Evaluation of the efficacy of probiotics in the chemoradiotherapy of colorectal cancer: a meta-analysis of Randomized Controlled Trials

Abstract Objective We undertook this study to assess the efficacy of probiotics in managing adverse reactions during chemoradiotherapy in patients with colorectal cancer. Method A comprehensive literature search was conducted on PubMed, ClinicalTrials.gov, Embase, Cochrane library,Web of Science, an...

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Main Authors: Rong Yang, Wei Liu, Shuiyan Cai, Xiurong Feng, Yongjing Chen, Xiangyu Cheng, Junjie Ma, Weiyu Ma, Zhihui Tian, Wenhui Yang
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-03914-y
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author Rong Yang
Wei Liu
Shuiyan Cai
Xiurong Feng
Yongjing Chen
Xiangyu Cheng
Junjie Ma
Weiyu Ma
Zhihui Tian
Wenhui Yang
author_facet Rong Yang
Wei Liu
Shuiyan Cai
Xiurong Feng
Yongjing Chen
Xiangyu Cheng
Junjie Ma
Weiyu Ma
Zhihui Tian
Wenhui Yang
author_sort Rong Yang
collection DOAJ
description Abstract Objective We undertook this study to assess the efficacy of probiotics in managing adverse reactions during chemoradiotherapy in patients with colorectal cancer. Method A comprehensive literature search was conducted on PubMed, ClinicalTrials.gov, Embase, Cochrane library,Web of Science, and Chinese databases until July 27, 2024. Data analysis was performed using RevMan5.3 statistical software. The risk of bias was assessed using the Cochrane collaboration tool. Relative risk (RR) was employed to incorporate statistical measures and calculate 95% confidence intervals (95%CI) for bipartite data. Standardized mean difference (SMD) was utilized to incorporate statistical measures and calculate 95% confidence intervals for continuous variables. Results A meta-analysis of 633 patients with colorectal cancer was conducted across eight studies. In comparison to the control group, probiotics demonstrated a significant reduction in the incidence of chemoradiotherapy-induced diarrhea among colorectal cancer patients(RR = 0.51,95%Cl:0.38 ~ 0.68,P < 0.001). Additionally, probiotic usage exhibited improvements in pain index (SMD = -2.27,95%Cl: -4.49 ~ -0.05,P = 0.04), dyspnea (SMD = -0.92,95%Cl: -1.61 ~ 0.22, P = 0.01) and insomnia (SMD = -2.95, 95%Cl: -5.44 ~ -0.47, P = 0.02) compared to the control group. However, there were no significant differences between two groups in abdominal distension(RR = 0.79, 95%Cl:0.21 ~ 3.00, P = 0.72), stomatitis risk (RR = 1.23, 95%Cl: 0.48 ~ 3.21, P = 0.67), fatigue (SMD = -7.12, 95%Cl:-14.99 ~ 0.75, P = 0.08)and loss of appetite(SMD = -2.86, 95%Cl: -5.83 ~ 0.11, P = 0.06). Furthermore, the use of probiotics did not significantly improve the quality of life (QOL) (SMD = 8.82, 95%Cl: -1.11 ~ 18.75, P = 0.08)of colorectal cancer patients receiving chemoradiotherapy. Conclusions This meta-analysis suggested that probiotic consumption may ameliorate certain adverse reactions in patients with colorectal cancer receiving chemoradiotherapy. Trial registrations Prospero registration number: PROSPERO (CRD42023465966).
