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Investigation Of The Effect Of Nutrition In Gynecologic Malignancy On The Early Genitourinary And Gastrointestinal Side Effects Profile Of Patients Receiving Pelvic Radiotherapy

Yıl 2025, Cilt: 25 Sayı: 2, 56 - 65, 13.09.2025

Öz

Aim: The The role of therapeutic or adjuvant radiotherapy in gynecological cancers is crucial. Genitourinary and gastrointestinal symptoms can occur in these diseases due to the anatomical relationships in the pelvic region. To prevent these complications, enriching the intestinal flora and microbiota, as well as providing supplementation with trace elements, vitamins, and minerals, has been shown to reduce side effects. This study aimed to investigate the early gastrointestinal and genitourinary side effect profiles in patients receiving nutritional support (NS) and radiotherapy.
Material and Methods: Patients who presented to the Department of Obstetrics and Gynecology and Radiation Oncology Department at Selçuk University Faculty of Medicine between 2023 and 2024 and received pelvic radiotherapy for gynecological malignancy were evaluated. Nutritional support is routinely provided in the clinic, and the study was designed as a retrospective study. The Radiation Therapy Oncology Group’s Radiation Toxicity Index was used for side effect scoring. A total of 120 patients were included in the study. Based on nutritional support, Group 1 (n=60) included those who received nutritional support, and Group 2 (n=60) included those who did not receive nutritional support.
Results: There was a difference in the distribution of genitourinary side effects among patients receiving radiotherapy according to their use of nutritional support (p<0.05). It was observed that the use of NS had the potential to reduce genitourinary side effects. There was a difference in the distribution of gastrointestinal side effects in patients receiving radiotherapy according to their NS use (p<0.05). Gastrointestinal side effects were less common in patients receiving NS.
Conclusion: Nutritional support is thought to reduce genitourinary and gastrointestinal side effects in gynecologic cancer patients undergoing pelvic radiotherapy. Individualized approaches are essential, regardless of nutritional index.

Etik Beyan

Ethical approval was obtained from the ethics committee of Selçuk University Faculty of Medicine. Ethics number: E-70632468-05004-905549. This study complies with the Declaration of Helsinki

Destekleyen Kurum

No conflict of interest.

Teşekkür

No.

