Impact of a low FODMAP diet on the amount of rectal gas and rectal volume during radiotherapy in patients with prostate cancer - a prospective pilot study

Schaefer, Christian; Zamboglou, Constantinos; Volegova-Neher, Natalja; Martini, Carmen; Nicolay, Nils Henrik; Schmidt-Hegemann, Nina-Sophie; Rogowski, Paul; Li, Minglun; Belka, Claus; Müller, Arndt-Christian; Grosu, Anca-Ligia und Brunner, Thomas (2020): Impact of a low FODMAP diet on the amount of rectal gas and rectal volume during radiotherapy in patients with prostate cancer - a prospective pilot study. In: Radiation Oncology, Bd. 15, Nr. 1, 27

Abstract

Background: Small inter- and intrafractional prostate motion was shown to be a prerequisite for precise radiotherapy (RT) of prostate cancer (PCa) to achieve good local control and low rectal toxicity. As rectal gas and rectal volume are known to have a relevant effect on prostate motion, this study aims to reduce these parameters by using a Low FODMAP Diet (LFD) and to show feasibility of this intervention. Methods We compared a prospective intervention group (IG, n = 25) which underwent RT for PCa and whose patients were asked to follow a LFD during RT with a retrospective control group (CG, n = 25) which did not get any dietary advice. In the planning CT scan and all available cone beam CT scans rectal gas was classified based on a semiquantitative score (scale from 1 to 5) and rectal volume was measured. Furthermore, patients' compliance was evaluated by a self-assessment questionnaire. Results Clinical and treatment characteristics were well balanced between both groups. A total of 266 (CG, 10.6 per patient) and 280 CT scans (IG, 11.2 per patient), respectively, were analysed. The frequency distribution of gas scores differed significantly from each other (p < .001) with the IG having lower scores. Rectal volume was smaller in the IG (64.28 cm(3), 95% CI 60.92-67.65 cm(3), SD 28.64 cm(3)) than in the CG (71.40 cm(3), 95% CI 66.47-76.32 cm(3), SD 40.80 cm(3)) (p = .02). Mean intrapatient standard deviation as a measure for the variability of rectal volume was 22 cm(3) in the IG and 23 cm(3) in the CG (p = .81). Patients' compliance and contentment were satisfying. Conclusions: The use of a LFD significantly decreased rectal gas and rectal volume. LFD was feasible with an excellent patients' compliance. However, prospective trials with a larger number of patients and a standardized evaluation of gastrointestinal toxicity and quality of life are reasonable.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Sprache: Englisch