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spelling doaj-art-98cf5ab6479e4b7db09e41b9bbadf1042025-08-20T02:55:35ZengBMCBMC Gastroenterology1471-230X2025-04-0125111610.1186/s12876-025-03914-yEvaluation of the efficacy of probiotics in the chemoradiotherapy of colorectal cancer: a meta-analysis of Randomized Controlled TrialsRong Yang0Wei Liu1Shuiyan Cai2Xiurong Feng3Yongjing Chen4Xiangyu Cheng5Junjie Ma6Weiyu Ma7Zhihui Tian8Wenhui Yang9Department of Gastroenterology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical UniversityDepartment of Pharmacy, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical UniversityDepartment of General Medicine, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical UniversityDepartment of Ultrasonography Lab, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical UniversityDepartment of Gastroenterology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical UniversityDepartment of Gastroenterology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical UniversityDepartment of Gastroenterology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical UniversityDepartment of Gastroenterology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical UniversityDepartment of Gastroenterology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical UniversityDepartment of Gastroenterology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical UniversityAbstract Objective We undertook this study to assess the efficacy of probiotics in managing adverse reactions during chemoradiotherapy in patients with colorectal cancer. Method A comprehensive literature search was conducted on PubMed, ClinicalTrials.gov, Embase, Cochrane library,Web of Science, and Chinese databases until July 27, 2024. Data analysis was performed using RevMan5.3 statistical software. The risk of bias was assessed using the Cochrane collaboration tool. Relative risk (RR) was employed to incorporate statistical measures and calculate 95% confidence intervals (95%CI) for bipartite data. Standardized mean difference (SMD) was utilized to incorporate statistical measures and calculate 95% confidence intervals for continuous variables. Results A meta-analysis of 633 patients with colorectal cancer was conducted across eight studies. In comparison to the control group, probiotics demonstrated a significant reduction in the incidence of chemoradiotherapy-induced diarrhea among colorectal cancer patients(RR = 0.51,95%Cl:0.38 ~ 0.68,P < 0.001). Additionally, probiotic usage exhibited improvements in pain index (SMD = -2.27,95%Cl: -4.49 ~ -0.05,P = 0.04), dyspnea (SMD = -0.92,95%Cl: -1.61 ~ 0.22, P = 0.01) and insomnia (SMD = -2.95, 95%Cl: -5.44 ~ -0.47, P = 0.02) compared to the control group. However, there were no significant differences between two groups in abdominal distension(RR = 0.79, 95%Cl:0.21 ~ 3.00, P = 0.72), stomatitis risk (RR = 1.23, 95%Cl: 0.48 ~ 3.21, P = 0.67), fatigue (SMD = -7.12, 95%Cl:-14.99 ~ 0.75, P = 0.08)and loss of appetite(SMD = -2.86, 95%Cl: -5.83 ~ 0.11, P = 0.06). Furthermore, the use of probiotics did not significantly improve the quality of life (QOL) (SMD = 8.82, 95%Cl: -1.11 ~ 18.75, P = 0.08)of colorectal cancer patients receiving chemoradiotherapy. Conclusions This meta-analysis suggested that probiotic consumption may ameliorate certain adverse reactions in patients with colorectal cancer receiving chemoradiotherapy. Trial registrations Prospero registration number: PROSPERO (CRD42023465966).https://doi.org/10.1186/s12876-025-03914-yProbioticsChemoradiotherapyColorectal cancerEfficacy
spellingShingle Rong Yang
Wei Liu
Shuiyan Cai
Xiurong Feng
Yongjing Chen
Xiangyu Cheng
Junjie Ma
Weiyu Ma
Zhihui Tian
Wenhui Yang
Evaluation of the efficacy of probiotics in the chemoradiotherapy of colorectal cancer: a meta-analysis of Randomized Controlled Trials
BMC Gastroenterology
Probiotics
Chemoradiotherapy
Colorectal cancer
Efficacy
title Evaluation of the efficacy of probiotics in the chemoradiotherapy of colorectal cancer: a meta-analysis of Randomized Controlled Trials
title_full Evaluation of the efficacy of probiotics in the chemoradiotherapy of colorectal cancer: a meta-analysis of Randomized Controlled Trials
title_fullStr Evaluation of the efficacy of probiotics in the chemoradiotherapy of colorectal cancer: a meta-analysis of Randomized Controlled Trials
title_full_unstemmed Evaluation of the efficacy of probiotics in the chemoradiotherapy of colorectal cancer: a meta-analysis of Randomized Controlled Trials
title_short Evaluation of the efficacy of probiotics in the chemoradiotherapy of colorectal cancer: a meta-analysis of Randomized Controlled Trials
title_sort evaluation of the efficacy of probiotics in the chemoradiotherapy of colorectal cancer a meta analysis of randomized controlled trials
topic Probiotics
Chemoradiotherapy
Colorectal cancer
Efficacy
url https://doi.org/10.1186/s12876-025-03914-y
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