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: PURPOSE This multi-institutional Phase III r and omized study compared 10 Gy single-fraction radiotherapy ( RT ) with 20 Gy in five fractions in the palliation of thoracic symptoms from lung cancer . METHODS AND MATERIAL S The primary end point was palliation of thoracic symptoms at 1 month after RT , evaluated by a patient-completed daily diary card . Secondary end points included quality of life , toxicity , and survival . RESULTS Most ( 69 % ) of 230 patients r and omized had locally advanced disease unsuitable for curative treatment . The treatment arms were well balanced with respect to the known prognostic factors . At 1 month after RT , no difference was found in symptom control between the two arms , as judged by the daily diary scores . The changes in the scores on the Lung Cancer Symptom Scale indicated that the fractionated RT ( five fractions ) group had greater improvement in symptoms related to lung cancer ( p = 0.009 ) , pain ( p = 0.0008 ) , ability to carry out normal activities ( p = 0.037 ) , and better global quality of life ( p = 0.039 ) . The European Organization for Research and Treatment of Cancer QLQ-C30 scores showed that patients receiving five fractions had a greater improvement in scores with respect to pain ( p = 0.04 ) . No significant difference was found in treatment-related toxicity . Patients who received five fractions survived on average 2 months longer ( p = 0.0305 ) than patients who received one fraction . CONCLUSION Although the two treatment strategies provided a similar degree of palliation of thoracic symptoms , the difference in survival between the two study arms was of a clinical ly relevant magnitude A phase III r and omized trial was conducted to investigate whether induction chemotherapy followed by radiation can influence survival as compared with radiation alone in unresectable , locally advanced non-small-cell lung cancer ( LADNSCLC ) . A total of 101 patients with unresectable stage IIIA or IIIB NSCLC were enrolled . Patients were stratified by performance status , weight loss , histology and stage , and then r and omized to receive combined chemoradiotherapy or radiotherapy alone . Radiotherapy was administered in 1.8 Gy to 2.0 Gy st and ard fractions daily 5 times weekly for a total dose of 60 Gy to 65 Gy . The combined group received induction of cisplatin , etoposide , and vinblastine ( PEV ) chemotherapy with cisplatin 20 mg/m2 on days 1 to 5 , etoposide 100 mg/m2 on days 2 to 4 , and vinblastine 6 mg/m2 on day 1 , which wasrepeated every 3 weeks for 3 courses , after which time the patients underwent radiotherapy .  Of 101 patients registered , 89 patients ( 43 combined , 46 radiotherapy alone ) were eligible for analysis . The response rates for the combined and radiotherapy groups were 65 % ( 28/43 ) and 70 % ( 32/46 ) , respectively . The median survival time ( MST ) showed a tendency to be more prolonged in the combined group than in the group receiving radiotherapy alone ( 13.8 vs. 8.5 months ) . The MST in patients with nonsquamous histology was strikingly prolonged in the combined group as compared with the radiotherapy group ( 14 vs. 3.6 months , p 0.027 ) . Likewise , the MST in patients with stage IIIB was significantly prolonged in the combined group as compared with the radiotherapy group ( 11.1 vs. 7.2 months , p 0.045 ) . Together , the MST of the high-risk group with nonsquamous or stage IIIB was significantly higher in the combined group than that seen in the radiotherapy group ( 11.6 vs. 8 months , p 0.046 ) , whereas the MST of the low-risk group , defined as having both squamous histology and stage IIIA , was similar in the two treatment groups ( 18.3 vs. 20.8 months , p = 0.293 ) . In conclusion , induction PEV chemotherapy plus radiotherapy is superior to radiotherapy alone in high-risk subsets of unresectable LAD-NSCLC and therapeutic strategy should be based on the identification of prognostic factors Two policies of palliative thoracic radiotherapy for non-small-cell lung cancer have been compared in a r and omised multicentre controlled