Exploiting dietary fibre and the gut microbiota in pelvic radiotherapy patients.

Content Provider	Europe PMC
Author	Eaton, Selina E. Kaczmarek, Justyna Mahmood, Daanish McDiarmid, Anna M. Norarfan, Alya N. Scott, Erin G. Then, Chee Kin Tsui, Hailey Y. Kiltie, Anne E.
Abstract	With an ageing population, there is an urgent need to find alternatives to current standard-of-care chemoradiation schedules in the treatment of pelvic malignancies. The gut microbiota may be exploitable, having shown a valuable role in improving patient outcomes in anticancer immunotherapy. These bacteria feed on dietary fibres, which reach the large intestine intact, resulting in the production of beneficial metabolites, including short-chain fatty acids. The gut microbiota can impact radiotherapy (RT) treatment responses and itself be altered by the radiation. Evidence is emerging that manipulation of the gut microbiota by dietary fibre supplementation can improve tumour responses and reduce normal tissue side effects following RT, although data on tumour response are limited to date. Both may be mediated by immune and non-immune effects of gut microbiota and their metabolites. Alternative approaches include use of probiotics and faecal microbiota transplantation (FMT). Current evidence will be reviewed regarding the use of dietary fibre interventions and gut microbiota modification in improving outcomes for pelvic RT patients. However, data regarding baseline (pre-RT) gut microbiota of RT patients and timing of dietary fibre manipulation (before or during RT) is limited, heterogenous and inconclusive, thus more robust clinical studies are required before these strategies can be applied clinically.
ISSN	00070920
Journal	British Journal of Cancer
Volume Number	127
PubMed Central reference number	PMC9727022
Issue Number	12
PubMed reference number	36175620
e-ISSN	15321827
DOI	10.1038/s41416-022-01980-7
Language	English
Publisher	Nature Publishing Group
Publisher Date	2022-09-29
Publisher Place	London
Access Restriction	Open
Rights License	Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2022
Subject Keyword	Cancer Microbiome
Content Type	Text
Resource Type	Article
Subject	Cancer Research Oncology