A systematic review and meta-analysis of probiotics for the management of radiation induced bowel disease

Hamad, Adeel; Fragkos, Konstantinos C.; Forbes, Alastair

doi:10.1016/j.clnu.2013.02.004

Cited by 51 publications

(38 citation statements)

References 37 publications

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“…This meta-analysis found that, for the incidence of diarrhea, the probiotic group had a significant reduction, as the pooled OR = 0.47 (95% CI of 0.28-0.76; P = 0.002). For subgroup analysis, the pooled OR of RID is 0.48 (95% CI of 0.27-0.85; P = 0.01), consistent with the result of Hamad et al 23 However, for the CID, the probiotic group seemingly had unclear numerical reduction in the incidence of diarrhea, as the pooled OR is 0.40 (95% CI of 0.15-1.03; P = 0.06), probably because the small number of studies and patients about chemotherapy were included. However, disappointedly, there was nonsignificant reduction in the frequency of CTC Grade ⩽ 2 diarrhea (OR = 1.33, 95% CI 0.67-2.64, P = 0.42).…”

Section: Efficacysupporting

confidence: 90%

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The efficacy and safety of probiotics for prevention of chemoradiotherapy-induced diarrhea in people with abdominal and pelvic cancer: a systematic review and meta-analysis

Wang

et al. 2016

Eur J Clin Nutr

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A systematic review and meta-analysis were designed to evaluate the efficacy and safety of probiotics for prevention of chemoradiotherapy-induced diarrhea in people with abdominal and pelvic cancer. We searched the Cochrane Library, PubMed, EMBASE and Web of Science up to November 2015. We also hand searched the citation lists of included studies and previously identified systematic reviews to identify further relevant trials. Odds ratio (OR) was used to compare efficacy, and the pooled OR was estimated using a random effects model; heterogeneity was assessed with Cochran's Q and the Higgins' I-test. Two reviewers assessed trial quality and extracted data independently. Analysis and bias for each included study were performed using Review Manager 5.2. Nine randomized and placebo-controlled studies (N=1265 participants) were included for assessing efficacy, of which seven were about radiotherapy and two about chemotherapy. Probiotic groups were compared with control groups with respect to the the incidence of diarrhea, OR=0.47 (95% confidence interval 0.28-0.76; P=0.002). Eleven studies, including 1612 people (873 consuming probiotics and 739 not consuming probiotics), were used for the analysis of safety of probiotics. Of the 11 studies, seven studies had no adverse events (AEs) caused by probiotics, whereas four studies reported varying degrees of AEs in their treatment. Probiotics may have a beneficial effect in prevention of chemoradiotherapy-induced diarrhea generally, especially for Grade⩾2 diarrhea. Probiotics may rarely cause AEs.

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Section: Efficacysupporting

confidence: 90%

“…22,23 However, few systematic reviews and metaanalysis were performed for abdominal and pelvic radiotherapy or CID for the cancers.…”

Section: Introductionmentioning

confidence: 99%

The efficacy and safety of probiotics for prevention of chemoradiotherapy-induced diarrhea in people with abdominal and pelvic cancer: a systematic review and meta-analysis

Wang

et al. 2016

Eur J Clin Nutr

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“…Although probiotic usage has been shown to be safe in a variety of other clinical settings, 12,13,16,26,27 several case reports suggest that the probiotic itself may have caused bacteremia in the setting of HCT. [30][31][32] Our results suggest that LBP administration is both safe and feasible.…”

Section: Discussionmentioning

confidence: 99%

“…9 Clinical trials and systematic analysis have suggested that probiotics are safe and may be beneficial for immunocompromised adults, adults with cancer receiving abdominal radiation and a wide range of pediatric conditions. [10][11][12][13][14][15][16][17] Although some studies have not demonstrated a benefit of probiotic therapy, systematic reviews and meta-analysis have attributed much of the inconsistency in the literature to the testing of variable doses, duration and strains. 15,18,19 Moreover, there has been a lack of studies elucidating the mechanisms of probiotics in a controlled clinical setting.…”

Section: Introductionmentioning

confidence: 99%

The safety and feasibility of probiotics in children and adolescents undergoing hematopoietic cell transplantation

Ladas

Bhatia

Chen

et al. 2015

Bone Marrow Transplant

110

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Hematopoietic cell transplantation (HCT) has become a standard treatment for many adult and pediatric conditions. Emerging evidence suggests that perturbations in the microbiota diversity increase recipients' susceptibilities to gut-mediated conditions such as diarrhea, infection and acute GvHD. Probiotics preserve the microbiota and may minimize the risk of developing a gutmediated condition; however, their safety has not been evaluated in the setting of HCT. We evaluated the safety and feasibility of the probiotic, Lactobacillus plantarum (LBP), in children and adolescents undergoing allogeneic HCT. Participants received oncedaily supplementation with LBP beginning on day − 8 or − 7 and continued until day +14. Outcomes were compliance with daily administration and incidence of LBP bacteremia. Administration of LBP was feasible with 97% (30/31, 95% confidence interval (CI) 83-100%) of children receiving at least 50% of the probiotic dose (median 97%; range 50-100%). We did not observe any case of LBP bacteremia (0% (0/30) with 95% CI 0-12%). There were not any unexpected adverse events related to LBP. Our study provides preliminary evidence that administration of LBP is safe and feasible in children and adolescents undergoing HCT. Future steps include the conduct of an approved randomized, controlled trial through Children's Oncology Group.

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“…superoxide dismutase and catalase)sults. 38 A prebiotic is "a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gastrointestinal microflora that confers benefits upon host well-being and health", whereas synergistic combinations of pro-and prebiotics are called synbiotics. 39 …”

Section: Biological Systems Probioticsmentioning

confidence: 99%

Radiation protection and secondary cancer prevention using biological radioprotectors in radiotherapy

Abdollahi

Shiri

Atashzar

et al. 2015

Int J Cancer Ther Oncol

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Radiotherapy is the feasible treatment approach for many malignant diseases and cancers. New radiotherapy techniques such as ion therapy, stereotactic radiosurgery and intensity modulated radiation therapy deliver higher low dose radiation to large volume of normal tissues and are in debating as more secondary cancers inducers. A secondary cancer after radiotherapy is an important issue that reduces treatment efficiency and should be decreased. Radioprotective compounds are of importance in clinical radiation therapy for saving normal tissues. In the present study, we are so interest to introduce, suggest and review the application of biological radioprotectors in radiotherapy. We propose probiotics, prebiotics, gas, vitamin and nanoparticle producing microorganisms as new biological systems based radioprotectors to protect normal tissues. Also, we reviewed the main biological pathways, molecules and also radioadaptive response that act as radioprotectors. In this review we tried to address the secondary cancer induction by radiotherapy and also main biological radiation protection approaches, although there is a wealth of data in this subject.

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A systematic review and meta-analysis of probiotics for the management of radiation induced bowel disease

Cited by 51 publications

References 37 publications

The efficacy and safety of probiotics for prevention of chemoradiotherapy-induced diarrhea in people with abdominal and pelvic cancer: a systematic review and meta-analysis

The efficacy and safety of probiotics for prevention of chemoradiotherapy-induced diarrhea in people with abdominal and pelvic cancer: a systematic review and meta-analysis

The safety and feasibility of probiotics in children and adolescents undergoing hematopoietic cell transplantation

Radiation protection and secondary cancer prevention using biological radioprotectors in radiotherapy

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