Author(s): Devina Janeendran, Bhama Santhosh Kumar, Jiya Marium George, Ayana S. Kumar, Ram Madhavan, Lakshmi R.

Email(s): lakshmir@aims.amrita.edu

DOI: 10.52711/0974-360X.2021.00698   

Address: Devina Janeendran1, Bhama Santhosh Kumar1, Jiya Marium George1, Ayana S. Kumar1, Ram Madhavan2, Lakshmi R.*
1Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
2Department of radiation Oncology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
*Corresponding Author

Published In:   Volume - 14,      Issue - 8,     Year - 2021


ABSTRACT:
Ionizing radiotherapy is a very common treatment modality for various types of cancer. However, its uses are expected to increase drastically with several advances in screening as well as early detection of cancer. Radiation injury due to radiation to the gastrointestinal tract is an imperative factor that works against better utility of this critical treatment modality. Moreover, following radiotherapy there are a higher chances of acute as well as chronic symptoms that would significantly reduce the quality of life of patients and furthermore adding an extra burden to the patients in terms of cost of healthcare. Thus interventions to reduce these adverse events can have long term benefits. Acute radiation induced gastrointestinal adverse events can be managed by modification of diet. Dietary modification of fat, lactose or non-starch polysaccharides (fibre) or combination of these dietary modifications reduces acute gastrointestinal adverse events during radiotherapy. In our study, we observed patients diagnosed with prostate and rectal cancer and those patients receiving neo adjuvant chemo-radiotherapy of rectum. The patients were advised to follow certain dietary modifications which aid in controlling the acute gastrointestinal side effects that developed after exposing to radiation therapy. The patients were followed up on a weekly basis and recorded the severity of the gastro intestinal symptoms after each cycle of radiation therapy and the quality of life was also calculated. Our study demonstrates that the dietary intervention appears to be a promising treatment option to control these adverse events. The dietary restriction of fat, fibre and lactose also helped in reducing the grades of adverse events during the radiotherapy. The Quality of Life of patients, however, after radiotherapy was found to be decreased when compared to the baseline.


Cite this article:
Devina Janeendran, Bhama Santhosh Kumar, Jiya Marium George, Ayana S. Kumar, Ram Madhavan, Lakshmi R. A Study on the Effect of Dietary Modifications in decreasing or delaying Radiation Induced Acute Gastrointestinal Adverse Events in patients receiving Pelvic Radiotherapy. Research Journal of Pharmacy and Technology. 2021; 14(8):4029-4. doi: 10.52711/0974-360X.2021.00698

Cite(Electronic):
Devina Janeendran, Bhama Santhosh Kumar, Jiya Marium George, Ayana S. Kumar, Ram Madhavan, Lakshmi R. A Study on the Effect of Dietary Modifications in decreasing or delaying Radiation Induced Acute Gastrointestinal Adverse Events in patients receiving Pelvic Radiotherapy. Research Journal of Pharmacy and Technology. 2021; 14(8):4029-4. doi: 10.52711/0974-360X.2021.00698   Available on: https://rjptonline.org/AbstractView.aspx?PID=2021-14-8-4


