Abstract
Although pelvic irradiation is effective for the treatment of various cancer types, many patients who receive radiotherapy experience serious complications. Gut microbial dysbiosis was hypothesized to be related to the occurrence of radiation-induced complications in cancer patients. Given the lack of clinical or experimental data on the impact of radiation on gut microbiota, a prospective observational study of gut microbiota was performed in gynecological cancer patients receiving pelvic radiotherapy. In the current study, the overall composition and alteration of gut microbiota in cancer patients receiving radiation were investigated by 454 pyrosequencing. Gut microbial composition showed significant differences (P < 0.001) between cancer patients and healthy individuals. The numbers of species-level taxa were severely reduced after radiotherapy (P < 0.045), and the abundance of each community largely changed. In particular, the phyla Firmicutes and Fusobacterium were significantly decreased by 10% and increased by 3% after radiation therapy, respectively. In addition, overall gut microbial composition was gradually remolded after the full treatment course of pelvic radiotherapy. In this set of cancer patients, dysbiosis of the gut microbiota was linked to health status, and the gut microbiota was influenced by pelvic radiotherapy. Although further studies are needed to elucidate the relationship between dysbiosis and complications induced by pelvic radiotherapy, the current study may offer insights into the treatment of cancer patients suffering from complications after radiation therapy.
Highlights
More than 50% of cancer patients receive irradiation for cancer treatment [1]
Impact of radiation therapy on gut microbiota of gynecologic cancer patients We examined the impact of radiation therapy on the gut microbial community of gynecological cancer patients
We examined the impact of radiation therapy on the gut microbial community composition in cancer patients
Summary
More than 50% of cancer patients receive irradiation for cancer treatment [1]. Pelvic irradiation has long been used as a curative or palliative therapy and has been proven to be successful for the treatment of various types of cancer, including abdominal and cervical cancers [2,3]. During and after the radiotherapy period, many patients (i.e., 75% of visceral pelvic cancer patients) suffer symptoms, including diarrhea, mucus discharge, rectal bleeding, tenesmus, and fecal incontinence. These complications may increase the healthcare costs and mortality of cancer patients, with longer hospitalizations and slower cancer treatments [2]. Crawford and Gordon revealed the importance of gut microbiota in the occurrence of radiation injury [5] They showed that germ-free mice were resistant to lethal radiation injury and had less radiationinduced epithelial cell damage as compared to conventional mice with commensal gut microbial flora. Despite increasing evidence of the relationship between gut microbiota and radiation enteropathy, no comprehensive molecular analyses have been performed to investigate the influence of irradiation on gut microbiota in human cancer patients
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