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: From 1990 to 1991 , 40 patients with squamous cell carcinoma of the thoracic oesophagus were admitted to our institutions and  chemotherapy ( oil Bleomycin p.o . and CDDP d.i.v . ) either combined with or without hyperthermia was performed , in a prospect i ve r and omized trial carried out to investigate the effects of hyperthermia . The two groups ( group A , consisting of 20 patients given chemotherapy alone ; and group B , made up of 20 given chemotherapy with hyperthermia ) were comparable with regard to various prognostic factors . Following the above treatment regimens , an oesophagectomy was done in 16 and 17 patients from groups A and B , respectively . A subjective improvement of dysphagia was seen in 8 ( 40.0 % ) , and in 14 patients ( 70.0 % ) , while a radiographic improvement was recognized in 5 ( 25.0 % ) and 10 cases ( 50.0 % ) in groups A and B , respectively . In the resected specimen of 16 ( group A ) and 17 patients ( group B ) , histopathological evidence of the effectiveness of the treatments were recognized in 3 ( 18.8 % ) and 7 ( 41.2 % ) from groups A and B , respectively . Excluding the cases of superficial carcinoma ( T1 tumour ) , histologic effectiveness of the treatments were recognized in 2 ( 14.3 % ) and 7 ( 58.3 % ) in groups A and B , respectively ( p < 0.05 ) . There was no difference in the occurrence of side effects between the groups . Therefore , the clinical and pathological effects were favourable in the hyperthermia combined with chemotherapy group , especially in the cases with advanced oesophageal cancer OBJECTIVE To evaluate the effects of continuous hyperthermic peritoneal perfusion ( CHPP ) together with st and ard chemotherapy on the prognosis of patients with gastric cancer invading the serosa . DESIGN Retrospective study . SETTING University hospital , Japan . SUBJECTS 174 patients who had undergone curative resection for gastric cancer invading the serosa ( T3 ) between 1980 and 1989 , 78 of whom had been r and omised to be treated with CHPP after operation and 96 who received st and ard chemotherapy .  INTERVENTIONS CHPP was done immediately after operation ; 8 - 10 l fluid containing 80 - 100 mg/m2 mitomycin C was perfused at a rate of 100 - 200 ml/minute , and inflow and out flow temperatures were maintained at 44 - 45 degrees C and 40 - 42 degrees C , respectively . This was followed by a st and ard regimen of mitomycin C and 1-(2-tetrahydrofuryl)-5-fluorouracil/uracil ( 1:4 ) ( UFT ) . The control group received the st and ard regimen only . MAIN OUTCOME MEASURES Five year survival and patterns of recurrence in three groups : no lymph node metastases , 1 - 9 , and 10 or more . RESULTS Only in the group with 1 - 9 lymph node metastases was there an appreciable but not significant difference in 5 year survival : 66 % compared with 44 % ( p = 0.084 ) . The mean disease free survival for patients with peritoneal metastases was 30 months in the CHPP group compared with 23 months among the controls . CONCLUSION CHPP improved prognosis in patients with T3 gastric cancer who had only 1 - 9 metastatic lymph nodes BACKGROUND Promising findings obtained using a weekly regimen of 5-fluorouracil ( 5-FU ) , epidoxorubicin , leucovorin ( LV ) , and cisplatin ( PELFw ) to treat locally advanced and metastatic gastric cancer prompted the Italian Group for the Study of Digestive Tract Cancer ( GISCAD ) to investigate the efficacy of this regimen as adjuvant treatment for high-risk radically resected gastric cancer patients . METHODS From January 1998 to January 2003 , 400 gastric cancer patients at high risk for recurrence including patients with serosal invasion ( stage pT3 N0 ) and /or lymph node metastasis ( stage pT2 or pT3 N1 , N2 , or N3 ) , were enrolled in a trial of adjuvant chemotherapies ; 201 patients were r and omly assigned to receive the  PELFw regimen , consisting of eight weekly administrations of cisplatin ( 40 mg/m2 ) , LV ( 250 mg/m2 ) , epidoxorubicin ( 35 mg/m2 ) , 5-FU ( 