Probiotics for prevention of radiation-induced diarrhea: A meta-analysis of randomized controlled trials

PLoS One. 2017 Jun 2;12(6):e0178870. doi: 10.1371/journal.pone.0178870. eCollection 2017.

Abstract

Background: Radiotherapy is commonly used for abdominal or pelvic cancer, and patients receiving radiotherapy have a high risk developing to an acute radiation-induced diarrhea. Several previous studies have discussed the effect of probiotics on prevention of radiation-induced diarrhea, but the results are still inconsistent.

Objective: We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of probiotic supplementation for prevention the radiation-induced diarrhea.

Methods: Relevant RCTs studies assessing the effect of probiotic supplementation on clinical outcomes compared with placebo were searched in PubMed, EMBASE, and the Cochrane Library databases (up to March 30 2016). Heterogeneity was assessed with I2 and H2, and publication bias was evaluated using sensitive analysis.

Results: Six trials, a total of 917 participants (490 participants received prophylactic probiotics and 427 participants received placebo), were included in this meta-analysis. Compared with placebo, probiotics were associated with a lower incidence of radiation-induced diarrhea (RR: 0.55; 95% CI: 0.34-0.88; P = 0.01; I2: 87%; 95% CI: 75%-94%; H2: 2.8; 95% CI: 2.0-4.0). However, there is no significant difference in the anti-diarrheal medication use (RR: 0.68; 95% CI: 0.40-1.14; P = 0.14) or bristol scale on stool form (RR: 0.64; 95% CI: 0.35-1.17; P = 0.14).

Conclusion: Probiotics may be beneficial to prevent radiation-induced diarrhea in patients who suffered from abdominal or pelvic cancers during radiotherapy period.

Publication types

  • Meta-Analysis

MeSH terms

  • Antidiarrheals / therapeutic use
  • Diarrhea / etiology*
  • Diarrhea / prevention & control*
  • Humans
  • Incidence
  • Pelvic Neoplasms / radiotherapy
  • Probiotics / therapeutic use*
  • Publication Bias
  • Radiotherapy / adverse effects*
  • Randomized Controlled Trials as Topic

Substances

  • Antidiarrheals

Grants and funding

This study was supported by the National Natural Science Foundation of China (no. 81202006).