The effects of probiotic supplementation on the incidence of diarrhea in cancer patients receiving radiation therapy: a systematic review with meta-analysis and trial sequential analysis of randomized controlled trials
The protective effects of probiotic supplementation against radiation-induced diarrhea (RID) have been reported in previous systematic reviews; however so far, only non-conclusive results have been obtained. The objective of this study was to systematically update and evaluate the available evidence...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI
2019
|
| Online Access: | http://psasir.upm.edu.my/id/eprint/38217/1/38217.pdf |
| _version_ | 1825949183003066368 |
|---|---|
| author | Devaraj, Navin Kumar Suppiah, Subapriya Veettil, Sajesh Kalkandi Ching, Siew Mooi Lee, Kai Wei Menon, Rohit Kunnath Soo, Man Jun Deuraseh, Inas Hoo, Fan Kee Sivaratnam, Dhashani |
| author_facet | Devaraj, Navin Kumar Suppiah, Subapriya Veettil, Sajesh Kalkandi Ching, Siew Mooi Lee, Kai Wei Menon, Rohit Kunnath Soo, Man Jun Deuraseh, Inas Hoo, Fan Kee Sivaratnam, Dhashani |
| author_sort | Devaraj, Navin Kumar |
| collection | UPM |
| description | The protective effects of probiotic supplementation against radiation-induced diarrhea (RID) have been reported in previous systematic reviews; however so far, only non-conclusive results have been obtained. The objective of this study was to systematically update and evaluate the available evidence for probiotic supplementation. The protocol of this systematic review has been registered (CRD42018106059) with the International Prospective Register of Systematic Reviews (PROSPERO). The primary efficacy outcome was the incidence of RID. Secondary outcomes were the incidence of watery stool, soft stool, and antidiarrheal medication use. There were eight trials, and a total of 1116 participants were included in the primary analysis. Compared with placebo, probiotics were associated with a lower risk of RID [risk ratio (RR) = 0.62, 95% CI = 0.46, 0.83]. A requisite heterogeneity-adjusted trial sequential analysis indicated conclusive evidence for this beneficial effect. No statistically significant reduction in RID (RR = 0.52, 95% CI = 0.14, 1.91) was observed on subgroup analysis in patients receiving both radiation therapy and chemotherapy. However, those patients receiving only radiation therapy (RT) demonstrated significant benefit (RR = 0.61, 95% CI = 0.48, 0.78). There was a significant difference in the antidiarrheal medication use (RR = 0.54, 95% CI = 0.35, 0.84) observed with the use of probiotics. However, no significant difference was observed for the incidence of soft and watery stool. The use of probiotics is beneficial in preventing RID in patients receiving RT. |
| first_indexed | 2024-03-06T08:40:38Z |
| format | Article |
| id | upm.eprints-38217 |
| institution | Universiti Putra Malaysia |
| language | English |
| last_indexed | 2024-03-06T08:40:38Z |
| publishDate | 2019 |
| publisher | MDPI |
| record_format | dspace |
| spelling | upm.eprints-382172020-05-04T15:59:21Z http://psasir.upm.edu.my/id/eprint/38217/ The effects of probiotic supplementation on the incidence of diarrhea in cancer patients receiving radiation therapy: a systematic review with meta-analysis and trial sequential analysis of randomized controlled trials Devaraj, Navin Kumar Suppiah, Subapriya Veettil, Sajesh Kalkandi Ching, Siew Mooi Lee, Kai Wei Menon, Rohit Kunnath Soo, Man Jun Deuraseh, Inas Hoo, Fan Kee Sivaratnam, Dhashani The protective effects of probiotic supplementation against radiation-induced diarrhea (RID) have been reported in previous systematic reviews; however so far, only non-conclusive results have been obtained. The objective of this study was to systematically update and evaluate the available evidence for probiotic supplementation. The protocol of this systematic review has been registered (CRD42018106059) with the International Prospective Register of Systematic Reviews (PROSPERO). The primary efficacy outcome was the incidence of RID. Secondary outcomes were the incidence of watery stool, soft stool, and antidiarrheal medication use. There were eight trials, and a total of 1116 participants were included in the primary analysis. Compared with placebo, probiotics were associated with a lower risk of RID [risk ratio (RR) = 0.62, 95% CI = 0.46, 0.83]. A requisite heterogeneity-adjusted trial sequential analysis indicated conclusive evidence for this beneficial effect. No statistically significant reduction in RID (RR = 0.52, 95% CI = 0.14, 1.91) was observed on subgroup analysis in patients receiving both radiation therapy and chemotherapy. However, those