trial . A total of 369 patients with inoperable , histologically or cytologically confirmed disease , too advanced for radical ' curative ' radiotherapy , and with their main symptoms related to the primary intrathoracic tumour even if metastases were present , were studied . They were allocated at r and om either to a regimen of 17 Gy given in two fractions of 8.5 Gy 1 week apart ( F2 regimen ) , or to a conventional multifractionated regimen of either 30 Gy in ten fractions or 27 Gy in six fractions ( a biologically equivalent dose ) , given daily except at weekends ( FM regimen ) . On admission , 93 % of the patients had cough , 47 % haemoptysis , 57 % chest pain , 58 % anorexia  , and 11 %  dysphagia . As assessed by the clinicians , palliation of the main symptoms was achieved in high proportions of patients ranging in the F2 group from 65 % for cough to 81 % for haemoptysis and in the FM group from 56 % for cough to 86 % for haemoptysis . Haemoptysis , chest pain , and anorexia disappeared for a time in well over half the patients with these symptoms , and cough in 37 % . For all the main symptoms , the median duration of palliation was 50 % or more of survival . Performance status improved in approximately half of the patients with a poor status on admission . All these results were similar in the two treatment groups . As assessed daily by the patients using a diary card , the quality of life deteriorated slightly during treatment but then improved steadily during the next 5 weeks . The proportion of patients with dysphagia increased considerably during treatment , but fell to the pretreatment level during the next 2 weeks . The results were similar in the two groups . Radiation myelopathy was suspected in one ( F2 ) patient . There was no difference in survival between the two groups ( log-rank test ) , the median survival time from the date of allocation being 179 days in the F2 and 177 days in the FM group . In the light of all the findings , the regimen of two fractions of 8.5 Gy given 1 week apart is recommended PURPOSE We conducted a phase III study to compare the survival impact of concurrent versus sequential treatment with radiotherapy ( RT ) and chemotherapy ( CT ) in unresectable stage III non-small-cell lung cancer ( NSCLC ) . PATIENTS AND METHODS Patients were r and omly assigned to one of the two treatment arms . In the sequential arm , patients received induction CT with cisplatin ( 120 mg/m2 ) on days 1 , 29 , and 57 , and vinorelbine ( 30 mg/m2/wk ) from day 1 to day 78 , followed by thoracic RT at a dose of 66 Gy in 33 fractions ( 2 Gy per fraction and 5 fractions per week ) . In the concurrent arm , the same RT was started on day 1 with two concurrent cycles of cisplatin 20 mg/m2/d and etoposide 50 mg/m2/d ( days 1 to 5 and days 29 to 33 ) ; patients then received consolidation therapy with cisplatin 80 mg/m2 on days 78 and 106 and vinorelbine 30 mg/m2/wk from days 78 to 127 . RESULTS Two hundred five patients were r and omly assigned . Pretreatment characteristics were well balanced between the two arms . There were six toxic deaths in the sequential arm and 10 in the concurrent arm . Median survival was 14.5 months in the sequential arm and 16.3 months in the concurrent arm ( log-rank test P = .24 ) . Two- , 3- , and 4-year survival rates were better in the concurrent arm ( 39 % , 25 % , and 21 % , respectively ) than in the sequential arm ( 26 % , 19 % , and 14 % , respectively ) . Esophageal toxicity was significantly more frequent in the concurrent arm than in the sequential arm ( 32 % v 3 % ) . CONCLUSION Although not statistically significant , clinical ly important differences in the median , 2- , 3- , and 4-year survival rates were observed , with a trend in favor of concurrent chemoradiation therapy , suggesting that is the optimal strategy for patients with locally advanced NSCLC PURPOSE The cisplatin-vinorelbine regimen has superior activity in advanced non-small-cell lung cancer ( NSCLC ) . We conducted a phase I trial to identify the maximum-tolerated dose ( MTD ) and dose-limiting toxicities ( DLTs ) of this regimen with concomitant