Probiotics for prevention of radiation-induced diarrhea: A meta-analysis of randomized controlled trials

<div><p>Background</p><p>Radiotherapy is commonly used for abdominal or pelvic cancer, and patients receiving radiotherapy have a high risk developing to an acute radiation-induced diarrhea. Several previous studies have discussed the effect of probiotics on prevention of radiation-induced diarrhea, but the results are still inconsistent.</p><p>Objective</p><p>We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of probiotic supplementation for prevention the radiation-induced diarrhea.</p><p>Methods</p><p>Relevant RCTs studies assessing the effect of probiotic supplementation on clinical outcomes compared with placebo were searched in PubMed, EMBASE, and the Cochrane Library databases (up to March 30 2016). Heterogeneity was assessed with <i>I</i>^<i>2</i> and <i>H</i>^<i>2</i>, and publication bias was evaluated using sensitive analysis.</p><p>Results</p><p>Six trials, a total of 917 participants (490 participants received prophylactic probiotics and 427 participants received placebo), were included in this meta-analysis. Compared with placebo, probiotics were associated with a lower incidence of radiation-induced diarrhea (RR: 0.55; 95% CI: 0.34–0.88; <i>P</i> = 0.01; <i>I</i>^<i>2</i>: 87%; 95% CI: 75%-94%; <i>H</i>^<i>2</i>: 2.8; 95% CI: 2.0–4.0). However, there is no significant difference in the anti-diarrheal medication use (RR: 0.68; 95% CI: 0.40–1.14; <i>P</i> = 0.14) or bristol scale on stool form (RR: 0.64; 95% CI: 0.35–1.17; <i>P</i> = 0.14).</p><p>Conclusion</p><p>Probiotics may be beneficial to prevent radiation-induced diarrhea in patients who suffered from abdominal or pelvic cancers during radiotherapy period.</p></div

Risk of bias summary.

<p>Risk of bias summary.</p

Risk of bias.

<p>Risk of bias.</p

Effect of preventive probiotics on bristol scale on stool form compared with control treatment.

<p>Effect of preventive probiotics on bristol scale on stool form compared with control treatment.</p

Publication bias in sensitivity analysis.

<p>Publication bias in sensitivity analysis.</p

Effect of preventive probiotics on incidence of anti-diarrheal medication use compared with placebo treatment.

<p>Effect of preventive probiotics on incidence of anti-diarrheal medication use compared with placebo treatment.</p

Characteristics of all included studies.

<p>Characteristics of all included studies.</p

Effect of probiotics on prevention of radiation-induced diarrhea compared with placebo.

<p>Effect of probiotics on prevention of radiation-induced diarrhea compared with placebo.</p

Cumulative incidence of diabetes mellitus by presence or absence of metabolic abnormalities at baseline in different population.

<p>(A): presence or absence of HTGW in the whole population; (B): presence or absence of MetS in the whole population; (C): presence or absence of HTGW in the population without elevated FPG; (D): presence or absence of MetS in the population without elevated FPG. DM = diabetes mellitus; HTGW = hypertriglyceridemic waist; MetS = metabolic syndrome; FPG = fasting plasma glucose.</p

A novel sesquiterpene derivative with a seven-membered B ring from <i>Illigera aromatica</i>

<p>A novel sesquiterpene derivative with a seven-membered B ring, illigerine (<b>1</b>), along with four known compounds, 1-<i>epi</i>-chiliophyllin (<b>2</b>), 3,4-dihydroxyphenethyl alcohol (<b>3</b>), coniferyl alcohol (<b>4</b>) and phenylpropionic acid (<b>5</b>), were isolated from <i>Illigera aromatica</i> S. Z. Huang et S. L. Mo. Their structures were identified by 1D/2D NMR, HRESIMS and electronic circular dichroism spectra and the cytotoxic activity and inhibitory effect of NO production in LPS-stimulated RAW264.7 were also evaluated. This is the first report of sesquiterpene isolated from the genus <i>Illigera</i>.</p