Cannizzaro Renato, Maiero Stefania, Pelizzo Paola, Gulotta Marco, Facchin Sonia, Tessarolo Giulia, Zucchetto Antonella, Matrone Fabio, Realdon Stefano, Bortolus Roberto
Oncological Gastroenterology-Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy.
Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, 34129 Trieste, Italy.
J Clin Med. 2025 Jul 7;14(13):4783. doi: 10.3390/jcm14134783.
: Prostate cancer is the most frequent cancer in men, for which Radiotherapy (RT) is used as a radical or post-surgical treatment. Actinic proctitis is one of the most disabling side effects of RT. Intestinal microbiome studies have highlighted the importance of short-chain fatty acids, in particular butyric acid, for their beneficial effects over intestinal epithelial cells. The aim of this prospective study is to evaluate if treatment with micro-encapsulated sodium butyrate (MESB) can reduce the incidence of actinic proctitis during RT in prostate cancer patients. : In total, 122 consecutive patients with prostate cancer treated in Radiotherapy Unit, Centro di Riferimento Oncologico, IRCCS Aviano, were enrolled. Patients received MESB (3 tablets/day) from one week before until four weeks after RT. They completed a diary, tracking daily bowel movements, rectal bleeding, abdominal pain, and perceived health status before, at the end, and one month after RT. : Although an improvement in symptoms was observed, when comparing interpatient data before RT vs. one month after the end of RT, statistically significant differences emerged only regarding abdominal pain (94.2% vs. 81.6% vs. 81.6%) (McNemar's test < 0.002). MESB appears effective in reducing radiation-induced bowel toxicity during RT, minimizing stool changes, incontinence, and abdominal pain. Although patients' health perception declined at RT completion, it improved after one month, suggesting MESB may support clinical recovery post-treatment.
前列腺癌是男性中最常见的癌症，放射治疗（RT）被用作根治性或术后治疗方法。放射性直肠炎是RT最致残的副作用之一。肠道微生物组研究强调了短链脂肪酸，特别是丁酸，因其对肠道上皮细胞的有益作用的重要性。这项前瞻性研究的目的是评估微囊化丁酸钠（MESB）治疗是否可以降低前列腺癌患者RT期间放射性直肠炎的发生率。
总共招募了122名在IRCCS阿维亚诺肿瘤参考中心放疗科接受治疗的连续前列腺癌患者。患者从RT前一周至RT后四周接受MESB（3片/天）。他们完成了一本日记，记录RT前、结束时和结束后一个月的每日排便情况、直肠出血、腹痛和自我感觉的健康状况。
尽管观察到症状有所改善，但在比较RT前与RT结束后一个月的患者间数据时，仅在腹痛方面出现了统计学上的显著差异（94.2%对81.6%对81.6%）（McNemar检验<0.002）。MESB似乎在降低RT期间辐射引起的肠道毒性方面有效，可将大便变化、失禁和腹痛降至最低。尽管患者在RT结束时的健康感知下降，但在一个月后有所改善，这表明MESB可能有助于治疗后的临床恢复。
