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The use of probiotics versus psyllium husk as a bowel preparation for prostate radiotherapy: a retrospective analysis

Published online by Cambridge University Press:  11 June 2015

Daniel G. Hamilton ,
Dean McKenzie ,
Jason Wasiak  and
Paul Fenton
Daniel G. Hamilton*
Affiliation:
Epworth Radiation Oncology, Epworth HealthCare, Melbourne, VIC, Australia
Dean McKenzie
Affiliation:
Clinical Trials and Research Centre, Epworth HealthCare, Melbourne, VIC, Australia School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
Jason Wasiak
Affiliation:
Epworth Radiation Oncology, Epworth HealthCare, Melbourne, VIC, Australia School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
Paul Fenton
Affiliation:
Epworth Radiation Oncology, Epworth HealthCare, Melbourne, VIC, Australia
*
Correspondence to: Daniel G. Hamilton, Epworth Radiation Oncology, Epworth Richmond, Level 4, 32 Erin St Richmond, Melbourne, VIC 3121, Australia. Tel: (03) 9936 8277. Fax: (03) 8420 1950. E-mail: [email protected]
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Abstract

Introduction

The use of bowel preparation strategies to reduce the degree of rectal distension during prostate radiotherapy is well documented. This retrospective pilot study analysed and compared a probiotic agent against a psyllium-supplemented diet to establish the feasibility of probiotics as a bowel preparation for patients receiving radical radiotherapy for prostate cancer.

Method

A retrospective chart review of five patients taking probiotics and five taking psyllium husk (psyllium) during their course of radiotherapy treatment was conducted. On treatment, cone beam computed tomography (CBCT) scans were compared with planning CTs to quantify inter-fractional variation in rectal volume and distension.

Results

Forty-five CBCT scans were available in both the psyllium and probiotics groups for analysis. Variation in mean difference in rectal volume from planning (ΔRV), mean rectal cross-section area (CSA) and mean relative cross-section area (CSArel) was significantly increased for the probiotics group compared with the psyllium group (p=0·001, 0·008 and 0·007, respectively). No statistically significant differences in mean ΔRV, CSA and CSArel were detected between the two groups.

Conclusion

This retrospective analysis suggests that a probiotics-based bowel preparation that utilises Lactobacillus acidophilus and Bifidobacterium lactis may result in increased rectal volume and CSA variation throughout treatment in comparison with a psyllium-supplemented diet.

Keywords

Cone beam computed tomographyprostate neoplasms/radiotherapyorgan size/radiation effectsrectum/physiologyrectum/radiography
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 14 , Issue 4 , December 2015 , pp. 378 - 384
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Copyright
© Cambridge University Press 2015 

