Abstract
PurposeRadiotherapy to the prostate gland and pelvic lymph nodes may cause acute and late bowel symptoms and diminish quality of life. The aim was to study the effects of a nutrition intervention on bowel symptoms and health-related quality of life, compared with standard care.MethodsPatients were randomised to a nutrition intervention (n = 92) aiming to replace insoluble fibres with soluble and reduce intake of lactose, or a standard care group (n = 88) who were recommended to maintain their habitual diet. Bowel symptoms, health-related quality of life and intake of fibre and lactose-containing foods were assessed up to 24 months after radiotherapy completion. Multiple linear regression was used to analyse the effects of the nutrition intervention on bowel symptoms during the acute (up to 2 months post radiotherapy) and the late (7 to 24 months post radiotherapy) phase.ResultsMost symptoms and functioning worsened during the acute phase, and improved during the late phase in both the intervention and standard care groups. The nutrition intervention was associated with less blood in stools (p = 0.047), flatulence (p = 0.014) and increased loss of appetite (p = 0.018) during the acute phase, and more bloated abdomen in the late phase (p = 0.029). However, these associations were clinically trivial or small.ConclusionsThe effect of the nutrition intervention related to dietary fibre and lactose on bowel symptoms from pelvic RT was small and inconclusive, although some minor and transient improvements were observed. The results do not support routine nutrition intervention of this type to reduce adverse effects from pelvic radiotherapy.
Highlights
Radiotherapy (RT) is a well-established treatment option for patients with intermediate or high-risk prostate cancer
The aim of the paper is to study the effects of an Nutrition interventions (NI), aiming to replace foods high in insoluble fibre and lactose with foods with a higher proportion of soluble fibre and low in lactose, on acute and late bowel symptoms and health-related quality of life (HRQoL), among men undergoing RT to the prostate gland and pelvic lymph nodes, compared with standard care
The most obvious changes were observed during the acute phase
Summary
Radiotherapy (RT) is a well-established treatment option for patients with intermediate or high-risk prostate cancer. Despite technical advances in delivery, pelvic RT exposes parts of the bowel to some degree of radiation, and 90% of patients experience a change in bowel habits during treatment [1–3]. Acute symptoms such as diarrhoea, abdominal pain and urgency can occur during the treatment period and may subside after RT completion [1, 4]. Severe acute symptoms increase the risk of late bowel symptoms [5]. I.e. symptoms that persist or develop months to years after RT, can be permanent and progressive in severity and may include diarrhoea, urgency, rectal bleeding and incontinence [6].
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