Abstract
Pelvic cancer radiotherapy may cause chronic radiation proctitis (CRP) that adversely affects patient’s quality of life, especially in patients with prolonged hematochezia. However, previous studies of radiation enteropathy mainly focused on acute irradiation hazards, and the detailed pathogenesis process and mechanism of prolonged hematochezia associated with radiation-induced toxicity remain unclear. In this study, we characterized the gut microbiota of 32 female CRP patients with or without hematochezia. Differential patterns of dysbiosis were observed. The abundance of Peptostreptococcaceae, Eubacterium, and Allisonella was significantly higher in CRP patients with hematochezia, while the compositions of the Lachnospiraceae, Megasphera, Megamonas, and Ruminococcaceae were lower in the microbiota of non-hematochezia patients. Functional prediction suggested significant difference in the expression of mineral absorption and the arachidonic acid metabolism proteins between hematochezia and non-hematochezia patients, possibly interdependent on radiation-induced inflammation. This study provides new insight into the altered composition and function of gut microbiota in patients with hematochezia, implying the potential use of probiotics and prebiotics for assessment and treatment of CRP.
Highlights
Pelvic radiotherapy is one of the most important treatments of gynecologic tumors
Thirty-two female participants were assigned into two groups: group NH, meaning chronic radiative proctitis (CRP) patients with no or mild hematochezia; and group H, meaning chronic radiation proctitis (CRP) patients with hematochezia (Table 1)
CRP patients are mostly outpatients in surgery clinic seeking for remission of rectal irritation and hematochezia
Summary
Pelvic radiotherapy is one of the most important treatments of gynecologic tumors. Chronic radiation proctitis (CRP) is a well-known complication of pelvic radiotherapy that occurs in 5% to 20% of the cancer survivors 6 months to several years later [1]. Unlike acute radiation enteropathy (RE), which presents with acute diarrhea and requires immediate termination of radiotherapy [2], CRP commonly manifests hematochezia, which adversely affects patient’s quality of life in the long term. Hemorrhage Associated Microbiota in CRP of mental effects including anxiety and depression, especially in female patients [3, 4]. Current treatments of CRP including high doses of 5-amin-osalicylic acid enemas, endoscopic thermal formalin therapy, and argon plasma coagulation rely on medical equipment and professional physicians [5,6,7]. Development of daily oral drugs for improving CRP symptoms with better compliance are under the spotlight [8]
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