Kaynakça

  • 1. Pritlove C, Capone G, Ramasamy M, et al. Eliminating Digestive Irregularities Caused by Late Effects: A Pilot Study of an Innovative Culinary Nutrition Intervention for Reducing Gastrointestinal Toxicity in Gynecologic Cancer Patients Who Have Undergone Pelvic Radiotherapy. Nutrients. 2024;16(23):422
  • 2. Borre M, Fassov J, Poulsen JL, et al. Dietary Intervention Improves Gastrointestinal Symptoms after Treatment of Cancer in the Pelvic Organs. J Clin Med. 2023;12(14):4766
  • 3. Lee, J., Lin, J. B., Weng, C. S., Chen, S. J., Chen, T. C., & Chen, Y. J. (2023). Impact of reduced margin pelvic radiotherapy on gastrointestinal toxicity and outcome in gynecological cancer. Clinical and translational radiation oncology, 43, 100671.
  • 4. Ahrén, I. L., Bjurberg, M., Steineck, G., Bergmark, K., & Jeppsson, B. (2022). Decreasing the Adverse Effects in Pelvic Radiation Therapy: A Randomized Controlled Trial Evaluating the Use of Probiotics. Advances in radiation oncology, 8(1), 101089.
  • 5. Andreou, L., Burrows, T., & Surjan, Y. (2021). The effect of nutritional interventions involving dietary counselling on gastrointestinal toxicities in adults receiving pelvic radiotherapy - A systematic review. Journal of medical radiation sciences, 68(4), 453– 464.
  • 6. Wedlake, L. J., Thomas, K., Lalji, A., Blake, P., Khoo, Pelvic Radiotherapy on Gynecologic Malignancy And Nutritional Support V. S., Tait, D., & Andreyev, H. J. (2010). Predicting late effects of pelvic radiotherapy: is there a better approach?. International journal of radiation oncology, biology, physics, 78(4), 1163–1170.
  • 7. Beer, W. H., Fan, A., & Halsted, C. H. (1985). Clinical and nutritional implications of radiation enteritis. The American journal of clinical nutrition, 41(1), 85–91.
  • 8. Henson, C. C., Burden, S., Davidson, S. E., & Lal, S. (2013). Nutritional interventions for reducing gastrointestinal toxicity in adults undergoing radical pelvic radiotherapy. The Cochrane database of systematic reviews, 2013(11),
  • 9. Gibson RJ, Keefe DM, Lalla RV, et al. Systematic review of agents for the management of gastrointestinal mucositis in cancer patients. Support Care Cancer. 2013;21(1):313-326.
  • 10. Croisier E, Brown T, Bauer J. The Efficacy of Dietary Fiber in Managing Gastrointestinal Toxicity Symptoms in Patients with Gynecologic Cancers undergoing Pelvic Radiotherapy: A Systematic Review. J Acad Nutr Diet. 2021;121(2):261-277
  • 11. Demark-Wahnefried W, Rock CL, Patrick K, Byers T. Lifestyle interventions to reduce cancer risk and improve outcomes. Am Fam Physician. 2008;77(11):1573-1578.
  • 12. Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995;31(5):1341-1346
  • 13. Kalaycı, Ş. SPSS Uygulamalı Çok Değişkenli İstatiksel Teknikler (6. Baskı). Ankara: Asil Yayın Dağıtım., 2005 14. Muscaritoli M, Arends J, Bachmann P, et al. ESPEN practical guideline: Clinical Nutrition in cancer. Clin Nutr. 2021;40(5):2898-2913.
  • 15. Hauer-Jensen M, Denham JW, Andreyev HJ. Radiation enteropathy--pathogenesis, treatment and prevention. Nat Rev Gastroenterol Hepatol. 2014;11(8):470-479.
  • 16. Chorbińska J, Krajewski W, Zdrojowy R. Urological complications after radiation therapy-nothing ventured, nothing gained: a Narrative Review. Transl Cancer Res. 2021;10(2):1096-1118.
  • 17. Li Y, Zhang Y, Wei K, et al. Review: Effect of Gut Microbiota and Its Metabolite SCFAs on Radiation- Induced Intestinal Injury. Front Cell Infect Microbiol. 2021;11:577236.
  • 18. Delia, P., Sansotta, G., Donato, V., Frosina, P., Messina, G., De Renzis, C., & Famularo, G. (2007). Use of probiotics for prevention of radiation-induced diarrhea. World journal of gastroenterology, 13(6), 912–915.
  • 19. Kim, Y. J., Yu, J., Park, S. P., Lee, S. H., & Kim, Y. S. (2021). Prevention of radiotherapy induced enteropathy by probiotics (PREP): protocol for a double-blind randomized placebo-controlled trial. BMC cancer, 21(1), 1032.
  • 20. Lin, S., & Shen, Y. (2020). The efficacy and safety of probiotics for prevention of chemoradiotherapy- induced diarrhea in people with abdominal and pelvic cancer: A systematic review and meta-analysis based on 23 randomized studies. International journal of surgery (London, England), 84, 69–77.
  • 21. Tan, S. E., Abdul Satar, N. F., & Majid, H. A. (2022). Effects of Immunonutrition in Head and Neck Cancer Patients Undergoing Cancer Treatment - A Systematic Review. Frontiers in nutrition, 9, 821924.
  • 22. Caccialanza R, Cereda E, Agustoni F, et al. Multicentre, randomised, open-label, parallel-group, clinical phase II study to evaluate immunonutrition in improving efficacy of immunotherapy in patients with metastatic non-small cell lung cancer, undergoing systematic nutritional counseling. BMC Cancer. 2022;22(1):1212.
  • 23. Schaefer C, Zamboglou C, Volegova-Neher N, et al. 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. Radiat Oncol. 2020;15(1):27.
  • 24. AlmasaudiA.S.(2024).AReviewoftheEfficacyofthe Low Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (FODMAP) Diet in Managing Gastrointestinal Symptoms Related to Cancer Treatment. Cureus, 16(3), e56579.
  • 25. Bossi P, Antonuzzo A, Cherny NI, et al. Diarrhoea in adult cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol. 2018;29(Suppl 4):iv126- iv142.
  • 26. Gatsinga R, Lim BJH, Kumar N, et al. Radiation- Induced Hemorrhagic Cystitis in Prostate Cancer Survivors: The Hidden Toll. Medicina (Kaunas). 2024;60(11):1746

