS in an effort to remove all or nearly all peritoneal tumor nodules . Using a closed technique , we administered hyperthermic mitomycin C into the peritoneal cavity for 90 min . Before treatment and then at 4-month postoperative intervals , we used the functional assessment of cancer therapy-colon subscale ( FACT-C ) instrument to assess the patients ’ quality of life . Results The median hospital stay was 9 days ; 12 patients were hospitalized at least 30 days or required readmission within 30 days after treatment . The postoperative mortality rate was 0 % ; adverse events occurred in 18 ( 51 % ) patients . As of December 2005 , 20 patients were alive ; 14 had died of progressive disease and 1 of an unrelated cause . The median survival time was 21.4 months . Quality of life measurements , including trial outcome index ( TOI ) , FACT-colon , and FACT-general , returned to baseline 4 months after treatment and were significantly improved at 8 and 12 months . Conclusions Despite early toxicity , CS plus HIPC may prolong the overall survival rate of patients with peritoneal metastases and improve quality of life measurements Background Treatment of peritoneal recurrence following surgical resection of intra-abdominal sarcomas presents a significant challenge to clinicians . Historically , treatment with systemic chemotherapy has been ineffective and surgical resection alone has not been durable . We prospect ively evaluated the feasibility of cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy ( HIPEC ) with cisplatin ( CDDP ) alone or in combination with mitoxantrone ( MITOX ) for the treatment of sarcomatosis . Methods Two phase I trials of HIPEC were conducted ( 1998–2003 ) . Eligible patients with evidence of sarcomatosis underwent cytoreductive surgery followed by HIPEC .  In the first trial , CDDP dosing was established as 90 mg/m2 with a perfusate time of 90 minutes and temperature of 41 ° C . In the second trial , MITOX ( 20 mg/m2 ) was instilled following perfusion with CDDP . Toxicity , efficacy , and quality of life ( QOL ) were evaluated . Results A total of 28 patients were enrolled in the two trials . We noted a higher overall toxicity score and complication rate with combination CDDP/MITOX versus CDDP alone and shorter overall survival duration ( 5.5 months vs 16.9 months , respectively ) . In addition , local recurrence rates were similar in both groups ( CDDP 79 % vs CDDP/MITOX 68 % ) . As expected , QOL scores at 6–8 weeks following HIPEC were 15–25 % lower than the baseline scores ; however , they returned to baseline at 3–6 months . Conclusions Although the HIPEC technique is feasible for patients with sarcomatosis , it is associated with significant toxicity and limited clinical benefit . Combination CDDP/MITOX failed to demonstrate any benefit over CDDP alone ; moreover , there was an increase in toxicity OBJECTIVE We aim ed to evaluate the feasibility and tolerability of hyperthermic intraperitoneal carboplatin ( HIPEC-carboplatin ) following secondary cytoreduction for recurrent , platinum-sensitive ovarian cancer . METHODS In a single institution prospect i ve , pilot study , ten patients underwent secondary cytoreductive surgery followed by HIPEC-carboplatin at 1000 mg/m(2 ) .  Consolidation ( 6 cycles ) was with platinum-based regimens .  Adverse and quality of life were measured throughout treatment . RESULTS Twelve patients were enrolled of which 2 were excluded ( one each for extra-abdominal disease indentified before surgery and suboptimal cytoreduction ) . All 10 remaining patients received prescribed HIPEC-carboplatin . There were no intra-operative complications or AEs attributable to HIPEC-therapy .  Grade 1/2 nausea was the most common post-operative toxicity ( 6/10 patients ) . Two patients had grade 4 post-operative neutropenia and thrombocytopenia but only one experienced transient treatment delay . The median hospital stay was 5.5 days . 