Probiotics in Adjunctive Prevention and Treatment of Chemotherapy-induced Diarrhea:A Meta-analysis / 中国药房

ABSTRACT

OBJECTIVE:To systematically evaluate the effectiveness of probiotics in adjunctive prevention and treatment of chemotherapy-induced diarrhea(CID),and to provide evidence-based reference in the clinic. METHODS:All relevant randomized controlled trials (RCTs) of probiotics in adjunctive prevention and treatment of CID were collected by searching EMBase,Co-chrane library,PubMed,CJFD,VIP,Wanfang databases and CBM. Meta-analysis were performed with Rev Man 5.2 software af-ter data extraction and quality evaluation by Cochrane Hand book 5.0risk-bias assessment tool. RESULTS:10 RCTs were includ-ed,involving 871 patients. The results of Meta-analysis showed that addition of probiotics on the basis of conventional symptomatic therapy significantly reduced the total rate of diarrhea in cancer patients [OR=0.31,95%CI(0.20,0.49),P<0.001] and Ⅲ-Ⅳ diar-rhea rate[OR=0.09,95%CI(0.03,0.24),P<0.001],improved overall response rate [OR=4.16,95%CI(2.40,7.23),P<0.001] and complete remission rate [OR=2.55,95%CI(1.66,3.90),P<0.001],with statistical significance. The probiotics had little effect onⅠ-Ⅱlevel diarrhea rate[OR=0.86,95%CI(0.48,1.56),P=0.62] and partial remission rate[OR=1.00,95%CI(0.67,1.50),P=1.00],with statistical significance. CONCLUSIONS:The use of probiotics before chemotherapy can effectively prevent the occur-rence of severe CID in cancer patients;in the treatment of CID,the combination of probiotics can also improve therapeutic effica-cy of conventional symptomatic treatment.