Jinekolojik Malignitelerde Beslenmenin Pelvik Radyoterapi Alan Hastaların Erken Genitoüriner ve Gastrointestinal Yan Etki Profiline Etkisinin Araştırılması

Yıl 2025, Cilt: 25 Sayı: 2, 56 - 65, 13.09.2025

Öz

Giriş/Amaç: Jinekolojik kanserlerde radyoterapinin rolü çok önemlidir. Pelvik bölgedeki anatomik ilişkiler nedeniyle bu hastalıklarda genitoüriner ve gastrointestinal semptomlar ortaya çıkabilir. Bu çalışmada beslenme desteği (ND) alan hastalarda erken gastrointestinal ve genitoüriner yan etki profillerinin araştırılması amaçlanmıştır.
Materyal ve Metod: Selçuk Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı'na 2023-2024 yılları arasında başvuran ve jinekolojik malignite tanısıyla pelvik radyoterapi alan hastalar değerlendirildi. Klinikte rutin olarak beslenme desteği verilmekte olup, çalışma retrospektif olarak tasarlandı. Yan etki skorlaması için Radyasyon Terapisi Onkoloji Grubu'nun Radyasyon Toksisite İndeksi kullanıldı. Çalışmaya toplam 120 hasta dahil edildi. Beslenme desteğine göre Grup 1 (n=60) beslenme desteği alanlar, Grup 2 (n=60) ise beslenme desteği almayan hastalardan oluşturuldu.
Bulgular: Radyoterapi alan hastalarda beslenme desteği kullanımına göre genitoüriner yan etkilerin dağılımında farklılık görüldü (p<0,05). ND kullanımının genitoüriner yan etkileri azaltma potansiyeline sahip olduğu görüldü. Radyoterapi alan hastalarda ND kullanımına göre gastrointestinal yan etkilerin dağılımında farklılık görüldü (p<0,05). ND alan hastalarda gastrointestinal yan etkiler daha az yaygın olarak raporlandı.
Sonuç: Pelvik radyoterapi uygulanan jinekolojik kanser hastalarında beslenme desteğinin genitoüriner ve gastrointestinal yan etkileri azalttığı düşünülmektedir. Beslenme indeksi ve ek hastalıklara göre kişiye özel yaklaşımlar esastır.

