title: Use of probiotics for prevention of radiation-induced diarrhea.
abstract: OBJECTIVE
  To investigate the efficacy of a high-potency probiotic preparation on prevention of radiation-induced diarrhea in cancer patients.
  
  
  METHODS
  This was a double-blind, placebo-controlled trial. Four hundred and ninety patients who underwent adjuvant postoperative radiation therapy after surgery for sigmoid, rectal, or cervical cancer were assigned to either the high-potency probiotic preparation VSL#3 (one sachet t.i.d.,) or placebo starting from the first day of radiation therapy. Efficacy endpoints were incidence and severity of radiation-induced diarrhea, daily number of bowel movements, and the time from the start of the study to the use of loperamide as rescue medication.
  
  
  RESULTS
  More placebo patients had radiation-induced diarrhea than VSL#3 patients (124 of 239 patients, 51.8%, and 77 of 243 patients, 31.6%; P<0.001) and more patients given placebo suffered grade 3 or 4 diarrhea compared with VSL#3 recipients (55.4% and 1.4%, P<0.001). Daily bowel movements were 14.7 +/- 6 and 5.1 +/- 3 among placebo and VSL#3 recipients (P<0.05), and the mean time to the use of loperamide was 86 +/- 6 h for placebo patients and 122 +/- 8 h for VSL#3 patients (P<0.001).
  
  
  CONCLUSIONS
  Probiotic lactic acid-producing bacteria are an easy, safe, and feasible approach to protect cancer patients against the risk of radiation-induced diarrhea.
authors.affiliation: Institute of Radiology, Oncologic Radiotherapy Unit, Azienda Ospedaliera Universitaria, Messina, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Delia
authors.forename: G
authors.initials: G
authors.lastname: Sansotta
authors.forename: V
authors.initials: V
authors.lastname: Donato
authors.forename: P
authors.initials: P
authors.lastname: Frosina
authors.forename: G
authors.initials: G
authors.lastname: Messina
authors.forename: C
authors.initials: C
authors.lastname: De Renzis
authors.forename: G
authors.initials: G
authors.lastname: Famularo
mesh_terms: D000930:Antidiarrheals / Q000627:therapeutic use; D003110:Colonic Neoplasms / Q000532:radiotherapy; D003967:Diarrhea / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007778:Lactobacillus; D008139:Loperamide / Q000627:therapeutic use; D008297:Male; D019936:Probiotics / Q000009:adverse effects / Q000627:therapeutic use*; D011832:Radiation Injuries / Q000517:prevention & control*; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy
chemical_list: D000930:Antidiarrheals; D008139:Loperamide