patients receiving only radiation therapy (RT) demonstrated significant benefit (RR = 0.61, 95% CI = 0.48, 0.78). There was a significant difference in the antidiarrheal medication use (RR = 0.54, 95% CI = 0.35, 0.84) observed with the use of probiotics. However, no significant difference was observed for the incidence of soft and watery stool. The use of probiotics is beneficial in preventing RID in patients receiving RT. MDPI 2019 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/38217/1/38217.pdf Devaraj, Navin Kumar and Suppiah, Subapriya and Veettil, Sajesh Kalkandi and Ching, Siew Mooi and Lee, Kai Wei and Menon, Rohit Kunnath and Soo, Man Jun and Deuraseh, Inas and Hoo, Fan Kee and Sivaratnam, Dhashani (2019) The effects of probiotic supplementation on the incidence of diarrhea in cancer patients receiving radiation therapy: a systematic review with meta-analysis and trial sequential analysis of randomized controlled trials. Nutrients, 11 (12). art. no. 2886. pp. 1-21. ISSN 2072-6643 https://www.mdpi.com/2072-6643/11/12/2886 10.3390/nu11122886 |
| spellingShingle | Devaraj, Navin Kumar Suppiah, Subapriya Veettil, Sajesh Kalkandi Ching, Siew Mooi Lee, Kai Wei Menon, Rohit Kunnath Soo, Man Jun Deuraseh, Inas Hoo, Fan Kee Sivaratnam, Dhashani The effects of probiotic supplementation on the incidence of diarrhea in cancer patients receiving radiation therapy: a systematic review with meta-analysis and trial sequential analysis of randomized controlled trials |
| title | The effects of probiotic supplementation on the incidence of diarrhea in cancer patients receiving radiation therapy: a systematic review with meta-analysis and trial sequential analysis of randomized controlled trials |
| title_full | The effects of probiotic supplementation on the incidence of diarrhea in cancer patients receiving radiation therapy: a systematic review with meta-analysis and trial sequential analysis of randomized controlled trials |
| title_fullStr | The effects of probiotic supplementation on the incidence of diarrhea in cancer patients receiving radiation therapy: a systematic review with meta-analysis and trial sequential analysis of randomized controlled trials |
| title_full_unstemmed | The effects of probiotic supplementation on the incidence of diarrhea in cancer patients receiving radiation therapy: a systematic review with meta-analysis and trial sequential analysis of randomized controlled trials |
| title_short | The effects of probiotic supplementation on the incidence of diarrhea in cancer patients receiving radiation therapy: a systematic review with meta-analysis and trial sequential analysis of randomized controlled trials |
| title_sort | effects of probiotic supplementation on the incidence of diarrhea in cancer patients receiving radiation therapy a systematic review with meta analysis and trial sequential analysis of randomized controlled trials |
| url | http://psasir.upm.edu.my/id/eprint/38217/1/38217.pdf |
| work_keys_str_mv | AT devarajnavinkumar theeffectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT suppiahsubapriya theeffectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT veettilsajeshkalkandi theeffectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT chingsiewmooi theeffectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT leekaiwei theeffectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT menonrohitkunnath theeffectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT soomanjun theeffectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT deurasehinas theeffectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT hoofankee theeffectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT sivaratnamdhashani theeffectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT devarajnavinkumar effectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT suppiahsubapriya effectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT veettilsajeshkalkandi effectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT chingsiewmooi effectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT leekaiwei effectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT menonrohitkunnath effectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT soomanjun effectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT deurasehinas effectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT hoofankee effectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials AT sivaratnamdhashani effectsofprobioticsupplementationontheincidenceofdiarrheaincancerpatientsreceivingradiationtherapyasystematicreviewwithmetaanalysisandtrialsequentialanalysisofrandomizedcontrolledtrials |