69/70 ( 98 % ) of planned chemotherapy doses were ultimately delivered with 1 patient electively forgoing her final treatment . At a median ( range ) follow-up of 16 ( 6 - 23 ) months , three patients have recurred at 8 , 14 , and 16 months from surgery . The median disease-free and overall survivals have not been reached . Fact-O scores were significantly lower following surgery ( 126 vs. 108 , p<.01 ) , but improved by completion of therapy ( 108 vs. 113 , p=0.27 ) . CONCLUSIONS HIPEC-carboplatin at 1000 mg/m(2 ) following optimal cytoreduction for ovarian cancer is feasible . Surgical complications were not observed , and post-operative AEs were largely within expected ranges . Consolidation using st and ard platinum-based regimens was feasible following HIPEC-carboplatin , and preliminary survival data suggests efficacy . Further investigation of HIPEC-carboplatin in the setting of debulkable cancer recurrence is warranted INTRODUCTION Cytoreductive Surgery ( CRS ) and Hyperthermic Intraperitoneal Chemotherapy ( HIPEC ) have demonstrated promising results in the treatment of peritoneal carcinomatosis ( PC ) . The purpose of this study was to assess the impact of this combined procedure on quality of life ( QoL ) . MATERIAL S AND METHODS A prospect i ve single centre study of 216 consecutive patients treated with CRS and HIPEC  was conducted using the Gastro-Intestinal Quality of Life Index question naire ( GIQLI ) , completed preoperatively and at 1 , 3 , 6 and 12 months . RESULTS Question naire compliance was 81 % , 90 % , 89 % , 89 % and 74 % at baseline , 1 , 3 , 6 and 12 months respectively . QoL was significantly decreased up to 6 months and returned to baseline at 12 months . In multivariate analysis , factors decreasing QoL were origin of PC at 3 months , presence of stoma at 6 months and length of surgery over 270 min and disease recurrence at 12 months . CONCLUSIONS Despite morbidity associated with CRS and HIPEC , QoL returned to baseline at one year after surg 
    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: Introduction The treatment of peritoneal carcinomatosis is based on cytoreduction followed by hyperthermic intraperitoneal chemotherapy and combined with adjuvant chemotherapy . In 2003 , a r and omized trial was finished comparing systemic chemotherapy alone with cytoreduction followed by hyperthermic intraperitoneal chemotherapy and systemic chemotherapy . This trial showed a positive result favoring the studied treatment . This trial has now been up date d to a minimal follow-up of 6 years to show long-term results . Patients and Methods For all patients still alive , the follow-up was up date d until 2007 . In the original study , four patients were excluded — two because of no eligible histology/pathology and two because of major protocol violations . After r and omization , four patients in the HIPEC arm and six in the control arm were not treated using the intended therapy , one patient because of withdrawal , one because of a life-threatening other malignant disease and the others because of progressive disease before initiation of the treatment . During the follow-up , one patient was crossed over from the control arm and underwent cytoreduction and HIPEC for recurrent disease , after the assigned treatment was completed . The data from these patients were censored at the moment of the cross-over . Progression-free and disease-specific survival were analyzed using the Kaplan Meyer test and compared using the log rank method . The long-term results were studied in more detail to evaluate efficacy and toxicity . Results At the time of this up date , the median follow-up was almost 8 years ( range 72–115 months ) . In the st and ard arm , 4 patients were still alive , 2 with and 2 without disease ; in the “ HIPEC ’ arm , 5 patients were still alive , 2 with and 3 without disease . The median progression-free survival was 7.7 months in the control arm and 12.6 months in the HIPEC arm ( P = 0.020 ) . The median disease-specific survival was 12.6 months in the control arm and 22.2 months in the HIPEC arm ( P = 0.028 ) . The 5-year survival was 45 % for those patients in whom a R1 resection was achieved . Conclusion With 90 % of all events having taken place up to this time , this r and omized trial shows that cytoreduction followed by HIPEC does significantly add survival time to patients affected by peritoneal carcinomatosis of colorectal origin . For a selected group , there is a possibility of long-term survival Objective To investigate the course of health-related quality of life ( HQL ) over time in patients with peritoneal carcinomatosis ( PC ) after complete cytoreductive surgery ( CRS ) and hyperthermic intraperitoneal chemotherapy ( HIPEC ) .  