thoracic radiation ( RT ) in patients with advanced chest malignancies . PATIENTS AND METHODS Patients with advanced chest malignancies that required RT were enrolled onto this phase I study of st and ard chest radiation ( 30 daily 2-Gy fractions for a total of 60 Gy ) and concurrent chemotherapy with cisplatin starting at 100 mg/m2 every 3 weeks and vinorelbine starting at 20 mg/m2/wk . RESULTS Thirty-seven patients were treated on this study . Two of three patients treated at the maximum-administered dose of cisplatin 100 mg/m2 per cycle and vinorelbine 25 mg/m2/wk experienced acute DLT ( neutropenia ) , which required deescalation . The dose level of cisplatin 100 mg/m2 and vinorelbine 20 mg/m2/wk , although tolerated acutely , produced delayed esophagitis , which proved dose-limiting . The recommended phase II dose was cisplatin 80 mg/m2 every 3 weeks and vinorelbine 15 mg/m2 given 2 of every 3 weeks with concomitant chest RT . CONCLUSION Concomitant chemoradiotherapy with cisplatin and vinorelbine is feasible . The recommended phase II dose is cisplatin 80 mg/m2 every 3 weeks with vinorelbine 15 mg/m2 given twice over 3 weeks on a day 1/day 8 schedule . Esophagitis is the DLT , with neutropenia occurring at higher dose levels . A Cancer and Leukemia Group B ( CALGB ) phase II trial is currently underway to evaluate further the efficacy and toxicities of this regimen in unresectable stage III NSCLC PURPOSE To determine the radiosensitizing effect of prolonged exposure of carboplatin in patients with locally unresectable non-small-cell lung cancer ( NSCLC ) . PATIENTS AND METHODS Patients with histologically proven NSCLC , performance score < 2 , weight loss < 10 % , and normal organ functions were r and omized between carboplatin 840 mg/m2 administered continuously during 6 weeks of radiotherapy or thoracic radiotherapy alone ( both 60 Gy ) . Toxicity was evaluated with National Cancer Institute Common Toxicity Criteria ( NCI CTC ) and the Radiation Therapy Oncology Group ( RTOG ) criteria . Quality of life was measured with European Organization for Research and Treatment of Cancer ( EORTC ) QLQ-C30/LC13 question naires . RESULTS One-hundred and sixty patients were included . Pathologically confirmed persistent tumor was present in 53 % of patients in the combination arm versus 58 % in the radiotherapy alone arm ( P=0.5 ) . Median survival in the combination arm was 11.8 [ 95 % confidence interval ( CI ) 9.3 - 14.2 ] months and in the radiotherapy alone arm 11.7 ( 95 % CI 8.1 - 15.5 ) months ; progression-free survival was not different between arms [ 6.8 and 7.5 months , respectively ( P=0.28 ) ] . Acute toxicity was mild , late toxicity was radiation-induced cardiomyopathy ( three patients ) and pulmonary fibrosis ( five patients ) . Quality of life was not different between arms , but in all measured patients cough and dyspnea improved , pain became less , and slight paresthesia developed 3 months after treatment . CONCLUSION Addition of continuously administered carboplatin as radiosensitizer for locally unresectable NSCLC does not improve local tumor control or overall survival Eighty one patients with inoperable non-small cell lung carcinoma ( NSCLC ) were entered in a r and omized phase II trial comparing split-dose irradiation alone to combined treatment radiotherapy and polychemotherapy ( C.A.P. + V.D.S. ) . The quality of life and the survival of the patients were studied . We have defined three classes of quality of life responses based on the time elapsed before the performance status index drops . A higher quality of life failure rate was observed in the combined treatment group ( p non-significant ) but the time elapsed before the Karnofsky index drops is longer in the combined treatment group for the quality of life " no change " subgroup ( p = 0.15 ) . Survival and quality adjusted survival are similar in both treatment groups . The same conclusion holds for retrospective stratified treatment groups . The results of the study are presented according to the decision tree theory . We conclude that as far as the quality of life is concerned , pol 
