Effectiveness of Nutritional Intervention in Reduction of Gastrointestinal Toxicity during External Beam Radiotherapy in Women with Gynecological Tumors




Jaime Humberto Soto-Lugo, Investigador principal, Residente de cuarto año de Radiooncología, Departamento de Radiooncología, Centro Médico del Noreste, Unidad Médica de Alta Especialidad No. 25, Instituto Mexicano del Seguro Social, Monterrey, N.L., México
Miguel Souto-del Bosque, Departamento de Radio-Oncología, Centro Médico del Noreste, Unidad Médica de Alta Especialidad 25, IMSS, Monterrey, N.L., México
Carlos Alberto Vázquez-Martínez, Director de Enseñanza, Departamento de Radiooncología, Centro Médico del Noreste, Unidad Médica de Alta Especialidad No. 25, Instituto Mexicano del Seguro Social, Monterrey, N.L., México


Objective: To assess if nutritional intervention with a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) decreases acute gastrointestinal toxicity induced by pelvic external beam radiotherapy in patients with gynecologic tumors. Material and methods: Single-center, randomized, prospective clinical trial comparing patients on a low-FODMAP diet vs. standard Mexican diet, designed to detect an 80% decrease in Grade 1-2 acute gastrointestinal toxicity in the standard diet group to 25% of Grade 1-2 acute gastrointestinal toxicity in the low-FODMAP diet group. Results: Thirteen patients were recruited per group, with higher gastrointestinal toxicity grade 1-2 (85 vs. 77%) and 3 (23 vs. 0%) being reported in the standard diet group with regard to the low-FODMAP diet (p = 0.16). The low-FODMAP diet group had a lower end of treatment symptom score in the cervical cancer patient quality of life questionnaire (1.41 vs. 1.85; p = 0.01) and lower ECOG mean deterioration (0.61 [SD ± 0.5] vs. 0.23 [SD ± 0.43]; p = 0.049). Excellent adherence to the diet was shown by 85% of patients. No factors associated with the presence of grade 3 gastrointestinal toxicity were found. Conclusion: Implementation of a low-FODMAP diet during pelvic external beam radiation therapy is a low-cost and high-adherence measure that reduces end-of-treatment performance status and symptom deterioration in patients with cervical cancer.



Keywords: Gynecologic tumor. Low-FODMAP diet. Quality of life. Gastrointestinal toxicity.





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