Methods Prospect i ve , single-center , nonr and omized cohort study using the European Organization for Research and Treatment of Cancer Quality of Life Question naire . Results Ninety patients who underwent CRS and HIPEC for PC in our institution were enrolled in the study . Mean age was 56 years ( range 27–77 years ) ( 61 % female ) . Primary tumor was colorectal in 21 % , ovarian in 19 % , pseudomyxoma peritonei in 16 % , an appendix tumor in 16 % , gastric cancer in 10 % , and peritoneal mesothelioma in 13 % of cases . Mean peritoneal carcinomatosis index was 22 ( range 2–39 ) . Mean global health status score was 69 ± 25 preoperatively and 55 ± 20 , 66 ± 22 , 66 ± 23 , 71 ± 23 , and 78 ± 21 at months 1 , 6 , 12 , 24 , and 36 , respectively . Physical and role function recovered significantly at 6 months and were close to baseline at the 24-month measurement . Emotional function starting from a low baseline recovered to baseline by month 12 . Cognitive and social function had slow recovery on follow-up . Fatigue , diarrhea , dyspnea , and sleep disturbance were symptoms persistent at 6-month follow-up , improving later on in survivors . Conclusions Survivors after CRS and HIPEC have postoperative quality of life similar to preoperatively , with most of the reduced elements recovering after 6–12 months . We conclude that reduced quality of life of patients after CRS and HIPEC should not be used as an argument to deny surgical therapy to these patients Background Inducing oxidative stress under hyperthermic conditions significantly decreases tumor cell growth in a murine model of human colon cancer carcinomatosis . This phase I study examines the safety and pharmacokinetics of induced oxidative stress by the addition of hydrogen peroxide ( H2O2 ) to the perfusate in patients undergoing cytoreduction and hyperthermic intraperitoneal chemotherapy ( HIPEC ) for advanced abdominal-only malignancies . Methods Patients with advanced colon or appendiceal malignancies underwent maximal cytoreduction followed by HIPEC with mitomycin C ( MMC ) . In addition , H2O2 was added to the perfusate at three concentrations ( n = 3/level , 0.05 , 0.075 , 0.1 % ) . A control group consisted of patients perfused with MMC alone ( n = 3 ) . Perfusate , serum MMC , and H2O2 levels were measured , as were tissue levels of MMC . Results Twelve patients were enrolled onto this trial . The median ( range ) peritoneal carcinomatosis index was 13 ( 3–20 ) requiring a median operative time of 6.3 ( 4–8.5 ) h. The median postoperative length of stay was 9 ( 5–34 ) days , with six patients requiring readmission within 30 days . Similar complications were observed at all three H2O2 levels , as well as in the control group . One patient required reexploration for a colon perforation ( control group ) , and three patients developed enterocutaneous fistulas ( 0.075 % H2O2 , 0.1 % H2O2 and control group ) . There were no operative mortalities . Conclusions Hyperthermic intraperitoneal chemotherapy with induced oxidative stress after maximal cytoreduction is well tolerated . On the basis of the encouraging toxicity profile after cytoreduction and HIPEC with induced oxidative stress , a phase II trial to verify activity is indicated Background The purpose of our study was to determine the toxicity and quality of life for patients with peritoneal metastases after cytoreductive surgery ( CS ) plus hyperthermic intraperitoneal chemotherapy ( HIPC ) .  Methods From 2001 to 2005 , 35 consecutive patients with peritoneal metastases enrolled in a prospect i ve trial approved by the University of Minnesota Institutional Review Board . Their primary cancer sites included the appendix ( 19 patients ) , colon ( 7 ) , mesothelioma ( 3 ) , stomach ( 2 ) , small bowel ( 2 ) , gallbladder ( 1 ) , and unknown ( 1 ) . We performed CS in an effort to remove all or nearly all peritoneal tumor nodules . Using a closed technique , we administered hyperthermic mitomycin C into the peritoneal cavity for 90 min . Before treatment and then at 4-month postoperative intervals , we used the functional assessment of cancer therapy-colon subscale ( FACT-C ) instrument to assess the patients ’ quality of life . Results The median hospital stay was 9 days ; 12 patients were hospitalized at least 30 days or required readmission within 30 days after treatment . The postoperative mortality rate was 0 % ; adverse events occurred in 18 ( 51 % ) patients . As of December 2005 , 20 patients were alive ; 14 had died of progressive disease and 1 of an unrelated cause . The median survival time was 21.4 months . Quality of life measurements , including trial outcome index ( TOI ) , FACT-colon , and FACT-general , returned to baseline 4 months after treatment and were significantly improved at 8 and 12 months . Conclusions Despite early toxicity , CS plus HIPC may prolong the overall survival rate of patients with peritoneal metastases and improve quality of life measurements Background Treatment of peritoneal recurrence following surgical resection of intra-abdominal sarcomas presents a significant challenge to clinicians . Historically , treatment with systemic chemotherapy has been ineffective and surgical resection alone has not been durable . We prospect ively evaluated the feasibility of cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy ( HIPEC ) with cisplatin ( CDDP ) alone or in combination with mitoxantrone ( MITOX ) for the treatment of sarcomatosis . Methods Two phase I trials of HIPEC were conducted ( 1998–2003 ) . Eligible patients with evidence of sarcomatosis underwent cytoreductive surgery followed by HIPEC .  