title: 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.
abstract: A systematic review and meta-analysis were designed to evaluate the efficacy and safety of probiotics for prevention of chemoradiotherapy-induced diarrhea in people with abdominal and pelvic cancer. We searched the Cochrane Library, PubMed, EMBASE and Web of Science up to November 2015. We also hand searched the citation lists of included studies and previously identified systematic reviews to identify further relevant trials. Odds ratio (OR) was used to compare efficacy, and the pooled OR was estimated using a random effects model; heterogeneity was assessed with Cochran's Q and the Higgins' I2-test. Two reviewers assessed trial quality and extracted data independently. Analysis and bias for each included study were performed using Review Manager 5.2. Nine randomized and placebo-controlled studies (N=1265 participants) were included for assessing efficacy, of which seven were about radiotherapy and two about chemotherapy. Probiotic groups were compared with control groups with respect to the the incidence of diarrhea, OR=0.47 (95% confidence interval 0.28-0.76; P=0.002). Eleven studies, including 1612 people (873 consuming probiotics and 739 not consuming probiotics), were used for the analysis of safety of probiotics. Of the 11 studies, seven studies had no adverse events (AEs) caused by probiotics, whereas four studies reported varying degrees of AEs in their treatment. Probiotics may have a beneficial effect in prevention of chemoradiotherapy-induced diarrhea generally, especially for Grade⩾2 diarrhea. Probiotics may rarely cause AEs.
authors.affiliation: The First Clinical Medical College of Lanzhou University, Lanzhou, China.|Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China.
authors.forename: Y-H
authors.initials: YH
authors.lastname: Wang
authors.affiliation: Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China.
authors.forename: N
authors.initials: N
authors.lastname: Yao
authors.affiliation: The First Clinical Medical College of Lanzhou University, Lanzhou, China.|Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China.
authors.forename: K-K
authors.initials: KK
authors.lastname: Wei
authors.affiliation: Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China.
authors.forename: L
authors.initials: L
authors.lastname: Jiang
authors.affiliation: The First Clinical Medical College of Lanzhou University, Lanzhou, China.
authors.forename: S
authors.initials: S
authors.lastname: Hanif
authors.affiliation: The First Clinical Medical College of Lanzhou University, Lanzhou, China.|Evidence Based Medical Centre of Lanzhou University, Lanzhou, China.
authors.forename: Z-X
authors.initials: ZX
authors.lastname: Wang
authors.affiliation: The First Clinical Medical College of Lanzhou University, Lanzhou, China.|Evidence Based Medical Centre of Lanzhou University, Lanzhou, China.
authors.forename: C-X
authors.initials: CX
authors.lastname: Pei
mesh_terms: D000008:Abdominal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D003967:Diarrhea / Q000517:prevention & control; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000517:prevention & control*; D010386:Pelvic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D019936:Probiotics; D011832:Radiation Injuries / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D012449:Safety