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References

1.Australian Institute of Health and Welfare. Prostate cancer in Australia. Cancer Series No. 79 Cat. No. CAN 76. Canberra: AIHW, 2013.Google Scholar
2.Hayden, A J, Martin, J M, Kneebone, A Bet al. Australian & New Zealand Faculty of Radiation Oncology Genito-Urinary Group: 2010 consensus guidelines for definitive external beam radiotherapy for prostate carcinoma. J Med Imaging Radiat Oncol 2010; 54: 513–525.CrossRefGoogle ScholarPubMed
3.Deurloo, K E I, Steenbakkers, R J H M, Zijp, L Jet al. Quantification of shape variation of prostate and seminal vesicles during external beam radiotherapy. Int J Radiat Oncol Biol Phys 2005; 61 (1): 228–238.CrossRefGoogle ScholarPubMed
4.De Crevoisier, R, Tucker, S L, Dong, Let al. Increased risk of biochemical and local failure in patients with distended rectum on the planning CT for prostate cancer radiotherapy. Int J Radiat Oncol Biol Phys 2005; 62: 965–973.CrossRefGoogle ScholarPubMed
5.Yahya, S, Zarkar, A, Southgate, E, Nightingale, P, Webster, G. Which bowel preparation is best? Comparison of a high-fibre diet leaflet, daily microenema and no preparation in prostate cancer patients treated with radical radiotherapy to assess the effect on planned target volume shifts due to rectal distension. Br J Radiol 2013; 86 (1031): 1–9.CrossRefGoogle ScholarPubMed
6.Ki, Y, Kim, W, Nam, Jet al. Probiotics for rectal volume variation during radiation therapy for prostate cancer. Int J Radiat Oncol Biol Phys 2013; 87 (4): 646–650.CrossRefGoogle ScholarPubMed
7.Beard, C J, Kijewski, P, Bussi`ere, Met al. Analysis of prostate and seminal vesicle motion: implications for treatment planning. Int J Radiat Oncol Biol Phys 1996; 34: 451–458.CrossRefGoogle ScholarPubMed
8.McNair, H A, Wedlake, L, Lips, I M, Andreyev, J, Van Vulpen, M, Dearnaley, D. A systematic review: effectiveness of rectal emptying preparation in prostate cancer patients. Pract Radiat Oncol 2014; 4 (6): 437–447.CrossRefGoogle ScholarPubMed
9.Gonlachanvit, S, Coleski, R, Owyang, C, Hasler, W. Inhibitory actions of a high fibre diet on intestinal gas transit in healthy volunteers. Gut 2004; 53 (11): 1577–1582.CrossRefGoogle ScholarPubMed
10.Stillie, A L, Kron, T, Fox, Cet al. Rectal filling at planning does not predict stability of the prostate gland during a course of radical radiotherapy if patients with large rectal filling are re-imaged. Clin Oncol (R Coll Radiol) 2009; 21: 760–767.CrossRefGoogle Scholar
11.Oates, R W, Schneider, M E, Lim Joon, Met al. A randomised study of a diet intervention to maintain consistent rectal volume for patients receiving radical radiotherapy to the prostate. Acta Oncol 2014; 53 (4): 569–571.CrossRefGoogle ScholarPubMed
12.Fuccio, L, Guido, A, Eusebi, L Het al. Effects of probiotics for the prevention and treatment of radiation-induced diarrhea. J Clin Gastroenterol 2009; 43 (6): 506–513.CrossRefGoogle ScholarPubMed
13.Magro, D O, de Oliveira, L M, Bernasconi, Iet al. Effect of yogurt containing polydextrose, Lactobacillus acidophilus NCFM and Bifidobacterium lactis HN019: a randomized, double-blind, controlled study in chronic constipation. Nutr J 2014; 13: 75.CrossRefGoogle ScholarPubMed
14.Lee, H, Kim, Y H, Kim, J Het al. A feasibility study of a probiotics pretreatment as a bowel preparation for colonoscopy in constipated patients. Dig Dis Sci 2010; 55: 2344–2351.CrossRefGoogle ScholarPubMed
15.Boehmer, D, Maingon, P, Poortmans, Pet al. Guidelines for primary radiotherapy of patients with prostate cancer. Radiother Oncol 2006; 79: 259–269.CrossRefGoogle ScholarPubMed
16.Ehrlich, S. Lactobacillus acidophilus, The University of Maryland Medical Centre website, 2011. http://umm.edu/health/medical/altmed/supplement/lactobacillus-acidophilus. Accessed on 2nd October 2014.Google Scholar
17.Miller, L E, Ouwehand, A C. Probiotic supplementation decreases intestinal transit time: meta-analysis of randomized controlled trials. World J Gastroenterol 2013; 19 (29): 4718–4725.CrossRefGoogle ScholarPubMed
18.Heemsbergen, W D, Hoogeman, M S, Witte, M Get al. Increased risk of biochemical and clinical failure for prostate patients with a large rectum at radiotherapy planning: results from the Dutch trial of 68 Gy versus 78 Gy. Int J Radiat Oncol Biol Phys 2007; 67: 1418–1424.CrossRefGoogle ScholarPubMed