    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: PURPOSE This multi-institutional Phase III r and omized study compared 10 Gy single-fraction radiotherapy ( RT ) with 20 Gy in five fractions in the palliation of thoracic symptoms from lung cancer . METHODS AND MATERIAL S The primary end point was palliation of thoracic symptoms at 1 month after RT , evaluated by a patient-completed daily diary card . Secondary end points included quality of life , toxicity , and survival . RESULTS Most ( 69 % ) of 230 patients r and omized had locally advanced disease unsuitable for curative treatment . The treatment arms were well balanced with respect to the known prognostic factors . At 1 month after RT , no difference was found in symptom control between the two arms , as judged by the daily diary scores . The changes in the scores on the Lung Cancer Symptom Scale indicated that the fractionated RT ( five fractions ) group had greater improvement in symptoms related to lung cancer ( p = 0.009 ) , pain ( p = 0.0008 ) , ability to carry out normal activities ( p = 0.037 ) , and better global quality of life ( p = 0.039 ) . The European Organization for Research and Treatment of Cancer QLQ-C30 scores showed that patients receiving five fractions had a greater improvement in scores with respect to pain ( p = 0.04 ) . No significant difference was found in treatment-related toxicity . Patients who received five fractions survived on average 2 months longer ( p = 0.0305 ) than patients who received one fraction . CONCLUSION Although the two treatment strategies provided a similar degree of palliation of thoracic symptoms , the difference in survival between the two study arms was of a clinical ly relevant magnitude A phase III r and omized trial was conducted to investigate whether induction chemotherapy followed by radiation can influence survival as compared with radiation alone in unresectable , locally advanced non-small-cell lung cancer ( LADNSCLC ) . A total of 101 patients with unresectable stage IIIA or IIIB NSCLC were enrolled . Patients were stratified by performance status , weight loss , histology and stage , and then r and omized to receive combined chemoradiotherapy or radiotherapy alone . Radiotherapy was administered in 1.8 Gy to 2.0 Gy st and ard fractions daily 5 times weekly for a total dose of 60 Gy to 65 Gy . The combined group received induction of cisplatin , etoposide , and vinblastine ( PEV ) chemotherapy with cisplatin 20 mg/m2 on days 1 to 5 , etoposide 100 mg/m2 on days 2 to 4 , and vinblastine 6 mg/m2 on day 1 , which wasrepeated every 3 weeks for 3 courses , after which time the patients underwent radiotherapy .  Of 101 patients registered , 89 patients ( 43 combined , 46 radiotherapy alone ) were eligible for analysis . The response rates for the combined and radiotherapy groups were 65 % ( 28/43 ) and 70 % ( 32/46 ) , respectively . The median survival time ( MST ) showed a tendency to be more prolonged in the combined group than in the group receiving radiotherapy alone ( 13.8 vs. 8.5 months ) . The MST in patients with nonsquamous histology was strikingly prolonged in the combined group as compared with the radiotherapy group ( 14 vs. 3.6 months , p 0.027 ) . Likewise , the MST in patients with stage IIIB was significantly prolonged in the combined group as compared with the radiotherapy group ( 11.1 vs. 7.2 months , p 0.045 ) . Together , the MST of the high-risk group with nonsquamous or stage IIIB was significantly higher in the combined group than that seen in the radiotherapy group ( 11.6 vs. 8 months , p 0.046 ) , whereas the MST of the low-risk group , defined as having both squamous histology and stage IIIA , was similar in the two treatment groups ( 18.3 vs. 20.8 months , p = 0.293 ) . In conclusion , induction PEV chemotherapy plus radiotherapy is superior to radiotherapy alone in high-risk subsets of unresectable LAD-NSCLC and therapeutic strategy should be based on the identification of prognostic factors Two policies of palliative thoracic radiotherapy for non-small-cell lung cancer have been compared in a r and omised multicentre controlled trial . A total of 369 patients with inoperable , histologically or cytologically confirmed disease , too advanced for radical ' curative ' radiotherapy , and with their main symptoms related to the primary intrathoracic tumour even if metastases were present , were studied . They were allocated at r and om either to a regimen of 17 Gy given in two fractions of 8.5 Gy 1 week apart ( F2 regimen ) , or to a conventional multifractionated regimen of either 30 Gy in ten fractions or 27 Gy in six fractions ( a biologically equivalent dose ) , given daily except at weekends ( FM regimen ) . On admission , 93 % of the patients had cough , 47 % haemoptysis , 57 % chest pain , 58 % anorexia  , and 11 %  dysphagia . As assessed by the clinicians , palliation of the main symptoms was achieved in high proportions of patients ranging in the F2 group from 65 % for cough to 81 % for haemoptysis and in the FM group from 56 % for cough to 86 % for haemoptysis . Haemoptysis , chest pain , and anorexia disappeared for a time in well over half the patients with these symptoms , and cough in 37 % . For all the main symptoms , the median duration of palliation was 50 % or more of survival . Performance status improved in approximately half of the patients with a poor status on admission . All these results were similar in the two treatment groups . As assessed daily by the patients using a diary card , the quality of life deteriorated slightly during treatment but then improved steadily during the next 5 weeks . The proportion of patients with dysphagia increased considerably during treatment , but fell to the pretreatment level during the next 2 weeks . The results were similar in the two groups . Radiation myelopathy was suspected in one ( F2 ) patient . There was no difference in survival between the two groups ( log-rank test ) , the median survival time from the date of allocation being 179 days in the F2 and 177 days in the FM group . In the light of all the findings , the regimen of two fractions of 8.5 Gy given 1 week apart is recommended PURPOSE We conducted a phase III study to compare the survival impact of concurrent versus sequential treatment with radiotherapy ( RT ) and chemotherapy ( CT ) in unresectable stage III non-small-cell lung cancer ( NSCLC ) . PATIENTS AND METHODS Patients were r and omly assigned to one of the two treatment arms . In the sequential arm , patients received induction CT with cisplatin ( 120 mg/m2 ) on days 1 , 29 , and 57 , and vinorelbine ( 30 mg/m2/wk ) from day 1 to day 78 , followed by thoracic RT at a dose of 66 Gy in 33 fractions ( 2 Gy per fraction and 5 fractions per week ) . In the concurrent arm , the same RT was started on day 1 with two concurrent cycles of cisplatin 20 mg/m2/d and etoposide 50 mg/m2/d ( days 1 to 5 and days 29 to 33 ) ; patients then received consolidation therapy with cisplatin 80 mg/m2 on days 78 and 106 and vinorelbine 30 mg/m2/wk from days 78 to 127 . RESULTS Two hundred five patients were r and omly assigned . Pretreatment characteristics were well balanced between the two arms . There were six toxic deaths in the sequential arm and 10 in the concurrent arm . Median survival was 14.5 months in the sequential arm and 16.3 months in the concurrent arm ( log-rank test P = .24 ) . Two- , 3- , and 4-year survival rates were better in the concurrent arm ( 39 % , 25 % , and 21 % , respectively ) than in the sequential arm ( 26 % , 19 % , and 14 % , respectively ) . Esophageal toxicity was significantly more frequent in the concurrent arm than in the sequential arm ( 32 % v 3 % ) . CONCLUSION Although not statistically significant , clinical ly important differences in the median , 2- , 3- , and 4-year survival rates were observed , with a trend in favor of concurrent chemoradiation therapy , suggesting that is the optimal strategy for patients with locally advanced NSCLC PURPOSE The cisplatin-vinorelbine regimen has superior activity in advanced non-small-cell lung cancer ( NSCLC ) . We conducted a phase I trial to identify the maximum-tolerated dose ( MTD ) and dose-limiting toxicities ( DLTs ) of this regimen with concomitant thoracic