Preservation of intestinal integrity during radiotherapy using live Lactobacillus acidophilus cultures

Salminen, Eeva; Elomaa, Inkeri; Minkkinen, J.; Vapaatalo, Heikki; Salminen, Sari

doi:10.1016/s0009-9260(88)80296-4

Cited by 162 publications

(115 citation statements)

References 6 publications

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“…Lactobacillus rhamnosus GG has been found to alleviate diarrhoea caused by a viral infection or Clostridium difficile, and to be useful in the prevention of traveller's diarrhoea or diarrhoea related to administration of antibiotics (Ouwehand et al, 2002;Vaarala, 2003). Probiotics may also reduce radiation therapy-related diarrhoea (Salminen et al, 1988;Urbancsek et al, 2001;Delia et al, 2002). The mode of action is not fully understood, but probiotics are involved in some cytoprotective processes, such as induction of heat-shock protein expression in intestinal epithelial cells (Tao et al, 2006), and prevention of cytokine-induced epithelial cell damage (Yan et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…Three studies have suggested that Lactobacillus acidophilus, L. rhamnosus, or a probiotic mixture may prevent radiotherapyinduced diarrhoea (Salminen et al, 1988;Urbancsek et al, 2001;Delia et al, 2002), but to our knowledge no controlled study has evaluated probiotics or fibre in the prevention of chemotherapyassociated diarrhoea. In the present study, we assessed the efficacy of L. rhamnosus GG and guar gum supplementation in reducing 5-FU-based chemotherapy toxicity.…”

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confidence: 99%

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Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study

et al. 2007

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5-Fluorouracil (5-FU)-based chemotherapy is frequently associated with diarrhoea. We compared two 5-FU-based regimens and the effect of Lactobacillus and fibre supplementation on treatment tolerability. Patients diagnosed with colorectal cancer (n ¼ 150) were randomly allocated to receive monthly 5-FU and leucovorin bolus injections (the Mayo regimen) or a bimonthly 5-FU bolus plus continuous infusion (the simplified de Gramont regimen) for 24 weeks as postoperative adjuvant therapy. On the basis of random allocation, the study participants did or did not receive Lactobacillus rhamnosus GG supplementation (1 -2 Â 10 10 per day) and fibre (11 g guar gum per day) during chemotherapy. Patients who received Lactobacillus had less grade 3 or 4 diarrhoea (22 vs 37%, P ¼ 0.027), reported less abdominal discomfort, needed less hospital care and had fewer chemotherapy dose reductions due to bowel toxicity. No Lactobacillus-related toxicity was detected. Guar gum supplementation had no influence on chemotherapy tolerability. The simplified de Gramont regimen was associated with fewer grade 3 or 4 adverse effects than the Mayo regimen (45 vs 89%), and with less diarrhoea. We conclude that Lactobacillus GG supplementation is well tolerated and may reduce the frequency of severe diarrhoea and abdominal discomfort related to 5-FU-based chemotherapy.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study

et al. 2007

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“…However, methodology was often weak, with reporting of method of randomisation, concealment of allocation and blinding lacking from many papers (Brown et al, 1980;Foster et al, 1980;Kinsella et al, 1981;Moriarty et al, 1981;Stryker and Bartholomew, 1986;Salminen et al, 1988;Karlson et al, 1989;Bye et al, 1992;Chowdhury et al, 2002;Delia et al, 2002). The choice of randomisation in papers that reported their methodology was adequate in two studies (Urbancsek et al, 2001;Martin et al, 2002).…”

Section: Methodological Quality Of Trialsmentioning

confidence: 99%

“…Low residue diet (Liu et al, 1997). Probiotic supplementation in sachet or fermented yogurt presentation and modified food intake compared with modified food intake alone (Salminen et al, 1988;Delia et al, 2002). Elemental diet as a supplement to modified food intake or as a sole source of nutritional intake compared to modified diet or total parenteral nutrition (Brown et al, 1980;Foster et al, 1980;McArdle et al, 1986;Craighead and Young, 1998;Capirci and Polico, 2000).…”

Section: Nutritional Interventionsmentioning

confidence: 99%

“…Two randomised studies, including 214 patients (Salminen et al, 1988;Delia et al, 2002), used probiotics during pelvic radiotherapy and demonstrated a decrease in the mean number of bowel movements (Po0.05) and a decrease in the incidence of diarrhoea (Po0.01), using VSL #3 sachets three times daily and 2 Â 10 9 daily dose of a L. acidophilus in a fermented yogurt product, respectively. In addition, one of the studies (Salminen et al, 1988) also restricted fibre, fat and obvious sources of lactose in all patients.…”

Section: Nutritional Interventionsmentioning

confidence: 99%

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Role of nutritional intervention in patients treated with radiotherapy for pelvic malignancy

et al. 2004

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Up to 12 000 patients with gynaecological, urological and rectal cancer undergo radical pelvic radiotherapy annually in the UK. More than 70% develop acute inflammatory changes causing gastrointestinal symptoms during treatment because healthy bowel tissue is encompassed in the radiation field. In total, 50% go on to develop chronic bowel symptoms, which affect quality of life due to permanent changes in the small and large intestine. Nutritional intervention may influence acute and chronic bowel symptoms but the validity of the advice given to patients is not clear. To assess the incidence and significance of malnutrition and to examine the efficacy of therapeutic nutritional interventions used to manage gastrointestinal side effects in patients undergoing pelvic radiotherapy and those with chronic bowel side effects after treatment, a critical review of relevant original studies on human subjects was carried out using a specific set of mesh terms in MEDLINE and EMBASE databases and the Cochrane Library in September 2003. Full texts of all relevant articles were collected and reference lists were checked. Sources of grey literature including conference abstracts and webbased information were also reviewed. A total of 36 papers published in peer-reviewed journals between 1966 and 2003 were identified. In all, 14 randomised controlled trials, 12 prospective cohorts, four retrospective, two qualitative, one validation, one pilot study and two case reports were obtained. These included 2646 patients. Eight articles including three conference abstracts and webbased information were found. None of the studies was definitive because of weakness in methodology. No studies could be combined because the interventions and the end points were different. There is no evidence base for the use of nutritional interventions to prevent or manage bowel symptoms attributable to radiotherapy. Low-fat diets, probiotic supplementation and elemental diet merit further investigation.

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Probiotics for the prevention or treatment of chemotherapy or radiotherapy related diarrhoea in cancer patients

Wang

et al. 2010

Cochrane Database of Systematic Reviews

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Preservation of intestinal integrity during radiotherapy using live Lactobacillus acidophilus cultures

Cited by 162 publications

References 6 publications

Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study

Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study

Role of nutritional intervention in patients treated with radiotherapy for pelvic malignancy

Probiotics for the prevention or treatment of chemotherapy or radiotherapy related diarrhoea in cancer patients

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