Nutritional interventions for reducing gastrointestinal toxicity in adults undergoing radical pelvic radiotherapy

Henson, Caroline C; Burden, Sorrel; Davidson, Susan E; Lal, Simon

doi:10.1002/14651858.cd009896

Cited by 9 publications

(11 citation statements)

References 19 publications

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“…Studies investigating more than one nutritional intervention are described with respect to the primary intervention. Four previous reviews on this topic have been published, two systematic reviews ( 31 , 32 ) and two Cochrane reviews ( 33 , 34 ) . The current paper summarises results of these previous reviews for most commonly trialled nutritional interventions including; elemental diet, low or modified fat diet, lactose-restricted, fibre and probiotic/prebiotic/synbiotic combinations.…”

Section: Potential Role Of Dietary Modulationmentioning

confidence: 99%

Nutritional strategies to prevent gastrointestinal toxicity during pelvic radiotherapy

Wedlake

2018

Proc. Nutr. Soc.

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Radiotherapy-induced damage to non-cancerous gastrointestinal mucosa has effects on secretory and absorptive functions and can interfere with normal gastrointestinal physiology. Nutrient absorption and digestion may be compromised. Dietary manipulation is an attractive option with sound rationale for intervention. The aim of this review was to synthesise published evidence for the use of elemental formulae, low or modified fat diets, fibre, lactose restriction and probiotics, prebiotics and synbiotics to protect the bowel from gastrointestinal side effects during long-course, radical pelvic radiotherapy. Thirty original studies (recruiting n 3197 patients) were identified comprising twenty-four randomised controlled trials, four cohort studies and two comparator trials. Endpoints varied and included symptom scales (Inflammatory Bowel Disease Questionnaire, Common Technology Criteria for Adverse Events, Radiation Therapy Oncology Group) and Bristol Stool Scale. Dietary and supplement interventions were employed with many studies using a combination of interventions. Evidence from RCT was weak for elemental, low or modified fat and low-lactose interventions and modestly positive for the manipulation of fibre during radiotherapy. Evidence for probiotics as prophylactic interventional agents was more promising with a number of trials reporting positive results but strength and strains of interventions vary, as do methodologies and endpoints making it difficult to arrive at firm conclusions with several studies lacking statistical power. This consolidated review concludes that there is insufficient high-grade evidence to recommend nutritional intervention during pelvic radiotherapy. Total replacement of diet with elemental formula could be effective in severe toxicity but this is unproven. Probiotics offer promise but cannot be introduced into clinical practice without rigorous safety analysis, not least in immunocompromised patients.

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Section: Potential Role Of Dietary Modulationmentioning

confidence: 99%

Nutritional strategies to prevent gastrointestinal toxicity during pelvic radiotherapy

Wedlake

2018

Proc. Nutr. Soc.

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“…Die Nahrungsaufnahme beeinträchtigende Symptome und Störungen können durch geeignete Maßnahmen häufig gelindert oder beseitigt werden; angemessen sind z. B. eine Anpassung der analgetischen oder antiemetischen Medikation, eine diätetische Beratung sowie gezielte supportive Therapien [59,60]. Darüber hinaus ist es wichtig, den Druck psychologischer und sozialer Belastungen zu erkennen.…”

Section: Therapieziele Und -Konzepteunclassified

Untitled

2015

Aktuel Ernahrungsmed

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“…With regard to different dietary interventions that have been assessed, their effectiveness has not been conclusively corroborated in spite of being a readily accessible and easy to implement option, which makes their use feasible in all healthcare centers, either alone or in combination with other measures for the reduction of this toxicity [17][18][19][20] . Based on the lack of conclusive evidence on GI toxicity reduction with nutritional interventions using the modification of a single dietary element in radiotherapy treated patients, the advantage of the low fructose, fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet lies in its intervention on multiple factors that influence radiation-induced enteropathy such as vowel motility regulation, lactose and osmotic agents restriction, and bacterial flora modification 9,21,22 , together with an improvement observed in abdominal symptoms of patients with inflammatory bowel disease, which has similarities with radiation-induced damage in its pathogenesis, and reported high compliance [23][24][25][26][27] .…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Nutritional Intervention in Reduction of Gastrointestinal Toxicity during External Beam Radiotherapy in Women with Gynecological Tumors

Soto-Lugo¹,

Bosque²,

Vázquez-Martínez³

2022

GAMO

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Objective: To assess if nutritional intervention with a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) decreases acute gastrointestinal toxicity induced by pelvic external beam radiotherapy in patients with gynecologic tumors. Material and methods: Single-center, randomized, prospective clinical trial comparing patients on a low-FODMAP diet vs. standard Mexican diet, designed to detect an 80% decrease in Grade 1-2 acute gastrointestinal toxicity in the standard diet group to 25% of Grade 1-2 acute gastrointestinal toxicity in the low-FODMAP diet group. Results: Thirteen patients were recruited per group, with higher gastrointestinal toxicity grade 1-2 (85 vs. 77%) and 3 (23 vs. 0%) being reported in the standard diet group with regard to the low-FODMAP diet (p = 0.16). The low-FODMAP diet group had a lower end of treatment symptom score in the cervical cancer patient quality of life questionnaire (1.41 vs. Nutritional intervention to reduce EBRT induced GI toxicity 85

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Nutritional interventions for reducing gastrointestinal toxicity in adults undergoing radical pelvic radiotherapy

Cited by 9 publications

References 19 publications

Nutritional strategies to prevent gastrointestinal toxicity during pelvic radiotherapy

Nutritional strategies to prevent gastrointestinal toxicity during pelvic radiotherapy

Untitled

Effectiveness of Nutritional Intervention in Reduction of Gastrointestinal Toxicity during External Beam Radiotherapy in Women with Gynecological Tumors

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