REFERENCES:
1.    Cancer. WHO. March 12, 2019 (https://www.who.int/topics/ cancer/en/).
2.    De Ruysscher D, Niedermann G, Burnt NG, Siva S, Lee AW, Hegi-Johnson F. Radiotherapy toxicity. Nat Rev Dis Primers 2019; 5: 13-32.
3.    Incrocci L, Jensen PT. Pelvic radiotherapy and sexual function in men and women. J Sex Med 2013; 10: 53-64.
4.    Hauer-Jensen M, Wang J, Boerma M, Fu Q, Denham JW. Radiation damage to the gastrointestinal tract: Mechanisms, diagnosis, and management. Curr Opin Support Palliat Care 2007; 1: 23-9.
5.    Khalid U, McGough C, Hackett C, Blake P, Harrington KJ, Khoo VS, Tait D, Norman AR, Andreyev HJ. A modified inflammatory bowel disease questionnaire and the Vaizey Incontinence questionnaire are more sensitive measures of acute gastrointestinal toxicity during pelvic radiotherapy than RTOG grading. International Journal of Radiation Oncology* Biology* Physics. 2006Apr1; 64(5): 1432-41.
6.    Andreyev HJ, Davidson SE, Gillespie C, Allum WH, Swarbrick E. Practice guidance on the management of acute and chronic gastrointestinal problems arising as a result of treatment for cancer. Gut. 2012 Feb1; 61(2): 179-92.
7.    Husebye E, Skar V, Høverstad T, Iversen T, Melby K. Abnormal intestinal motor patterns explain enteric colonization with gram-negative bacilli in late radiation enteropathy. Gastroenterology.1995Oct1; 109(4): 1078-89.
8.    Husebye E, Hauer-Jensen M, Kjørstad K, Skar V. Severe late radiation enteropathy is characterized by impaired motility of proximal small intestine. Dig Dis Sci 1994; 39: 2341-9.
9.    Cook SI, Sellin JH. Short chain fatty acids in health and disease. Alimentary pharmacology and therapeutics.1998Jun; 12(6): 499-507.
10.    Hamer HM, Jonkers DM, Venema K, Vanhoutvin SA, Troost FJ, Brummer RJ. The role of butyrate on colonic function. Alimentary pharmacology and therapeutics. 2008 Jan; 27(2): 104-19.
11.    Wedlake L, Thomas K, McGough C, Andreyev HJ. Small bowel bacteria lover growth and lactose intolerance during radical pelvic radiotherapy: An observational study. European Journal of Cancer. 2008 Oct1; 44(15): 2212-7.
12.    Liu L, Glicksman AS, Coachman N, Kuten A. Low acute gastrointestinal and genitourinary toxicities in whole pelvic irradiation of prostate cancer. International journal of radiation oncology, biology, physics. 1997Apr; 38(1): 65-71.
13.    Resbeut M, Marteau P, Cowen D, Richaud P, Bourdin S, Dubois JB, Mere P, N'Guyen TD. A randomized double blind placebo controlled multicenter study of mesalazine for the prevention of acute radiation enteritis. Radiotherapy and Oncology. 1997 Jul 1; 44(1): 59-63.
14.    Salminen E, Elomaa I, Minkkinen J, Vapaatalo H, Salminen S. Preservation of intestinal integrity during radiotherapy using live Lactobacillus acidophilus cultures. Clin Radiol1988; 39: 435-7.
15.    Lodge N, Evans ML, Wilkins M, Blake PR, Fryatt I. A randomized cross‐over study of the efficacy of codeine phosphate versus Ispaghulahusk in patients with gynaecological cancer experiencing diarrhea during pelvic radiotherapy. European journal of cancer care. 1995Mar; 4(1): 8-10.
16.    McArdle AH, Wittnich C, Freeman CR, Duguid WP. Elemental diet as prophylaxis against radiation injury: histological and ultra structural studies. Archives of Surgery. 1985Sep1; 120(9): 1026-32.
17.    Craighead PS, Young S. Phase II study assessing the feasibility of using elemental supplements to reduce acute enteritis in patients receiving radical pelvic radiotherapy. American journal of clinical oncology. 1998Dec1; 21(6): 573-8.
18.    Capirci C, Polico C, Amichetti M, Bonetta A, Gava A, Maranzano E, Turcato G, Valentini V. Diet prevention of radiation acute enteric toxicity: multi centric randomized study. Radiother Oncol. 2000; 56(Suppl1): S44.