500 mg/m2 ) , and glutathione ( 1.5 g/m2 ) with the support of filgrastim , and 196 patients were assigned to a regimen consisting of six monthly administrations of a 5-day course of 5-FU ( 375 mg/m2 daily ) and LV ( 20 mg/m2 daily , 5-FU/LV ) . Disease-free and overall survival were estimated and compared between arms using hazard ratios ( HRs ) and Kaplan-Meier estimates . All statistical tests were two-sided . RESULTS The 5-year survival rates were 52 % in the PELFw arm and 50 % in the 5-FU/LV arm . Compared with the 5-FU/LV regimen , the PELFw regimen did not reduce the risk of death ( HR = 0.95 , 95 % confidence interval [ CI ] = 0.70 to 1.29 ) or relapse ( HR = 0.98 , 95 % CI = 0.75 to 1.29 ) . Less than 10 % of patients in either arm experienced a grade 3 or 4 toxic episode . Neutropenia ( occurring more often in the PELFw arm ) and diarrhea and mucositis ( more prevalent in the 5-FU/LV arm ) were the most common serious side effects . Nevertheless , only 19 patients ( 9.4 % ) completed the treatment in the PELFw arm and 85 ( 43 % ) patients completed the treatment in the 5-FU/LV arm . CONCLUSIONS Our study found no benefit from an intensive weekly chemotherapy in gastric cancer . The extent of toxicity experienced by the patients in the adjuvant setting suggests that , in gastric cancer , chemotherapy may be more safely administered preoperatively Purpose : This phase II r and omised trial was design ed to evaluate the therapeutic efficacy and feasibility of radio frequency regional hyperthermia in combination with chemotherapy for patients with advanced non-small lung cancer ( NSCLC ) . Methods : Eighty patients with pathologically proven advanced NSCLC , were enrolled and divided into two groups . Group A patients were treated by radio frequency regional hyperthermia in combination with the regimen of gemcitabine and cisplatin ( GP ) . Group B patients were treated with the GP regimen alone . Results : In group A , one patient achieved a complete response ( CR ) , 18 achieved a partial response ( PR ) , 18 achieved a stable disease and three experienced a progression of the disease . Thirty-three patients had a positive Clinical Benefit Response ( CBR ) . In group B , no patient achieved CR , 17 achieved PR , 19 achieved a stable disease and four experienced a progression of the disease . Nineteen patients had a positive CBR . Significant differences between the two groups were observed for the CBR ( P < 0.05 ) , but not for RR . Major toxicities included bone marrow depression , nausea , vomiting , without significant differences between the two groups ( P > 0.05 ) . Conclusions : Radio-frequency regional hyperthermia in combination with chemotherapy ( GP ) is a safe , well tolerated , and effective therapeutic modality for patients with advanced NSCLC . The addition of hyperthermia improved quality of life From 1988 to 1990 , 53 patients with squamous cell carcinoma of the thoracic oesophagus underwent subtotal oesophagectomy after either preoperative hyperthermo-chemoradiotherapy ( HCR therapy ) or chemoradiotherapy without hyperthermia ( CR therapy )  , in a prospect i ve r and omized trial carried out to examine the effects of hyperthermia given preoperatively . The two groups ( 27 patients given HCR therapy and 26 given CR therapy ) were found to be comparable with regard to prognostic factors of age , site of carcinoma , TNM stage , etc . Following preoperative evaluation by an upper GI series and endoscopy , a subtotal oesophagectomy was done for all 53 patients . All the resected specimens , including the lymph nodes , were histopathologically examined , and the effects of preoperative treatment were evaluated by findings in the upper GI series and endoscopy , as well as based on the histopathology of the excised tissues . There were no viable cancer cells in the resected specimens of seven patients in the HCR therapy group ( 26.9 % ) and of two patients in the CR therapy group ( 7.7 % ) . In addition , no hyperthermia complications were observed . The study suggests