Published online Oct 15, 2021. doi: 10.4251/wjgo.v13.i10.1518
Peer-review started: April 27, 2021
First decision: June 13, 2021
Revised: June 26, 2021
Accepted: August 27, 2021
Article in press: August 27, 2021
Published online: October 15, 2021
Processing time: 168 Days and 23.8 Hours
Colorectal cancer (CRC) is one of the leading causes of mortality due to malignant diseases worldwide. Capecitabine, the prodrug of 5-fluorouracil (5-FU), is one of the most important chemotherapeutic agents used in CRC treatment. Prolonged use of regimens containing capecitabine can lead to systemic toxicity with the consequent discontinuation of the treatment.
To improve the management of CRC patients, it is necessary the incorporation of therapies that mitigate the side effects of the conventional CRC treatment and reduce its resistance. Probiotics have beneficial properties when they are used in the management of many gastrointestinal diseases. Also, it is known that probiotics are able to reduce undesirable effects of 5-FU in CRC patients and to benefit CRC patients treated surgically. In a rat CRC model, probiotic supplementation potentiated the antitumor effect of 5-FU chemotherapy on colon. The positive impact of probiotics in a preclinical model of CRC under capecitabine treatment was unknown when we started our experimental work.
The aim of this study was to evaluate the impact of a mixture of probiotics strains in the outcome of a rat CRC model treated with capecitabine and monitored until the end of life.
Male Wistar-Lewis rats with CRC induced by 1,2-dimethylhydrazine dihydrochloride (1,2-DMH) were grouped as follow: 1.2-DMH alone (DMH group, n = 10), 1,2-DMH + capecitabine (DMH-C group, n = 10), 1,2-DMH + probiotics (DMH-P group, n = 10), 1,2-DMH + capecitabine + probiotics (DMH-C-P group, n = 10). Two groups of male Wistar-Lewis rats were used as controls: untreated group (Control n = 5) and Control + probiotics group (Control-P, n = 5). During the experiment, the following were analyzed in all groups: survival time, clinicopathological characteristics, quality of life and cause of death.
The administration of probiotics showed a benefit in survival time, weight gain, clinical manifestations and cancer development.
The fact that the animals were followed until the end of life allow to conclude that this study is the first that shows the positive impact of probiotics in the overall survival of rats with CRC under capecitabine treatment.
The use of probiotics could improve the overall survival and quality of life of patients with CRC treated with capecitabine.