Eficácia de simbióticos na redução de sintomas de proctite aguda e de resposta inflamatória retal em pacientes submetidos a radioterapia para câncer de próstata : ensaio clínico randomizado, duplo cego e placebo controlado

Abstract

Inflammation of the rectal lining during radiotherapy for prostate cancer, in addition to causing uncomfortable symptoms, can generate long-term sequelae, impairing patients' quality of life. PURPOSE: Evaluate whether the daily intake of synbiotics improves symptoms and rectal/systemic inflammatory response in patients with radiation-induced acute proctitis. METHOD: Twenty patients who underwent three-dimensional conformal radiotherapy for prostate cancer were randomized to intake either a synbiotic powder containing probiotics of the species Lactobacillus reuteri (108 CFU) and soluble fiber (4.3 g) or placebo. EORTC QLQ-PRT2 questionnaire was applied before the beginning of radiotherapy and after the fifth, sixth, and seventh weeks of treatment, and the sum of both the complete (proctitis symptoms plus quality of life) and partial (proctitis symptoms) scores were compared. Fecal calprotectin was measured at Day 0 and in the fourth week of treatment, and serum C-reactive protein/albumin ratio were measured in the fourth week of treatment. RESULTS: Both the complete and partial questionnaire score (median and range) were higher in the fifth and sixth weeks in the placebo group; there was a higher increase in fecal calprotectin in the placebo group and no difference comparing CRP/albumin ratio. CONCLUSIONS: in the present study, synbiotics reduced proctitis symptoms and improved quality of life by preventing rectal inflammation during radiotherapy for prostate cancer.