that preoperative HCR therapy may be a more beneficial therapy than preoperative CR therapy in patients with squamous cell carcinoma of the oesophagus who undergo a subtotal oesophagectomy BACKGROUND Surgical resection of adenocarcinoma of the stomach is curative in less than 40 percent of cases . We investigated the effect of surgery plus postoperative ( adjuvant ) chemoradiotherapy on the survival of patients with resectable adenocarcinoma of the stomach or gastroesophageal junction . METHODS A total of 556 patients with resected adenocarcinoma of the stomach or gastroesophageal junction were r and omly assigned to surgery plus postoperative chemoradiotherapy or surgery alone . The adjuvant treatment consisted of 425 mg of fluorouracil per square meter of body-surface area per day , plus 20 mg of leucovorin per square meter per day , for five days , followed by 4500 cGy of radiation at 180 cGy per day , given five days per week for five weeks , with modified doses of fluorouracil and leucovorin on the first four and the last three days of radiotherapy . One month after the completion of radiotherapy , two five-day cycles of fluorouracil ( 425 mg per square meter per day ) plus leucovorin ( 20 mg per square meter per day ) were given one month apart . RESULTS The median overall survival in the surgery-only group was 27 months , as compared with 36 months in the chemoradiotherapy group ; the hazard ratio for death was 1.35 ( 95 percent confidence interval , 1.09 to 1.66 ; P=0.005 ) . The hazard ratio for relapse was 1.52 ( 95 percent confidence interval , 1.23 to 1.86 ; P<0.001 ) . Three patients ( 1 percent ) died from toxic effects of the chemoradiotherapy ; grade 3 toxic effects occurred in 41 percent of the patients in the chemoradiotherapy group , and grade 4 toxic effects occurred in 32 percent . CONCLUSIONS Postoperative chemoradiotherapy should be considered for all patients at high risk for recurrence of adenocarcinoma of the stomach or gastroesophageal junction who have undergone curative resection Purpose : The aim of this report was to determine the impact of hyperthermia ( HT ) on preoperative radiochemotherapy for locally advanced rectal cancer . Material s and methods : Between 1996 and 2007 , 235 patients with locally advanced rectal cancer were treated with concurrent preoperative radiochemotherapy with or without HT . The total dose of radiotherapy was 39.6 Gy for 109 patients ( group A ) and 45 Gy for 126 patients ( group B ) . Two or three cycles of chemotherapy were administered . Hyperthermia was given immediately after radiotherapy . Results : In the HT subgroup of group A , more patients achieved down-staging of T stage when compared to the non-HT subgroup ( 57.9 % versus 38 % , p = 0.047 ) . For the cN+ subgroup of all patients , the number of patients with ypN+ were significantly less in the HT subgroup ( 25 % versus 50 % , p = 0.022 ) . In group A , HT appeared to reduce distant metastasis , increase disease-free survival , and improve overall survival . Conclusions : HT seemed to increase the response of both primary tumour and lymph nodes to preoperative radiochemotherapy in patients with locally advanced rectal cancer . The relationship between increased response by HT and survival should be confirmed by a large prospect i ve r and omised trial BACKGROUND / AIMS Although the most frequent cause of death after curative resection of advanced gastric cancer is peritoneal recurrence , there was no effective therapy for the prevention of peritoneal recurrence . This r and omized trial sought to determine whether intraoperative chemohyperthermic peritoneal perfusion could eliminate microscopic residual disease and thereby improve survival of patients with advanced gastric cancer . METHODOLOGY One-hundred and thirty-nine patients with T2 - 4 gastric cancer underwent curative gastrectomy with extended lymphadenectomy .  These patients were r and omly allocated into the following three groups . Patients in the CHPP group received surgery + chemohyperther 
