The Second Clinical Medical College, Zhejiang Chinese Medical University, Zhejiang 310000, China.
Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe East Road, Zhengzhou, Henan 450052, China.
J Stomatol Oral Maxillofac Surg. 2024 Oct;125(5S2):101983. doi: 10.1016/j.jormas.2024.101983. Epub 2024 Aug 24.
Oral mucositis is a frequent adverse reaction in cancer treatment. Probiotics exhibit anti-inflammatory and immunomodulatory properties that could prevent the occurrence of severe oral mucositis (SOM) induced by chemotherapy or radiation therapy in patients. This meta-analysis aimed to investigate the influence of probiotics on the incidence of SOM in cancer patients undergoing chemotherapy and/or radiotherapy.
We conducted a comprehensive search in PubMed, Embase, the Cochrane Library, and the China National Knowledge Infrastructure (CNKI) from their inception to September 2023. Dichotomous variables are analyzed with odds ratios (ORs) with 95% CIs, and statistical significance was set at a two-tailed P <0 .05. The primary outcome indicator was the effect of probiotics on SOM. Secondary outcome indicators included the effect of probiotics on oral mucositis and the ratio of diarrhoea. Statistical analysis was conducted using RevMan (5.4) and Stata 17.0 software.
The study included a total of 12 articles and involved 1055 patients. All patients had undergone either radiotherapy or chemotherapy. Our findings revealed that the experimental group, which received probiotics for treatment, exhibited a lower ratio of SOM compared to the control group that received traditional placebo treatment (OR=0.37, 95%CI [0.28, 0.50], P<0.01). Subgroup analysis revealed variations in the ratio of SOM based on therapeutic regimen, tumor type, and region. The overall ratio of oral mucositis was significantly lower in the experimental group compared to the control group (OR=0.19, 95%CI [0.09-0.39], P<0.01). The ratio of diarrhea in the two patient groups showed no significant difference (OR=0.85, 95%CI [0.24, 3.01], P>0.05).
The results of this meta-analysis suggest that probiotics could decrease the occurrence of SOM.
口腔黏膜炎是癌症治疗中常见的不良反应。益生菌具有抗炎和免疫调节作用，可预防化疗或放疗引起的癌症患者严重口腔黏膜炎（SOM）的发生。本荟萃分析旨在探讨益生菌对接受化疗和/或放疗的癌症患者 SOM 发生率的影响。
我们全面检索了 PubMed、Embase、Cochrane 图书馆和中国国家知识基础设施（CNKI）从成立到 2023 年 9 月的数据。二分类变量采用比值比（ORs）和 95%置信区间（CI）进行分析，双侧 P<0.05 为统计学意义。主要结局指标是益生菌对 SOM 的影响。次要结局指标包括益生菌对口腔黏膜炎和腹泻发生率的影响。统计分析采用 RevMan（5.4）和 Stata 17.0 软件。
该研究共纳入 12 篇文章，涉及 1055 例患者。所有患者均接受放疗或化疗。我们的研究结果表明，接受益生菌治疗的实验组 SOM 发生率低于接受传统安慰剂治疗的对照组（OR=0.37，95%CI [0.28, 0.50]，P<0.01）。亚组分析显示 SOM 发生率因治疗方案、肿瘤类型和地区而异。实验组口腔黏膜炎的总发生率明显低于对照组（OR=0.19，95%CI [0.09-0.39]，P<0.01）。两组患者腹泻的发生率无显著差异（OR=0.85，95%CI [0.24, 3.01]，P>0.05）。
本荟萃分析结果表明，益生菌可降低 SOM 的发生。
