Exploiting dietary fibre and the gut microbiota in pelvic radiotherapy patients

Selina E. Eaton, Justyna Kaczmarek, Daanish Mahmood, Anna M. McDiarmid, Alya N. Norarfan, Erin G. Scott, Chee Kin Then, Hailey Y. Tsui, Anne E. Kiltie*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

5 Citations (Scopus)
4 Downloads (Pure)


With an ageing population, there is an urgent need to find alternatives to current standard-of-care chemoradiation schedules in the treatment of pelvic malignancies. The gut microbiota may be exploitable, having shown a valuable role in improving patient outcomes in anticancer immunotherapy. These bacteria feed on dietary fibres, which reach the large intestine intact, resulting in the production of beneficial metabolites, including short-chain fatty acids. The gut microbiota can impact radiotherapy (RT) treatment responses and itself be altered by the radiation. Evidence is emerging that manipulation of the gut microbiota by dietary fibre supplementation can improve tumour responses and reduce normal tissue side effects following RT, although data on tumour response are limited to date. Both may be mediated by immune and non-immune effects of gut microbiota and their metabolites. Alternative approaches include use of probiotics and faecal microbiota transplantation (FMT). Current evidence will be reviewed regarding the use of dietary fibre interventions and gut microbiota modification in improving outcomes for pelvic RT patients. However, data regarding baseline (pre-RT) gut microbiota of RT patients and timing of dietary fibre manipulation (before or during RT) is limited, heterogenous and inconclusive, thus more robust clinical studies are required before these strategies can be applied clinically.

Original languageEnglish
Pages (from-to)2087–2098
Number of pages12
JournalBritish Journal of Cancer
Early online date29 Sept 2022
Publication statusPublished - 7 Dec 2022

Bibliographical note

We thank Mrs Pat Bain for her assistance in creating Fig. 1.

Funding Information:
AEK’s salary is funded by Friends of ANCHOR and the University of Aberdeen Development Trust. CKT’s DPhil was funded by the Clarendon Fund, Balliol College, Oxford and Cancer Research UK. JK’s summer research project was funded by a Royal College of Radiologists’ Summer Undergraduate Research Fellowship. The authors received no specific funding for this work.

Data Availability Statement



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