Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan.
Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan.
Clin Nutr. 2017 Feb;36(1):93-99. doi: 10.1016/j.clnu.2015.11.008. Epub 2015 Nov 25.
The clinical value of synbiotics in patients receiving neoadjuvant chemotherapy currently remains unclear. The aim of this study was to investigate the effects of synbiotics in esophageal cancer patients receiving neoadjuvant chemotherapy on the intestinal microbiota and the adverse events of chemotherapy.
Sixty-one patients with advanced esophageal cancer who were scheduled to receive neoadjuvant chemotherapy were randomly allocated to 2 groups. One group received synbiotics during chemotherapy (n = 30), while the other group did not (n = 31). The fecal microbiota and organic acid concentrations were analyzed. The primary endpoint was the incidence of chemotherapy-related adverse events.
The numbers of beneficial and harmful bacteria were significantly larger and smaller, respectively, in the synbiotics group than in the control group on day 10 of chemotherapy. The concentrations of acetic acid and propionic acid were significantly higher in the synbiotics group on day 10 of chemotherapy. The frequencies of severe lymphopenia and diarrhea were significantly less in the synbiotics group than in the control group (P = 0.033, 0.035, respectively). Furthermore, febrile neutropenia occurred less in the synbiotics group (10/30 in the synbiotics group vs 19/31 in the control group, P = 0.029).
Synbiotics during neoadjuvant chemotherapy in esophageal cancer patients reduced the occurrence of adverse events of chemotherapy through adjustments to the intestinal microbiota. (University Hospital Medical Information Network (http://www.umin.ac.jp), registration number UMIN000006875).
目前，联合应用益生菌和益生元（synbiotics）辅助接受新辅助化疗的患者的临床价值尚不清楚。本研究旨在探讨 synbiotics 对接受新辅助化疗的食管癌患者肠道微生物群和化疗不良反应的影响。
将 61 例拟接受新辅助化疗的晚期食管癌患者随机分为两组，化疗期间一组（n=30）给予 synbiotics，另一组（n=31）不给予。分析粪便微生物群和有机酸浓度。主要终点是化疗相关不良反应的发生率。
化疗第 10 天，益生菌组有益菌和有害菌的数量明显多于对照组。化疗第 10 天，益生菌组乙酸和丙酸浓度明显升高。益生菌组严重淋巴细胞减少和腹泻的发生率明显低于对照组（P=0.033，0.035）。此外，益生菌组发热性中性粒细胞减少症的发生率较低（益生菌组 30 例中有 10 例，对照组 31 例中有 19 例，P=0.029）。
在食管癌患者新辅助化疗期间应用 synbiotics 通过调整肠道微生物群减少了化疗不良反应的发生。（大学医院医学信息网络（http://www.umin.ac.jp），注册号 UMIN000006875）。
