Probiotics as prevention of radiation-induced diarrhoea

Abstract

Aim: To assess the efficacy of a probiotic preparation on the prevention of radiation-induced diarrhoea in cancer patients.Methods: Group of 42 radio-oncology patients who had undergone adjuvant post-operative radiation therapy (RT) after abdominal and pelvic cancer were randomised to receive either the probiotic preparation "5'' Strain Dophilus (twice per day; L-Group), or the preparation Hylak Tropfen Forte (40 drops, three times per day; H-Group). Supplementation started on the first day and lasted until the end of RT. Efficacy endpoints were the incidence and the severity of the radiation-induced diarrhoea. All patients received a paper form in which they recorded monitored parameters on a daily basis during RT. Results:The mean daily number of bowel movements during the whole period was 4.16 in the L-Group and 2.52 in the H-Group; 62.5% of patients in L-Group and 81% in H-Group had a mean daily number of bowel movements of 4/day. Abdominal pain was recorded in 25% of the patients in L-Group and 22% of the patients in H-Group. Blood in the bowel movement was found in one patient from H-Group (9 days). Of patients in L-Group, 27% required diphenoxylate treatment during pelvic radiotherapy, compared with 55% in H-Group. Of patients from L-Group, 9% required antibiotics administration, compared with 25% in H-Group.Conclusion: We concluded that the prophylactic probiotic therapy produced a highly favourable benefit/ risk ratio. Supplementation with the probiotic preparation is an easy and safe approach to protect cancer patients from the risk of radiation-induced diarrhoea and carry out improvement in their quality of life.

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

“…30 One ineligible study did not provide the number of people suffering from diarrhea. 16 The third study was excluded because of its follow-up study in Delia et al 20,33 Quality assessment The risk of bias for each RCT is displayed in Figure 2, and the risk of bias across all RCTs is displayed in Figure 3. These indicated generally good methodological quality.…”

“…As displayed in Supplementary Table S1, of the 11 studies, seven studies had no AEs caused by probiotics in prevention of chemoradiotherapy-induced diarrhea, [14][15][16][17]19,20,29 whereas four studies reported AEs with varying degrees in their treatment. 5,21,30,31 The 11 studies included 1612 people (873 consuming probiotics and 739 not consuming probiotics).…”

“…12,13 Several clinical trials have shown the efficiency of probiotics in patients undergoing pelvic radiotherapy and chemotherapy. 5,9,[14][15][16][17][18][19][20][21] However, both their dosages, bacterial strains and time of therapy were short of homogeneity. In addition, some of studies have not shown a positive curative effect and improvement of the quality of patients.…”

Probiotics, Prebiotics, Synbiotics: Is There Enough Evidence to Support Their Use in Colorectal Cancer Surgery?

“…In a smaller-scale randomized trial of 42 radio-oncology patients who had undergone adjuvant postoperative radiation therapy after abdominal and pelvic cancer, of which only 10 had been treated for CRC, either the probiotic preparation '5' Strain Dophilus (twice per day; L-group) or the preparation Hylak Tropfen Forte (40 drops, three times per day; H-group) were supplemented, starting on the first day and lasting until the end of radiotherapy [75]. The mean daily number of bowel movements was 4.16 in the L-group and 2.52 in the H-group.…”

“…Of the patients in the L-group, 9% required antibiotics administration, compared with 25% in the H-group. The authors concluded that the prophylactic probiotic therapy produced a highly favorable benefit/risk ratio [75]. The few available trials and the presence of significant clinical and statistical heterogeneity limit the potential for robust evidence, but the results are pretty encouraging.…”