PMID- 30928672
OWN - NLM
STAT- MEDLINE
DCOM- 20190716
LR  - 20190716
IS  - 1743-9159 (Electronic)
IS  - 1743-9159 (Linking)
VI  - 65
DP  - 2019 May
TI  - The significance of probiotics in preventing radiotherapy-induced diarrhea in 
      patients with cervical cancer: A systematic review and meta-analysis.
PG  - 61-69
LID - S1743-9191(19)30073-1 [pii]
LID - 10.1016/j.ijsu.2019.03.015 [doi]
AB  - AIMS: A systematic review and meta-analysis was designed to evaluate the efficacy 
      and safety of probiotics for prevention of radiotherapy-induced diarrhea (RID) in 
      patients with cervical cancer. Previous studies failed to give a comprehensive 
      analysis of the efficacy and safety of probiotics in this point. METHODS: We 
      searched the Cochrane Library, PubMed, EMBASE and Web of Science up to June 4, 
      2018. We also hand searched some studies included in previous reviews. Our 
      primary outcome aims to compare the incidence of all Common Toxicity Criteria 
      (CTC) grades of RID and adverse events (AEs) in both probiotics groups and 
      placebo groups. Relative risk (RR) with its 95% confidence interval (CI) was used 
      to compare the efficacy of probiotics in prevention of RID, and the pooled RRs 
      were estimated using a fixed- or random-effect model; heterogeneity was assessed 
      with Cochran's Q and Higgins I(2) test. Two reviewers assessed trial quality and 
      extracted data independently. The analysis and bias for each of included studies 
      were performed and assessed using Review Manager 5.2. RESULTS: Nine randomized, 
      placebo-controlled studies (N = 1508 participants) were included for assessing 
      the efficacy of probiotics. Compared with placebo groups, participants in 
      probiotic groups experienced much lower incidence of RID with RR of 0.61 (95% CI 
      0.46-0.81; P = 0.0007). In addition, significant results were also observed in 
      CTC grade >/=2 and grade >/=3 RID, with the pooled RRs of 0.52 (95% CI 0.30-0.98; 
      P = 0.02) and 0.32 (95% CI 0.12-0.82; P = 0.02) respectively. Eight studies, 
      included 1410 participants (726 consuming probiotics, 657 consuming placebo, 27 
      lost to follow-up), were used for the analysis of safety of probiotics. Of the 8 
      studies, 4 studies had no AEs caused by probiotics, while another 4 studies 
      reported varying degrees of AEs during their treatment. CONCLUSIONS: Probiotics 
      may have a beneficial effect in prevention of RID generally, especially for Grade 
      >/=2 or 3 diarrhea. Probiotics may be safe and rarely cause severe AEs during 
      treatment.
CI  - Copyright (c) 2019 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights 
      reserved.
FAU - Qiu, Guijing
AU  - Qiu G
AD  - Department of Gynecology, Tiantai Branch of Zhejiang Provincial People's 
      Hospital, Tiantai, 317200, China.
FAU - Yu, Yan
AU  - Yu Y
AD  - Department of Gynecology, Zhejiang Provincial People's Hospital, People's 
      Hospital of Hangzhou Medical College, Hangzhou, 310014, China.
FAU - Wang, Yanpeng
AU  - Wang Y
AD  - Department of Gynecology, Zhejiang Provincial People's Hospital, People's 
      Hospital of Hangzhou Medical College, Hangzhou, 310014, China.
FAU - Wang, Xinyan
AU  - Wang X
AD  - Department of Gynecology, Zhejiang Provincial People's Hospital, People's 
      Hospital of Hangzhou Medical College, Hangzhou, 310014, China. Electronic 
      address: yjwang18@163.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20190327
PL  - United States
TA  - Int J Surg
JT  - International journal of surgery (London, England)
JID - 101228232
SB  - IM
MH  - Diarrhea/*prevention & control
MH  - Female
MH  - Humans
MH  - Probiotics/*therapeutic use
MH  - Radiotherapy/adverse effects
MH  - Uterine Cervical Neoplasms/*radiotherapy
OTO - NOTNLM
OT  - Cervical cancer
OT  - Diarrhea
OT  - Probiotics
EDAT- 2019/04/01 06:00
MHDA- 2019/07/17 06:00
CRDT- 2019/04/01 06:00
PHST- 2018/12/09 00:00 [received]
PHST- 2019/02/01 00:00 [revised]
PHST- 2019/03/22 00:00 [accepted]
PHST- 2019/04/01 06:00 [pubmed]
PHST- 2019/07/17 06:00 [medline]
PHST- 2019/04/01 06:00 [entrez]
AID - S1743-9191(19)30073-1 [pii]
AID - 10.1016/j.ijsu.2019.03.015 [doi]
PST - ppublish
SO  - Int J Surg. 2019 May;65:61-69. doi: 10.1016/j.ijsu.2019.03.015. Epub 2019 Mar 27.