• 文献检索未发现检验妇科癌症手术或化疗对肠道或阴道菌群的可能影响的研究;
  • 3个前瞻性队列研究中,有2个评价了胃肠道毒性,8名女性在放疗期间发生了2或3级的腹泻,提示肠道菌群变化和放疗的关系,并显示肠道菌群种类丰富度和多样性下降;
  • 在接受放疗前,拟杆菌属、小类杆菌属及韦永氏球菌属丰度较高的患者在放疗后可能发展出腹泻症状;
  • 亟需关于妇科癌症治疗的女性阴道和肠道菌群的大型研究,探索癌症治疗与长期胃肠毒性的关系。

Systematic Review: The Impact of Cancer Treatment on the Gut and Vaginal Microbiome in Women With a Gynecological Malignancy



2017-06-06, Review

Abstract & Authors:展开

BACKGROUND AND AIM: Worldwide, 1,470,900 women are diagnosed yearly with a gynecological malignancy (21,000 in the UK). Some patients treated with pelvic radiotherapy develop chronic changes in their bowel function. This systematic review summarizes current research on the impact of cancer treatment on the gut and vaginal microbiome in women with a gynecological malignancy.
METHODS: The Preferred reporting Items for Systematic Reviews and Meta-analyses guidelines for systematic reviews were used to ensure transparent and complete reporting. Quantitative studies exploring the gut or vaginal microbiome in this patient cohort were included. Animal studies were excluded. There were no language restrictions.
RESULTS: No studies examined the possible effects of surgery or chemotherapy for gynecological cancers on the gut or vaginal microbiome.Three prospective cohort studies were identified using sequencing of changes in the gut microbiome reporting on a total of 23 women treated for gynecological cancer. All studies included patients treated with radiotherapy with a dosage ranging from 43.0 to 54.0 Gy. Two studies assessed gastrointestinal toxicity formally; 8 women (57%) developed grade 2 or 3 diarrhea during radiotherapy. The outcomes suggest a correlation between changes in the intestinal microbiome and receiving radiotherapy and showed a decrease in abundance and diversity of the intestinal bacterial species. Before radiotherapy, those who developed diarrhea had an increased abundance of Bacteroides, Dialister, and Veillonella (P < 0.01), and a decreased abundance of Clostridium XI and XVIII, Faecalibacterium, Oscillibacter, Parabacteroides, Prevotella, and unclassified bacteria (P < 0.05).
CONCLUSION: The limited evidence to date implies that larger studies including both the vaginal and gut microbiome in women treated for a gynecological malignancy are warranted to explore the impact of cancer treatments on the microbiome and its relation to developing long-term gastrointestinal toxicity. This may lead to new avenues to stratify those at risk and explore personalized treatment options and prevention of gastrointestinal consequences of cancer treatments.

First Authors:
Ann Muls

Correspondence Authors:
Ann Muls

All Authors:
Ann Muls,Jervoise Andreyev,Susan Lalondrelle,Alexandra Taylor,Christine Norton,Ailsa Hart