    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: From 1990 to 1991 , 40 patients with squamous cell carcinoma of the thoracic oesophagus were admitted to our institutions and  chemotherapy ( oil Bleomycin p.o . and CDDP d.i.v . ) either combined with or without hyperthermia was performed , in a prospect i ve r and omized trial carried out to investigate the effects of hyperthermia . The two groups ( group A , consisting of 20 patients given chemotherapy alone ; and group B , made up of 20 given chemotherapy with hyperthermia ) were comparable with regard to various prognostic factors . Following the above treatment regimens , an oesophagectomy was done in 16 and 17 patients from groups A and B , respectively . A subjective improvement of dysphagia was seen in 8 ( 40.0 % ) , and in 14 patients ( 70.0 % ) , while a radiographic improvement was recognized in 5 ( 25.0 % ) and 10 cases ( 50.0 % ) in groups A and B , respectively . In the resected specimen of 16 ( group A ) and 17 patients ( group B ) , histopathological evidence of the effectiveness of the treatments were recognized in 3 ( 18.8 % ) and 7 ( 41.2 % ) from groups A and B , respectively . Excluding the cases of superficial carcinoma ( T1 tumour ) , histologic effectiveness of the treatments were recognized in 2 ( 14.3 % ) and 7 ( 58.3 % ) in groups A and B , respectively ( p < 0.05 ) . There was no difference in the occurrence of side effects between the groups . Therefore , the clinical and pathological effects were favourable in the hyperthermia combined with chemotherapy group , especially in the cases with advanced oesophageal cancer OBJECTIVE To evaluate the effects of continuous hyperthermic peritoneal perfusion ( CHPP ) together with st and ard chemotherapy on the prognosis of patients with gastric cancer invading the serosa . DESIGN Retrospective study . SETTING University hospital , Japan . SUBJECTS 174 patients who had undergone curative resection for gastric cancer invading the serosa ( T3 ) between 1980 and 1989 , 78 of whom had been r and omised to be treated with CHPP after operation and 96 who received st and ard chemotherapy .  INTERVENTIONS CHPP was done immediately after operation ; 8 - 10 l fluid containing 80 - 100 mg/m2 mitomycin C was perfused at a rate of 100 - 200 ml/minute , and inflow and out flow temperatures were maintained at 44 - 45 degrees C and 40 - 42 degrees C , respectively . This was followed by a st and ard regimen of mitomycin C and 1-(2-tetrahydrofuryl)-5-fluorouracil/uracil ( 1:4 ) ( UFT ) . The control group received the st and ard regimen only . MAIN OUTCOME MEASURES Five year survival and patterns of recurrence in three groups : no lymph node metastases , 1 - 9 , and 10 or more . RESULTS Only in the group with 1 - 9 lymph node metastases was there an appreciable but not significant difference in 5 year survival : 66 % compared with 44 % ( p = 0.084 ) . The mean disease free survival for patients with peritoneal metastases was 30 months in the CHPP group compared with 23 months among the controls . CONCLUSION CHPP improved prognosis in patients with T3 gastric cancer who had only 1 - 9 metastatic lymph nodes BACKGROUND Promising findings obtained using a weekly regimen of 5-fluorouracil ( 5-FU ) , epidoxorubicin , leucovorin ( LV ) , and cisplatin ( PELFw ) to treat locally advanced and metastatic gastric cancer prompted the Italian Group for the Study of Digestive Tract Cancer ( GISCAD ) to investigate the efficacy of this regimen as adjuvant treatment for high-risk radically resected gastric cancer patients . METHODS From January 1998 to January 2003 , 400 gastric cancer patients at high risk for recurrence including patients with serosal invasion ( stage pT3 N0 ) and /or lymph node metastasis ( stage pT2 or pT3 N1 , N2 , or N3 ) , were enrolled in a trial of adjuvant chemotherapies ; 201 patients were r and omly assigned to receive the  PELFw regimen , consisting of eight weekly administrations of cisplatin ( 40 mg/m2 ) , LV ( 250 mg/m2 ) , epidoxorubicin ( 35 mg/m2 ) , 5-FU ( 500 