Kaynakça

  • 1. Pritlove C, Capone G, Ramasamy M, et al. Eliminating Digestive Irregularities Caused by Late Effects: A Pilot Study of an Innovative Culinary Nutrition Intervention for Reducing Gastrointestinal Toxicity in Gynecologic Cancer Patients Who Have Undergone Pelvic Radiotherapy. Nutrients. 2024;16(23):422
  • 2. Borre M, Fassov J, Poulsen JL, et al. Dietary Intervention Improves Gastrointestinal Symptoms after Treatment of Cancer in the Pelvic Organs. J Clin Med. 2023;12(14):4766
  • 3. Lee, J., Lin, J. B., Weng, C. S., Chen, S. J., Chen, T. C., & Chen, Y. J. (2023). Impact of reduced margin pelvic radiotherapy on gastrointestinal toxicity and outcome in gynecological cancer. Clinical and translational radiation oncology, 43, 100671.
  • 4. Ahrén, I. L., Bjurberg, M., Steineck, G., Bergmark, K., & Jeppsson, B. (2022). Decreasing the Adverse Effects in Pelvic Radiation Therapy: A Randomized Controlled Trial Evaluating the Use of Probiotics. Advances in radiation oncology, 8(1), 101089.
  • 5. Andreou, L., Burrows, T., & Surjan, Y. (2021). The effect of nutritional interventions involving dietary counselling on gastrointestinal toxicities in adults receiving pelvic radiotherapy - A systematic review. Journal of medical radiation sciences, 68(4), 453– 464.
  • 6. Wedlake, L. J., Thomas, K., Lalji, A., Blake, P., Khoo, Pelvic Radiotherapy on Gynecologic Malignancy And Nutritional Support V. S., Tait, D., & Andreyev, H. J. (2010). Predicting late effects of pelvic radiotherapy: is there a better approach?. International journal of radiation oncology, biology, physics, 78(4), 1163–1170.
  • 7. Beer, W. H., Fan, A., & Halsted, C. H. (1985). Clinical and nutritional implications of radiation enteritis. The American journal of clinical nutrition, 41(1), 85–91.
  • 8. Henson, C. C., Burden, S., Davidson, S. E., & Lal, S. (2013). Nutritional interventions for reducing gastrointestinal toxicity in adults undergoing radical pelvic radiotherapy. The Cochrane database of systematic reviews, 2013(11),
  • 9. Gibson RJ, Keefe DM, Lalla RV, et al. Systematic review of agents for the management of gastrointestinal mucositis in cancer patients. Support Care Cancer. 2013;21(1):313-326.
  • 10. Croisier E, Brown T, Bauer J. The Efficacy of Dietary Fiber in Managing Gastrointestinal Toxicity Symptoms in Patients with Gynecologic Cancers undergoing Pelvic Radiotherapy: A Systematic Review. J Acad Nutr Diet. 2021;121(2):261-277
  • 11. Demark-Wahnefried W, Rock CL, Patrick K, Byers T. Lifestyle interventions to reduce cancer risk and improve outcomes. Am Fam Physician. 2008;77(11):1573-1578.
  • 12. Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995;31(5):1341-1346
  • 13. Kalaycı, Ş. SPSS Uygulamalı Çok Değişkenli İstatiksel Teknikler (6. Baskı). Ankara: Asil Yayın Dağıtım., 2005 14. Muscaritoli M, Arends J, Bachmann P, et al. ESPEN practical guideline: Clinical Nutrition in cancer. Clin Nutr. 2021;40(5):2898-2913.
  • 15. Hauer-Jensen M, Denham JW, Andreyev HJ. Radiation enteropathy--pathogenesis, treatment and prevention. Nat Rev Gastroenterol Hepatol. 2014;11(8):470-479.
  • 16. Chorbińska J, Krajewski W, Zdrojowy R. Urological complications after radiation therapy-nothing ventured, nothing gained: a Narrative Review. Transl Cancer Res. 2021;10(2):1096-1118.
  • 17. Li Y, Zhang Y, Wei K, et al. Review: Effect of Gut Microbiota and Its Metabolite SCFAs on Radiation- Induced Intestinal Injury. Front Cell Infect Microbiol. 2021;11:577236.
  • 18. Delia, P., Sansotta, G., Donato, V., Frosina, P., Messina, G., De Renzis, C., & Famularo, G. (2007). Use of probiotics for prevention of radiation-induced diarrhea. World journal of gastroenterology, 13(6), 912–915.
  • 19. Kim, Y. J., Yu, J., Park, S. P., Lee, S. H., & Kim, Y. S. (2021). Prevention of radiotherapy induced enteropathy by probiotics (PREP): protocol for a double-blind randomized placebo-controlled trial. BMC cancer, 21(1), 1032.
  • 20. Lin, S., & Shen, Y. (2020). The efficacy and safety of probiotics for prevention of chemoradiotherapy- induced diarrhea in people with abdominal and pelvic cancer: A systematic review and meta-analysis based on 23 randomized studies. International journal of surgery (London, England), 84, 69–77.
  • 21. Tan, S. E., Abdul Satar, N. F., & Majid, H. A. (2022). Effects of Immunonutrition in Head and Neck Cancer Patients Undergoing Cancer Treatment - A Systematic Review. Frontiers in nutrition, 9, 821924.
  • 22. Caccialanza R, Cereda E, Agustoni F, et al. Multicentre, randomised, open-label, parallel-group, clinical phase II study to evaluate immunonutrition in improving efficacy of immunotherapy in patients with metastatic non-small cell lung cancer, undergoing systematic nutritional counseling. BMC Cancer. 2022;22(1):1212.
  • 23. Schaefer C, Zamboglou C, Volegova-Neher N, et al. 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. Radiat Oncol. 2020;15(1):27.
  • 24. AlmasaudiA.S.(2024).AReviewoftheEfficacyofthe Low Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols (FODMAP) Diet in Managing Gastrointestinal Symptoms Related to Cancer Treatment. Cureus, 16(3), e56579.
  • 25. Bossi P, Antonuzzo A, Cherny NI, et al. Diarrhoea in adult cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol. 2018;29(Suppl 4):iv126- iv142.
  • 26. Gatsinga R, Lim BJH, Kumar N, et al. Radiation- Induced Hemorrhagic Cystitis in Prostate Cancer Survivors: The Hidden Toll. Medicina (Kaunas). 2024;60(11):1746
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Jinekolojik Onkoloji Cerrahisi
Bölüm Araştırma Makalesi
Yazarlar

