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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*
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: daniel.hamilton@epworth.org.au

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.

Type
Original Articles
Copyright
© Cambridge University Press 2015 

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