mg/m2 ) , and glutathione ( 1.5 g/m2 ) with the support of filgrastim , and 196 patients were assigned to a regimen consisting of six monthly administrations of a 5-day course of 5-FU ( 375 mg/m2 daily ) and LV ( 20 mg/m2 daily , 5-FU/LV ) . Disease-free and overall survival were estimated and compared between arms using hazard ratios ( HRs ) and Kaplan-Meier estimates . All statistical tests were two-sided . RESULTS The 5-year survival rates were 52 % in the PELFw arm and 50 % in the 5-FU/LV arm . Compared with the 5-FU/LV regimen , the PELFw regimen did not reduce the risk of death ( HR = 0.95 , 95 % confidence interval [ CI ] = 0.70 to 1.29 ) or relapse ( HR = 0.98 , 95 % CI = 0.75 to 1.29 ) . Less than 10 % of patients in either arm experienced a grade 3 or 4 toxic episode . Neutropenia ( occurring more often in the PELFw arm ) and diarrhea and mucositis ( more prevalent in the 5-FU/LV arm ) were the most common serious side effects . Nevertheless , only 19 patients ( 9.4 % ) completed the treatment in the PELFw arm and 85 ( 43 % ) patients completed the treatment in the 5-FU/LV arm . CONCLUSIONS Our study found no benefit from an intensive weekly chemotherapy in gastric cancer . The extent of toxicity experienced by the patients in the adjuvant setting suggests that , in gastric cancer , chemotherapy may be more safely administered preoperatively Purpose : This phase II r and omised trial was design ed to evaluate the therapeutic efficacy and feasibility of radio frequency regional hyperthermia in combination with chemotherapy for patients with advanced non-small lung cancer ( NSCLC ) . Methods : Eighty patients with pathologically proven advanced NSCLC , were enrolled and divided into two groups . Group A patients were treated by radio frequency regional hyperthermia in combination with the regimen of gemcitabine and cisplatin ( GP ) . Group B patients were treated with the GP regimen alone . Results : In group A , one patient achieved a complete response ( CR ) , 18 achieved a partial response ( PR ) , 18 achieved a stable disease and three experienced a progression of the disease . Thirty-three patients had a positive Clinical Benefit Response ( CBR ) . In group B , no patient achieved CR , 17 achieved PR , 19 achieved a stable disease and four experienced a progression of the disease . Nineteen patients had a positive CBR . Significant differences between the two groups were observed for the CBR ( P < 0.05 ) , but not for RR . Major toxicities included bone marrow depression , nausea , vomiting , without significant differences between the two groups ( P > 0.05 ) . Conclusions : Radio-frequency regional hyperthermia in combination with chemotherapy ( GP ) is a safe , well tolerated , and effective therapeutic modality for patients with advanced NSCLC . The addition of hyperthermia improved quality of life From 1988 to 1990 , 53 patients with squamous cell carcinoma of the thoracic oesophagus underwent subtotal oesophagectomy after either preoperative hyperthermo-chemoradiotherapy ( HCR therapy ) or chemoradiotherapy without hyperthermia ( CR therapy )  , in a prospect i ve r and omized trial carried out to examine the effects of hyperthermia given preoperatively . The two groups ( 27 patients given HCR therapy and 26 given CR therapy ) were found to be comparable with regard to prognostic factors of age , site of carcinoma , TNM stage , etc . Following preoperative evaluation by an upper GI series and endoscopy , a subtotal oesophagectomy was done for all 53 patients . All the resected specimens , including the lymph nodes , were histopathologically examined , and the effects of preoperative treatment were evaluated by findings in the upper GI series and endoscopy , as well as based on the histopathology of the excised tissues . There were no viable cancer cells in the resected specimens of seven patients in the HCR therapy group ( 26.9 % ) and of two patients in the CR therapy group ( 7.7 % ) . In addition , no hyperthermia complications were observed . The study suggests that