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Chee Kin Then

DPhil student, Department of Oncology, University of Oxford

Professor Anne Kiltie

Department of Oncology, University of Oxford

Oxford University researchers are discovering how gut flora can be modified to improve patient outcomes in radiotherapy.

A key area of research is the value of using pro- and prebiotics in protecting patients against radiotherapy induced gut injury. “We know that many patients can suffer from radiation induced injury, for example, diarrhoea, or long-term fibrosis. So, the potential gains for patients are significant,” says Professor Anne Kiltie, Professor of Experimental Clinical Oncology, at the University of Oxford.

Recent studies have highlighted gut microbiota modulation as a way of maximising treatment efficacy in chemotherapy and immunotherapy, but little research exists for this application in radiotherapy. Even though over half of people with cancer will receive this therapy, often with curative intent, radiotherapy is comparatively under-researched.

Redressing the research imbalance

As one of the research centres in the new CRUK RadNet network, Oxford University is now looking to redress this imbalance. Recent studies have looked at the application in radiotherapy of antibiotics to enhance the anti-tumour efficacy and the abscopal effect of the treatment.

Professor Anne Kiltie and her team are now looking to see whether a similar effect can be achieved by using high fibre as a way of radiosensitising a tumour – opening up the possibility of more effective and targeted treatment.

Among the fibre products now being investigated is psyllium, which is already widely used and available as an ingredient in simple over the counter medicines for constipation. Studies centre on the effect in the gut of the short chain fatty acid butyrate, which is a by-product of dietary fibre, and which is essential for healthy gut function. Studies suggest that butyrate can accumulate in the tumour and make it more sensitive to radiation.

Currently, research is still at an early stage, but the research team is hopeful of moving into human trials soon. “There is a lot of value in seeking effective alternatives to antibiotics. Initial results are very promising,” says Professor Kiltie.

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