In the first trial , CDDP dosing was established as 90 mg/m2 with a perfusate time of 90 minutes and temperature of 41 ° C . In the second trial , MITOX ( 20 mg/m2 ) was instilled following perfusion with CDDP . Toxicity , efficacy , and quality of life ( QOL ) were evaluated . Results A total of 28 patients were enrolled in the two trials . We noted a higher overall toxicity score and complication rate with combination CDDP/MITOX versus CDDP alone and shorter overall survival duration ( 5.5 months vs 16.9 months , respectively ) . In addition , local recurrence rates were similar in both groups ( CDDP 79 % vs CDDP/MITOX 68 % ) . As expected , QOL scores at 6–8 weeks following HIPEC were 15–25 % lower than the baseline scores ; however , they returned to baseline at 3–6 months . Conclusions Although the HIPEC technique is feasible for patients with sarcomatosis , it is associated with significant toxicity and limited clinical benefit . Combination CDDP/MITOX failed to demonstrate any benefit over CDDP alone ; moreover , there was an increase in toxicity OBJECTIVE We aim ed to evaluate the feasibility and tolerability of hyperthermic intraperitoneal carboplatin ( HIPEC-carboplatin ) following secondary cytoreduction for recurrent , platinum-sensitive ovarian cancer . METHODS In a single institution prospect i ve , pilot study , ten patients underwent secondary cytoreductive surgery followed by HIPEC-carboplatin at 1000 mg/m(2 ) .  Consolidation ( 6 cycles ) was with platinum-based regimens .  Adverse and quality of life were measured throughout treatment . RESULTS Twelve patients were enrolled of which 2 were excluded ( one each for extra-abdominal disease indentified before surgery and suboptimal cytoreduction ) . All 10 remaining patients received prescribed HIPEC-carboplatin . There were no intra-operative complications or AEs attributable to HIPEC-therapy .  Grade 1/2 nausea was the most common post-operative toxicity ( 6/10 patients ) . Two patients had grade 4 post-operative neutropenia and thrombocytopenia but only one experienced transient treatment delay . The median hospital stay was 5.5 days . 69/70 ( 98 % ) of planned chemotherapy doses were ultimately delivered with 1 patient electively forgoing her final treatment . At a median ( range ) follow-up of 16 ( 6 - 23 ) months , three patients have recurred at 8 , 14 , and 16 months from surgery . The median disease-free and overall survivals have not been reached . Fact-O scores were significantly lower following surgery ( 126 vs. 108 , p<.01 ) , but improved by completion of therapy ( 108 vs. 113 , p=0.27 ) . CONCLUSIONS HIPEC-carboplatin at 1000 mg/m(2 ) following optimal cytoreduction for ovarian cancer is feasible . Surgical complications were not observed , and post-operative AEs were largely within expected ranges . Consolidation using st and ard platinum-based regimens was feasible following HIPEC-carboplatin , and preliminary survival data suggests efficacy . Further investigation of HIPEC-carboplatin in the setting of debulkable cancer recurrence is warranted INTRODUCTION Cytoreductive Surgery ( CRS ) and Hyperthermic Intraperitoneal Chemotherapy ( HIPEC ) have demonstrated promising results in the treatment of peritoneal carcinomatosis ( PC ) . The purpose of this study was to assess the impact of this combined procedure on quality of life ( QoL ) . MATERIAL S AND METHODS A prospect i ve single centre study of 216 consecutive patients treated with CRS and HIPEC  was conducted using the Gastro-Intestinal Quality of Life Index question naire ( GIQLI ) , completed preoperatively and at 1 , 3 , 6 and 12 months . RESULTS Question naire compliance was 81 % , 90 % , 89 % , 89 % and 74 % at baseline , 1 , 3 , 6 and 12 months respectively . QoL was significantly decreased up to 6 months and returned to baseline at 12 months . In multivariate analysis , factors decreasing QoL were origin of PC at 3 months , presence of stoma at 6 months and length of surgery over 270 min and disease recurrence at 12 months . CONCLUSIONS Despite morbidity associated with CRS and HIPEC , QoL returned to baseline at one year after surg 
    Output:
    