19.    Andreyev J. Gastrointestinal symptoms after pelvic radiotherapy: A new understanding to improve management of symptomatic patients. Lancet Oncol 2007; 8: 1007-17.
20.    Andreyev HJ. Gastrointestinal problems after pelvic radiotherapy: the past, the present and the future. Clinical Oncology. 2007 Dec 1; 19(10): 790-9.
21.    Henson CC, Andreyev HJ, Symonds RP ,Peel D, Swindell R, Davidson SE. Late onset bowel dysfunction after pelvic radiotherapy: a national survey of current practice and opinions of clinical oncologists. Clinical Oncology. 2011Oct 1; 23(8): 552-7.
22.    Theis VS, Sripadam R, Ramani V, Lal S. Chronic radiation enteritis. Clinical Oncology. 2010 Feb 1; 22(1): 70-83.
23.    Ruiz-Tovar J, Morales V, Hervás A, Sanjuanbenito A, Lobo E, Martínez Molina E. Late gastrointestinal complications after pelvic radiotherapy: radiation enteritis. Clinical and Translational Oncology. 2009 Aug 1; 11(8): 539-43.
24.    Harb AH, Fadel CA, Sharara AI. Radiation enteritis. Current gastroenterology reports. 2014 May 1; 16(5): 383.
25.    Abayomi J, Kirwan J, Hackett A. The prevalence of chronic radiation enteritis following radiotherapy for cervical or endometrial cancer and its impact on quality of life. European Journal of Oncology Nursing. 2009 Sep1; 13(4): 262-7.
26.    Poon M, Dennis K, De Angelis C, Chung H, Stinson J, Zhang L, Bedard G, Popovic M, Lao N, Pulenzas N, Wong S. A prospective study of gastrointestinal radiation therapy-induced nausea and vomiting. Supportive Care in Cancer. 2014 Jun1; 22(6): 1493-507.
27.    Poon M, Dennis K, De Angelis C, Chung H, Stinson J, Zhang L, Bedard G, Wong E, Popovic M, Lao N, Pulenzas N. Symptom clusters of gastrointestinal cancer patients undergoing radiotherapy using the Functional Living Index—Emesis(FLIE) quality-of-life tool. Supportive Care in Cancer. 2015 Sep 1; 23(9): 2589-98.
28.    Maranzano E, De Angelis V, Pergolizzi S, Lupattelli M, Frata P, Spagnesi S, Frisio ML, Mandoliti G, Malinverni G, Trippa F, Fabbietti L. A prospective observational trial on emesis in radiotherapy: analysis of 1020 patients recruited in 45 Italian radiation oncology centres. Radiotherapy and Oncology. 2010 Jan 1; 94(1): 36-41.
29.    Naeim A, Dy SM, Lorenz KA, Sanati H, Walling A, Asch SM. Evidence based recommendations for cancer nausea and vomiting. Journal of Clinical Oncology. 2008 Aug 10; 26(23): 3903-10.
30.    McGough C, Baldwin C, Frost G, Andreyev HJ. Role of nutritional intervention in patients treated with radiotherapy for pelvic malignancy. British journal of cancer. 2004 Jun; 90(12): 2278-87.
31.    Isenring E, Bauer J, Capra S. The scored Patient-generated Subjective Global Assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy. European journal of clinical nutrition. 2003 Feb; 57(2): 305-9.
32.    Pettersson A, Johansson B, Persson C, Berglund A, Turesson I. Effects of a dietary intervention on acute gastrointestinal side effects and other aspects of health-related quality of life: a randomized controlled trial in prostate cancer patients undergoing radiotherapy. Radiotherapy and Oncology. 2012 Jun 1; 103(3): 333-40.
33.    Stryker JA, Mortel R, Hepner GW. The effect of pelvic irradiation on lactose absorption. International Journal of Radiation Oncology* Biology* Physics. 1978 Sep 1; 4(9-10): 859-63.
34.    Ravasco P, Monteiro‐Grillo I, Marques Vidal P, Camilo ME. Impact of nutrition on outcome: a prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Head and Neck: Journal for the Sciences and Specialties of the Head and Neck. 2005 Aug; 27(8): 659-68.

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