Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-21T23:14:44.788Z Has data issue: false hasContentIssue false

Probiotics as prevention of radiation-induced diarrhoea

Published online by Cambridge University Press:  23 November 2010

Jaroslav Timko*
Affiliation:
Department of Clinical Microbiology, Central Military Hospital, Ruzomberok, Slovakia
*
Correspondence to: Jaroslav Timko, Department of clinical microbiology, Central Military Hospital, Ruzomberok, Slovakia. Email: [email protected]

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.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bismar, MM, Sinicrope, FA. Radiation enteritis. Curr Gastroenterol Rep 2002, Oct; 4(5): 361365.CrossRefGoogle ScholarPubMed
Resbeut, M, Marteau, P, Cowen, D et al. A randomized double blind placebo controlled multicenter study of mesalazine for the prevention of acute radiation enteritis. Radiother Oncol 1997; 44(1): 5963.CrossRefGoogle ScholarPubMed
Andreyev, J. Gastrointestinal complications of pelvic radiotherapy: are they of any importance? Gut 2005, Aug; 54(8): 10511054.CrossRefGoogle ScholarPubMed
Donner, CS. Pathophysiology and therapy of chronic radiation-induced injury to the colon. Dig Dis 1998; 16: 253261.Google Scholar
Gami, B, Harrington, K, Blake, P, Dearnaley, D, Tait, D, Davies, J, Norman, AR, Andreyev, HJ. How patients manage gastrointestinal symptoms after pelvic radiotherapy. Aliment Pharmacol Ther 2003, Nov 15; 18(10): 987994.Google Scholar
Urbancsek, H, Kazar, T, Mezes, I et al. Results of a double blind, randomised study to evaluate the efficacy and safety of Antibiophilus in patients with radiation-induced diarrhoea. Eur J Gastroenterol Hepatol 2001; 13: 391396.CrossRefGoogle ScholarPubMed
Maria-Aggeliki, KS, Nikolaos, KL, George, KM, Vassilis, KE. The potential clinical impact of probiotic treatment for the prevention and/or anti-inflammatory therapeutic effect against radiation induced intestinal mucositis. A review. Recent Pat Inflamm Allergy Drug Discov 2009, Nov; 3(3): 195200.Google Scholar
Fuccio, L, Guido, A, Eusebi, LH, Laterza, L, Grilli, D, Cennamo, V, Ceroni, L, Barbieri, E, Bazzoli, F. Effects of probiotics for the prevention and treatment of radiation-induced diarrhoea. J Clin Gastroenterol 2009, Jul; 43(6): 506513. Review.Google Scholar
Famularo, G, De Simone, C, Matteuzzi, D et al. Traditional and high-potency probiotic preparations: advances, perspectives and safety of oral bacteriotherapy. Biodrugs 1999; 12: 455470.Google Scholar
Fotiadis, CI, Stoidis, CN, Spyropoulos, BG, Zografos, ED. Role of probiotics, prebiotics and synbiotics in chemoprevention for colorectal cancer. World J Gastroenterol 2008, Nov 14; 14(42): 64536457. Review.CrossRefGoogle ScholarPubMed
Geier, MS, Butler, RN, Howarth, GS. Probiotics, prebiotics and synbiotics: a role in chemoprevention for colorectal cancer? Cancer Biol Ther 2006, Oct; 5(10): 12651269. Review.CrossRefGoogle ScholarPubMed
Bowen, JM, Stringer, AM, Gibson, RJ, Yeoh, AS, Hannam, S, Keefe, DM. VSL#3 probiotic treatment reduces chemotherapy-induced diarrhoea and weight loss. Cancer Biol Ther 2007 Sep; 6(9): 1449–54.CrossRefGoogle ScholarPubMed
Osterlund, P, Ruotsalainen, T, Korpela, R, Saxelin, M, Ollus, A, Valta, P, Kouri, M, Elomaa, I, Joensuu, H. Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study. Br J Cancer 2007, Oct 22; 97(8): 10281034.Google Scholar
Delia, P, Sansotta, G, Donato, V et al. Prophylaxis of diarrhoea in patients submitted to radiotherapeutic treatment on pelvic district: personal experience. Digest Liver Dis 2002; 34: S84S86.Google Scholar
Salminen, E, Elomaa, I, Minkkinen, J et al. Preservation of intestinal integrity during radiotherapy using live Lactobacillus acidophilus cultures. Clin Radiol 1988; 39: 435437.Google Scholar
Giralt, J, Regadera, JP, Verges, R, Romero, J, de la Fuente, I, Biete, A, Villoria, J, Cobo, JM, Guarner, F. Int J Radiat Oncol Biol Phys 2008 Jul 15; 71(4): 12131219Google Scholar
Minocha, A. Probiotics for preventive health. Nutr Clin Pract 2009, Apr–May; 24(2): 227241. Review.CrossRefGoogle ScholarPubMed
Fuccio, L, Guido, A, Eusebi, LH, Laterza, L, Grilli, D, Cennamo, V, Ceroni, L, Barbieri, E, Bazzoli, F. Effects of probiotics for the prevention and treatment of radiation-induced diarrhea. J Clin Gastroenterol 2009, Jul; 43(6): 506513. Review.Google Scholar
Delia, P, Sansotta, G, Donato, V et al. Use of probiotics for prevention of radiation-induced diarrhoea. World J Gastroenterol 2007; 13: 912915.CrossRefGoogle Scholar
Cummings, JH. Constipation, dietary fiber and the control of large bowel function. Post Med J 1984; 60: 811881.Google Scholar
Kollmorgen, C, Meagher, A, Wolff, B et al. The long-term effect of adjuvant post-operative chemoradiotherapy for rectal carcinoma on bowel function. Ann Surg 1994; 220: 676682.CrossRefGoogle ScholarPubMed
Bozzetti, F. Nutrition and gastrointestinal cancer. Curr Opin Clin Nutr Metab Care 2001, Nov; 4(6): 541546. Review.Google Scholar
McGough, C, Baldwin, C, Frost, G et al. Role of nutritional intervention in patients treated with radiotherapy for pelvic malignancy. Br J Cancer 2004; 90: 22782287.Google Scholar
Blanarova, C, Galovicova, A, Petrasova, D. Use of probiotics for prevention of radiation-induced diarrhoea. Bratisl Lek Listy 2009; 110(2): 98104.Google Scholar
Abe, M, Takahashi, M, Yabumoto, E, Adachi, H, Yoshii, M, Mori, K. Clinical experiences with intraoperative radiotherapy of locally advanced cancers. Cancer 1980, Jan 1; 45(1): 4048.Google Scholar