What do systematic reviews say?

Single‐fraction radiotherapy (8 Gy) vs short‐course radiotherapy (16 Gy

Single‐fraction radiotherapy (8 Gy) showed no clear difference in adverse events Grade 3 oesophagitis, diarrhoea and nausea compared with short‐course radiotherapy (16 Gy (moderate certainty).

• Interventions for the treatment of metastatic extradural spinal cord compression in adults 2015 · Cochrane Headline outcomes only
  RR 0.14 [0.01, 2.69]
  1 study · 303 participants
  Moderate

Split‐course radiotherapy (8 fractions, 30 Gy) vs short‐course radiotherapy (16 Gy

Split‐course radiotherapy (8 fractions, 30 Gy) showed no clear difference in adverse events Grade 3 oesophagitis, diarrhoea, and nausea compared with short‐course radiotherapy (2 fractions, 16 Gy) (moderate certainty).

• Interventions for the treatment of metastatic extradural spinal cord compression in adults 2015 · Cochrane Headline outcomes only
  RR 1.77 [0.43, 7.25]
  1 study · 276 participants
  Moderate

Probiotics vs placebo

• Probiotics for the prevention or treatment of chemotherapy‐ or radiotherapy‐related diarrhoea in people with cancer 2018 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 226 participants
  Very low

Summary of findings: Aminosalicylates vs placebo

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Intervention diet vs usual on‐treatment diet

Summary of findings: Diet interventions showed no clear difference in diarrhoea (grade 2+) compared with usual on‐treatment diet (low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 0.79 [0.45, 1.38]
  1 study · 50 participants
  Low

Intervention diet vs usual on‐treatment diet

Summary of findings: Diet interventions showed no clear difference in diarrhoea (grade 1+) compared with usual on‐treatment diet (low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 0.74 [0.45, 1.23]
  1 study · 119 participants
  Low

Probiotics vs placebo

Probiotics showed no clear difference in diarrhoea grade 2 or higher compared with placebo (low certainty).

• Probiotics for the prevention or treatment of chemotherapy‐ or radiotherapy‐related diarrhoea in people with cancer 2018 · Cochrane Headline outcomes only
  RR 0.75 [0.55, 1.03]
  4 studies · 420 participants
  Low

Probiotics vs placebo

• Probiotics for the prevention or treatment of chemotherapy‐ or radiotherapy‐related diarrhoea in people with cancer 2018 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 793 participants
  Low

Sucralfate vs placebo

Summary of findings: Sucralfate may leads to lower diarrhoea (grade 2+) [during RT] compared with placebo (low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 0.81
  4 studies · 284 participants
  Low

Probiotics vs other active intervention

Probiotics may leads to lower severity of diarrhoea: grade 3 or higher compared with other active treatment (low certainty).

• Probiotics for the prevention or treatment of chemotherapy‐ or radiotherapy‐related diarrhoea in people with cancer 2018 · Cochrane Headline outcomes only
  OR 0.38 [0.16, 0.89]
  1 study · 148 participants
  Low

Probiotics vs placebo

Probiotics showed no clear difference in diarrhoea grade 4 compared with placebo (low certainty).

• Probiotics for the prevention or treatment of chemotherapy‐ or radiotherapy‐related diarrhoea in people with cancer 2018 · Cochrane Headline outcomes only
  RR 0.33 [0.01, 7.78]
  1 study · 46 participants
  Low

Probiotics vs placebo or control

Summary of findings: Probiotics may leads to lower diarrhoea (grade 2+) compared with control (placebo or no intervention) (low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 0.43 [0.22, 0.82]
  5 studies · 923 participants
  Low

Summary of findings: Proteolytic enzymes vs placebo or control

It is very uncertain whether summary of findings: Proteolytic enzymes changes diarrhoea (grade 2+) compared with control (placebo or no intervention) (very low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 1.6 [0.89, 2.89]
  1 study · 56 participants
  Very low

Glutamine vs placebo

Summary of findings: Glutamine showed no clear difference in diarrhoea (grade 2+) compared with placebo (high certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 0.98 [0.78, 1.24]
  4 studies · 289 participants
  High

Summary of findings: BT vs external beam radiotherapy (EBRT)

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  0 participants
  GRADE not reported

Counselling vs no intervention

Summary of findings: Counselling may leads to lower diarrhoea (grade 2+) compared with no intervention (low certainty).

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  RR 0.12 [0.03, 0.47]
  1 study · 74 participants
  Low

Summary of findings: Reduced dose volume vs standard dose volume

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Summary of findings: Higher bladder volume vs lower bladder volume

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Summary of findings: Hydrogel spacer vs no intervention

The review found no eligible studies for this question.

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Summary of findings: Conformal RT vs conventional dose RT

• Interventions to reduce acute and late adverse gastrointestinal effects of pelvic radiotherapy for primary pelvic… 2018 · Cochrane Headline outcomes only
  no estimate extracted
  0 participants
  GRADE not reported