Belma Gözde Özdemir 0000-0002-7025-4087

Burak Deli 0000-0002-0225-8078

Anara Madinaeva 0009-0001-7364-3029

Hamit Başaran 0000-0002-2122-8720

Cagdas Yavas 0000-0003-3940-1541

Ahmet Bilgi 0000-0001-8682-1739

Cetin Celik 0000-0001-6165-5092

Yayımlanma Tarihi 13 Eylül 2025
Gönderilme Tarihi 9 Ağustos 2025
Kabul Tarihi 12 Eylül 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 25 Sayı: 2

Kaynak Göster

APA Özdemir, B. G., Deli, B., Madinaeva, A., … Başaran, H. (2025). Investigation Of The Effect Of Nutrition In Gynecologic Malignancy On The Early Genitourinary And Gastrointestinal Side Effects Profile Of Patients Receiving Pelvic Radiotherapy. Türk Jinekolojik Onkoloji Dergisi, 25(2), 56-65.
AMA Özdemir BG, Deli B, Madinaeva A, vd. Investigation Of The Effect Of Nutrition In Gynecologic Malignancy On The Early Genitourinary And Gastrointestinal Side Effects Profile Of Patients Receiving Pelvic Radiotherapy. TRSGO Dergisi. Eylül 2025;25(2):56-65.
Chicago Özdemir, Belma Gözde, Burak Deli, Anara Madinaeva, Hamit Başaran, Cagdas Yavas, Ahmet Bilgi, ve Cetin Celik. “Investigation Of The Effect Of Nutrition In Gynecologic Malignancy On The Early Genitourinary And Gastrointestinal Side Effects Profile Of Patients Receiving Pelvic Radiotherapy”. Türk Jinekolojik Onkoloji Dergisi 25, sy. 2 (Eylül 2025): 56-65.
EndNote Özdemir BG, Deli B, Madinaeva A, Başaran H, Yavas C, Bilgi A, Celik C (01 Eylül 2025) Investigation Of The Effect Of Nutrition In Gynecologic Malignancy On The Early Genitourinary And Gastrointestinal Side Effects Profile Of Patients Receiving Pelvic Radiotherapy. Türk Jinekolojik Onkoloji Dergisi 25 2 56–65.
IEEE B. G. Özdemir, B. Deli, A. Madinaeva, H. Başaran, C. Yavas, A. Bilgi, ve C. Celik, “Investigation Of The Effect Of Nutrition In Gynecologic Malignancy On The Early Genitourinary And Gastrointestinal Side Effects Profile Of Patients Receiving Pelvic Radiotherapy”, TRSGO Dergisi, c. 25, sy. 2, ss. 56–65, 2025.
ISNAD Özdemir, Belma Gözde vd. “Investigation Of The Effect Of Nutrition In Gynecologic Malignancy On The Early Genitourinary And Gastrointestinal Side Effects Profile Of Patients Receiving Pelvic Radiotherapy”. Türk Jinekolojik Onkoloji Dergisi 25/2 (Eylül2025), 56-65.
JAMA Özdemir BG, Deli B, Madinaeva A, Başaran H, Yavas C, Bilgi A, Celik C. Investigation Of The Effect Of Nutrition In Gynecologic Malignancy On The Early Genitourinary And Gastrointestinal Side Effects Profile Of Patients Receiving Pelvic Radiotherapy. TRSGO Dergisi. 2025;25:56–65.
MLA Özdemir, Belma Gözde vd. “Investigation Of The Effect Of Nutrition In Gynecologic Malignancy On The Early Genitourinary And Gastrointestinal Side Effects Profile Of Patients Receiving Pelvic Radiotherapy”. Türk Jinekolojik Onkoloji Dergisi, c. 25, sy. 2, 2025, ss. 56-65.
Vancouver Özdemir BG, Deli B, Madinaeva A, Başaran H, Yavas C, Bilgi A, vd. Investigation Of The Effect Of Nutrition In Gynecologic Malignancy On The Early Genitourinary And Gastrointestinal Side Effects Profile Of Patients Receiving Pelvic Radiotherapy. TRSGO Dergisi. 2025;25(2):56-65.