Proactive.

Top Line: Does a probiotic regimen reduce GI toxicity from pelvic radiation for gynecologic cancers?

The Study: GI toxicity is common when treating gynecologic malignancies. So much so that multiple randomized trials have been conducted to demonstrate a reduction in GI toxicity with IMRT. In this small randomized trial, 75 patients receiving pelvic radiation for mostly endometrial (48%) and cervical cancer (48%) were randomized to receive placebo, a low dose probiotic, or a high dose probiotic. Most patients (53%) also received concurrent chemotherapy. The probiotic consisted of Lactobacillus plantarum HEAL9 and Lactobacillus plantarum 299 with 1x10^10 CFU/capsule in the low dose arm and 5x10^10 CFU/capsule in the high dose arm. Capsules were taken twice per day starting 1-2 weeks prior to radiation. There was no difference in the primary outcome of the number of loose/watery stools per day among groups. However, high dose probiotic significantly reduced the number of days with loose/watery stool from 15→ 8.7 days. There were also reductions in abdominal pain and fecal urgency.  

TBL: A high dose probiotic regimen during pelvic radiation for gynecologic cancer modestly reduces the severity of lower GI toxicity. | Ahren, Adv Radiat Oncol 2022