Nutritional interventions for reducing gastrointestinal toxicity in adults undergoing radical pelvic radiotherapy

Dietary modification, including lactose and fat restriction and fibre supplementation, may help reduce radiotherapy-induced diarrhoea in adults undergoing pelvic radiotherapy.

The quality of evidence is downgraded by study limitations (incomplete outcome data) and imprecise results (only small studies).

Summary

A Cochrane review included 10 studies with a total of 1670 patients to assess the effects of nutritional interventions for reducing GI toxicity in adults undergoing radical pelvic radiotherapy. Four studies, three of which were RCTs and one prospective study, investigated the effect of elemental diet on GI symptoms; one RCT investigated the effect of dietary modification and elemental diet; and five RCTs investigated dietary modification. These included single interventions or combinations of modified fat or lactose-restriction and fibre supplementation.

A meta-analysis could not be performed. Data were dichotomised for presence and absence of diarrhoea at the end of radiotherapy for four trials evaluating dietary modification comprising modified fat, lactose, fibre or combinations of these dietary changes. A reduction in diarrhoea was demonstrated with nutritional intervention (table 1). Two trials evaluating dietary modification on weight change showed no difference between intervention and control (Table 1).

Clinical comments

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Ədəbiyyat

1. Henson CC, Burden S, Davidson SE et al. Nutritional interventions for reducing gastrointestinal toxicity in adults undergoing radical pelvic radiotherapy. Cochrane Database Syst Rev 2013;11():CD009896.