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Objective: To assess if nutritional intervention with a diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) decreases acute gastrointestinal toxicity induced by pelvic external beam radiotherapy in patients with gynecologic tumors. Material and methods: Single-center, randomized, prospective clinical trial comparing patients on a low-FODMAP diet vs. standard Mexican diet, designed to detect an 80% decrease in Grade 1-2 acute gastrointestinal toxicity in the standard diet group to 25% of Grade 1-2 acute gastrointestinal toxicity in the low-FODMAP diet group. Results: Thirteen patients were recruited per group, with higher gastrointestinal toxicity grade 1-2 (85 vs. 77%) and 3 (23 vs. 0%) being reported in the standard diet group with regard to the low-FODMAP diet (p = 0.16). The low-FODMAP diet group had a lower end of treatment symptom score in the cervical cancer patient quality of life questionnaire (1.41 vs. 1.85; p = 0.01) and lower ECOG mean deterioration (0.61 [SD ± 0.5] vs. 0.23 [SD ± 0.43]; p = 0.049). Excellent adherence to the diet was shown by 85% of patients. No factors associated with the presence of grade 3 gastrointestinal toxicity were found. Conclusion: Implementation of a low-FODMAP diet during pelvic external beam radiation therapy is a low-cost and high-adherence measure that reduces end-of-treatment performance status and symptom deterioration in patients with cervical cancer. (creativecommons.org/licenses/by-nc-nd/4.0/). Si n co nt ar c on e l c on se nt im ie nt o pr ev io p or e sc ri to d el e di to r, no p od rá r ep ro du ci rs e ni f ot oc op ia rs e ni ng un a pa rt e de e st a pu bl ic ac ió n. © P er m an ye r M éx ic o 20 17 Nutritional intervention to reduce EBRT induced GI toxicity 85

gaceta mexicana de oncología/gaceta mexicana de oncología

Effectiveness of Nutritional Intervention in Reduction of Gastrointestinal Toxicity during External Beam Radiotherapy in Women with Gynecological Tumors