Use of probiotics for prevention of radiation-induced diarrhea.
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.
Delia
P
P
Institute of Radiology, Oncologic Radiotherapy Unit, Azienda Ospedaliera Universitaria, Messina, Italy.
Sansotta
G
G
Donato
V
V
Frosina
P
P
Messina
G
G
De Renzis
C
C
Famularo
G
G
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
D000930:Antidiarrheals; D008139:Loperamide