Microbial Diversity and Composition Is Associated with Patient-Reported Toxicity during Chemoradiation Therapy for Cervical Cancer
Open accessAbstract
Purpose Patients receiving pelvic radiation for cervical cancer experience high rates of acute gastrointestinal (GI) toxicity. The association of changes in the gut microbiome with bowel toxicity from radiation is not well characterized.Methods and materials Thirty-five patients undergoing definitive chemoradiation therapy (CRT) underwent longitudinal sampling (baseline and weeks 1, 3, and 5) of the gut microbiome and prospective assessment of patient-reported GI toxicity. DNA was isolated from stool obtained at rectal examination and analyzed with 16S rRNA sequencing. GI toxicity was assessed with the Expanded Prostate Cancer Index Composite instrument to evaluate frequency, urgency, and discomfort associated with bowel function. Shannon diversity index was used to characterize alpha (within sample) diversity. Weighted UniFrac principle coordinates analysis was used to compare beta (between sample) diversity between samples using permutational multivariate analysis of variance. Linear discriminant analysis effect size highlighted microbial features that best distinguish categorized patient samples.Results Gut microbiome diversity continuously decreased over the course of CRT, with the largest decrease at week 5. Expanded Prostate Cancer Index Composite bowel function scores also declined over the course of treatment, reflecting increased symptom burden. At all individual time points, higher diversity of the gut microbiome was linearly correlated with better patient-reported GI function, but baseline diversity was not predictive of eventual outcome. Patients with high toxicity demonstrated different compositional changes during CRT in addition to compositional differences in Clostridia species.Conclusions Over time, increased radiation toxicity is associated with decreased gut microbiome diversity. Baseline diversity is not predictive of end-of-treatment bowel toxicity, but composition may identify patients at risk for developing high toxicity.
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Compositional characteristics associated with members of the Clostridiales order are found in patients who experienced less toxicity.
“we identified compositional characteristics associated with members of the Clostridiales order in patients who experienced less toxicity.”
From Gut microbiome diversity is an independent predictor of survival in cervical cancer patients receiving chemoradiation (2021) · cites this paper as [30]
Increased radiation toxicity is associated with a decrease in gut microbiome diversity.
“We found increased radiation toxicity to be associated with a decrease in gut microbiome diversity.”
From Gut microbiome diversity is an independent predictor of survival in cervical cancer patients receiving chemoradiation (2021) · cites this paper as [30]
Baseline gut diversity is not predictive of end-of-treatment bowel toxicity.
“although baseline gut diversity was not predictive of end-of-treatment bowel toxicity”
From Gut microbiome diversity is an independent predictor of survival in cervical cancer patients receiving chemoradiation (2021) · cites this paper as [30]
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Microbiome-mediated regulation of chemoradiotherapy response
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[Relationship between chronic radiation enteritis of cervical cancer and gut microbiota].
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Self-citationRole of Human Microbiome in Development and Management of Head and Neck Squamous Cell Carcinoma
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Electron-beam FLASH whole brain irradiation induced a unique changes of intestinal flora
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Link between dysbiosis and cancer: Contributing mechanisms and factors
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Implicaciones del microbioma en la etiología y el tratamiento del cáncer de próstata en humanos.
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Patients with Trachelectomy Surgery Sexual Performance Domains in Cervical Cancer Patients
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Palliative care and quality of life
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Systemic Onco-Sphere: Host Microbiome and Cancer
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A Review of the Relationship between Tumors of the Biliary System and Intestinal Microorganisms
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Alterations in Gut Microbiota Correlate With Hematological Injuries Induced by Radiation in Beagles
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Gut Microbiota Is Not Significantly Altered by Radioiodine Therapy
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Radiobiome: investigating the functional resilience of gut microbiome species to radiation
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Microbiome and chemotherapy/radiotherapy-induced toxicities
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- Authors
- Mitra, A., Grossman Biegert, G. W., Delgado, A. Y., Karpinets, T. V., Solley, T. N., Mezzari, M. P., Yoshida-Court, K., Petrosino, J. F., Mikkelson, M. D., Lin, L., Eifel, P., Zhang, J., Ramondetta, L. M., Jhingran, A., Sims, T. T., Schmeler, K., Okhuysen, P., Colbert, L. E., & Klopp, A. H.
- Affiliations
- The University of Texas MD Anderson Cancer Center (US)
- Baylor College of Medicine (US)
- Corresponding author
- Colbert, Lauren E.
- ORCID
- Venue
- International Journal of Radiation Oncology*Biology*Physics
- Publisher
- Elsevier BV
- Published
- 2020-05
- Volume
- 107
- Issue
- 1
- Pages
- 163-171
- ISSN
- 0360-3016 (ISSN-L)
- PMC
- PMC7932475
- OpenAlex
- W3002865023
- Cited by
- 90
- References
- 34
- Citations by year
- 2026: 8 · 2025: 20 · 2024: 15 · 2023: 16 · 2022: 15 · 2021: 15 · 2020: 1
- FWCI
- 3.81
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Radiation Oncology*Biology*Physics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Cancer Institute (P30CA016672)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Infectious Diseases › Clostridium difficile and Clostridium perfringens research
- Keywords
- gut microbiota, cervical cancer, chemoradiotherapy, radiation-induced gastrointestinal toxicity, microbiome diversity, patient-reported toxicity, Expanded Prostate Cancer Index Composite, Clostridia, predictive biomarkers, microbiota composition
- MeSH terms
- Gastrointestinal Microbiome, Patient Reported Outcome Measures, Adult, Aged, Uterine Cervical Neoplasms, Female, Humans, Middle Aged, Safety, Cohort Studies, Gastrointestinal Tract, Biodiversity, Chemoradiotherapy
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