radiation ( RT ) in patients with advanced chest malignancies . PATIENTS AND METHODS Patients with advanced chest malignancies that required RT were enrolled onto this phase I study of st and ard chest radiation ( 30 daily 2-Gy fractions for a total of 60 Gy ) and concurrent chemotherapy with cisplatin starting at 100 mg/m2 every 3 weeks and vinorelbine starting at 20 mg/m2/wk . RESULTS Thirty-seven patients were treated on this study . Two of three patients treated at the maximum-administered dose of cisplatin 100 mg/m2 per cycle and vinorelbine 25 mg/m2/wk experienced acute DLT ( neutropenia ) , which required deescalation . The dose level of cisplatin 100 mg/m2 and vinorelbine 20 mg/m2/wk , although tolerated acutely , produced delayed esophagitis , which proved dose-limiting . The recommended phase II dose was cisplatin 80 mg/m2 every 3 weeks and vinorelbine 15 mg/m2 given 2 of every 3 weeks with concomitant chest RT . CONCLUSION Concomitant chemoradiotherapy with cisplatin and vinorelbine is feasible . The recommended phase II dose is cisplatin 80 mg/m2 every 3 weeks with vinorelbine 15 mg/m2 given twice over 3 weeks on a day 1/day 8 schedule . Esophagitis is the DLT , with neutropenia occurring at higher dose levels . A Cancer and Leukemia Group B ( CALGB ) phase II trial is currently underway to evaluate further the efficacy and toxicities of this regimen in unresectable stage III NSCLC PURPOSE To determine the radiosensitizing effect of prolonged exposure of carboplatin in patients with locally unresectable non-small-cell lung cancer ( NSCLC ) . PATIENTS AND METHODS Patients with histologically proven NSCLC , performance score < 2 , weight loss < 10 % , and normal organ functions were r and omized between carboplatin 840 mg/m2 administered continuously during 6 weeks of radiotherapy or thoracic radiotherapy alone ( both 60 Gy ) . Toxicity was evaluated with National Cancer Institute Common Toxicity Criteria ( NCI CTC ) and the Radiation Therapy Oncology Group ( RTOG ) criteria . Quality of life was measured with European Organization for Research and Treatment of Cancer ( EORTC ) QLQ-C30/LC13 question naires . RESULTS One-hundred and sixty patients were included . Pathologically confirmed persistent tumor was present in 53 % of patients in the combination arm versus 58 % in the radiotherapy alone arm ( P=0.5 ) . Median survival in the combination arm was 11.8 [ 95 % confidence interval ( CI ) 9.3 - 14.2 ] months and in the radiotherapy alone arm 11.7 ( 95 % CI 8.1 - 15.5 ) months ; progression-free survival was not different between arms [ 6.8 and 7.5 months , respectively ( P=0.28 ) ] . Acute toxicity was mild , late toxicity was radiation-induced cardiomyopathy ( three patients ) and pulmonary fibrosis ( five patients ) . Quality of life was not different between arms , but in all measured patients cough and dyspnea improved , pain became less , and slight paresthesia developed 3 months after treatment . CONCLUSION Addition of continuously administered carboplatin as radiosensitizer for locally unresectable NSCLC does not improve local tumor control or overall survival Eighty one patients with inoperable non-small cell lung carcinoma ( NSCLC ) were entered in a r and omized phase II trial comparing split-dose irradiation alone to combined treatment radiotherapy and polychemotherapy ( C.A.P. + V.D.S. ) . The quality of life and the survival of the patients were studied . We have defined three classes of quality of life responses based on the time elapsed before the performance status index drops . A higher quality of life failure rate was observed in the combined treatment group ( p non-significant ) but the time elapsed before the Karnofsky index drops is longer in the combined treatment group for the quality of life " no change " subgroup ( p = 0.15 ) . Survival and quality adjusted survival are similar in both treatment groups . The same conclusion holds for retrospective stratified treatment groups . The results of the study are presented according to the decision tree theory . We conclude that as far as the quality of life is concerned , pol 
    Output:
    