preoperative HCR therapy may be a more beneficial therapy than preoperative CR therapy in patients with squamous cell carcinoma of the oesophagus who undergo a subtotal oesophagectomy BACKGROUND Surgical resection of adenocarcinoma of the stomach is curative in less than 40 percent of cases . We investigated the effect of surgery plus postoperative ( adjuvant ) chemoradiotherapy on the survival of patients with resectable adenocarcinoma of the stomach or gastroesophageal junction . METHODS A total of 556 patients with resected adenocarcinoma of the stomach or gastroesophageal junction were r and omly assigned to surgery plus postoperative chemoradiotherapy or surgery alone . The adjuvant treatment consisted of 425 mg of fluorouracil per square meter of body-surface area per day , plus 20 mg of leucovorin per square meter per day , for five days , followed by 4500 cGy of radiation at 180 cGy per day , given five days per week for five weeks , with modified doses of fluorouracil and leucovorin on the first four and the last three days of radiotherapy . One month after the completion of radiotherapy , two five-day cycles of fluorouracil ( 425 mg per square meter per day ) plus leucovorin ( 20 mg per square meter per day ) were given one month apart . RESULTS The median overall survival in the surgery-only group was 27 months , as compared with 36 months in the chemoradiotherapy group ; the hazard ratio for death was 1.35 ( 95 percent confidence interval , 1.09 to 1.66 ; P=0.005 ) . The hazard ratio for relapse was 1.52 ( 95 percent confidence interval , 1.23 to 1.86 ; P<0.001 ) . Three patients ( 1 percent ) died from toxic effects of the chemoradiotherapy ; grade 3 toxic effects occurred in 41 percent of the patients in the chemoradiotherapy group , and grade 4 toxic effects occurred in 32 percent . CONCLUSIONS Postoperative chemoradiotherapy should be considered for all patients at high risk for recurrence of adenocarcinoma of the stomach or gastroesophageal junction who have undergone curative resection Purpose : The aim of this report was to determine the impact of hyperthermia ( HT ) on preoperative radiochemotherapy for locally advanced rectal cancer . Material s and methods : Between 1996 and 2007 , 235 patients with locally advanced rectal cancer were treated with concurrent preoperative radiochemotherapy with or without HT . The total dose of radiotherapy was 39.6 Gy for 109 patients ( group A ) and 45 Gy for 126 patients ( group B ) . Two or three cycles of chemotherapy were administered . Hyperthermia was given immediately after radiotherapy . Results : In the HT subgroup of group A , more patients achieved down-staging of T stage when compared to the non-HT subgroup ( 57.9 % versus 38 % , p = 0.047 ) . For the cN+ subgroup of all patients , the number of patients with ypN+ were significantly less in the HT subgroup ( 25 % versus 50 % , p = 0.022 ) . In group A , HT appeared to reduce distant metastasis , increase disease-free survival , and improve overall survival . Conclusions : HT seemed to increase the response of both primary tumour and lymph nodes to preoperative radiochemotherapy in patients with locally advanced rectal cancer . The relationship between increased response by HT and survival should be confirmed by a large prospect i ve r and omised trial BACKGROUND / AIMS Although the most frequent cause of death after curative resection of advanced gastric cancer is peritoneal recurrence , there was no effective therapy for the prevention of peritoneal recurrence . This r and omized trial sought to determine whether intraoperative chemohyperthermic peritoneal perfusion could eliminate microscopic residual disease and thereby improve survival of patients with advanced gastric cancer . METHODOLOGY One-hundred and thirty-nine patients with T2 - 4 gastric cancer underwent curative gastrectomy with extended lymphadenectomy .  These patients were r and omly allocated into the following three groups . Patients in the CHPP group received surgery + chemohyperther 
    Output:
    