The effect of nutritional interventions in acute radiation-induced diarrhoea in patients with primary pelvic cancer: A systematic review

Crit Rev Oncol Hematol. 2023 Aug:188:104038. doi: 10.1016/j.critrevonc.2023.104038. Epub 2023 May 25.

Abstract

Acute radiation-induced diarrhoea (RID) is a well-known side effect of external radiation therapy for pelvic cancer. Acute RID is an unresolved clinical problem in approximately 80% of patients. We investigated the effect of nutritional interventions on acute RID in patients with pelvic cancer treated with curative radiotherapy. A search was conducted using PubMed, Embase.com, CINAHL, and Cochrane Library, from 1 January 2005 until 10 October 2022. We included randomised controlled trials or prospective observational studies. Eleven of the 21 identified studies had low quality of evidence, mainly because of low patient numbers distributed among several cancer diagnoses, and non-systematic assessment of acute RID. Interventions included probiotics (n = 6), prebiotics (n = 6), glutamine (n = 4), and others (n = 5). Five studies, of which two provided high quality evidence, showed that probiotics improved acute RID. Future well-designed studies investigating the effects of probiotics on acute RID are warranted. PROSPERO ID: CRD42020209499).

Keywords: Bowel-related symptoms; External radiotherapy; GI toxicity; Nutritional intervention.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Diarrhea / etiology
  • Diarrhea / therapy
  • Humans
  • Observational Studies as Topic
  • Pelvic Neoplasms* / complications
  • Pelvic Neoplasms* / radiotherapy
  • Probiotics* / therapeutic use