{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T14:46:32Z","timestamp":1778856392261,"version":"3.51.4"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T00:00:00Z","timestamp":1752364800000},"content-version":"vor","delay-in-days":193,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mediators of Inflammation"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    This is the first prospective clinical study to evaluate the impact of prebiotic and probiotic use on acute radiation\u2010induced pelvic side effects and associated changes in serum cytokine levels in patients with pelvic malignancies.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    This multicenter prospective study included 80 patients with pelvic cancers treated at two centers between 2021 and 2023. Patients were divided into three groups: probiotic\u2009+\u2009prebiotic, prebiotic only, and nonsupplemented. Serum cytokine levels (tumor necrosis factor\u2010alpha (TNF\u2010\u03b1) and interleukin (IL)\u20106) and radiation\u2010related side effect scores were assessed at the beginning of pelvic radiotherapy (RT) and again at the fifth week. Based on data normality, the Wilcoxon signed\u2010rank test was used for statistical analysis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    According to side effect scores, in the prebiotic\u2010only group, a modest yet statistically significant increase in fecal incontinence (FI;\n                    <jats:italic>p<\/jats:italic>\n                    = 0.040) and blood and mucus in the stool (BMS;\n                    <jats:italic>p<\/jats:italic>\n                    = 0.049) was observed. Conversely, the probiotic\u2009+\u2009prebiotic group showed a significant increase in dysuria (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.001) and impotence (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.016). IL\u20106 levels significantly increased in the prebiotic\u2010only group (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.035), while TNF\u2010\u03b1 levels rose significantly in the group without any nutritional support (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.025). No significant increase in cytokine levels or intestinal side effects was observed in the combined probiotic\u2009+\u2009prebiotic group (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009 &gt; 0.05 for all comparisons).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    The absence of a rise in cytokine levels and intestinal toxicity in the probiotic\u2009+\u2009prebiotic group suggests that probiotics may play a role in mitigating radiation\u2010induced intestinal side effects and inflammatory responses.\n                  <\/jats:p>","DOI":"10.1155\/mi\/1441225","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T04:33:57Z","timestamp":1752467637000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Effects of Probiotic\u2013Prebiotic Use on Acute Inflammatory Parameters in Patients Receiving Pelvic Radiotherapy: A Prospective Multicenter Study"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5747-2522","authenticated-orcid":false,"given":"Muge","family":"Akmansu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1771-8188","authenticated-orcid":false,"given":"Sefika","family":"Dincer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4034-1614","authenticated-orcid":false,"given":"Esra","family":"Kaytan Saglam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2420-1259","authenticated-orcid":false,"given":"Zuleyha","family":"Akgun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hatice","family":"Pasaoglu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,13]]},"reference":[{"key":"e_1_2_13_1_2","unstructured":"Cancer Research UK [Available 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