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Probiotic supplements (Lactobacillus, Bifidobacterium) may reduce diarrhoea during pelvic radiotherapy for cervical, rectal and prostate cancer and some chemotherapy, but a 2018 Cochrane review rated the evidence low certainty and strains differ between trials. Patients in profound neutropenia or with a central line should not take them without advice, because bloodstream infections have occurred.
A 2018 Cochrane review of randomised trials found that probiotics may reduce the incidence and severity of diarrhoea caused by chemotherapy or radiotherapy, with low-certainty evidence and marked variation in strains (Lactobacillus, Bifidobacterium, VSL#3), doses and endpoints. Trials in pelvic radiotherapy for cervical, rectal and prostate cancer are the most consistent. Cases of bacteraemia and fungaemia in immunocompromised patients mean probiotics are avoided during profound neutropenia and in patients with central venous catheters unless specifically advised. Separately, antibiotics and probiotics around checkpoint immunotherapy may reduce response by disturbing the microbiome, a distinct question covered in the immunotherapy record.
Colonising bacteria compete with pathogens, reinforce the mucosal barrier and modulate local inflammation in irradiated or chemotherapy-damaged gut.
Query for this technology: (TITLE:"Probiotics for chemotherapy and radiotherapy diarrhoea" OR ABSTRACT:"Probiotics for chemotherapy and radiotherapy diarrhoea") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Probiotics for chemotherapy and radiotherapy diarrhoea, not a curated reading list.
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