Preventive effects of combined live Bifidobacterium, Lactobacillus, Enterococcus, and Bacillus cereus tablets on radiation pneumonitis-associated with cyberknife treatment for pulmonary malignancies.

Wei Wang, Yingchun Zhao, Ying Guo, Qian Wang, Lichao Hong

Journal: Annals of clinical microbiology and antimicrobials 2025;24(1):66

PMID: 41257942

Abstract

BACKGROUD

To investigate the preventive effects of combined live Bifidobacterium, Lactobacillus, Enterococcus, and Bacillus cereus tablets (CBLEBTL) on patients with radiation pneumonitis associated with CyberKnife treatment for pulmonary malignancies.

METHODS

In total, 130 patients who received CyberKnife treatment for pulmonary malignancies at the First Hospital of Hebei Medical University between August 2023 and February 2025 were enrolled. Patients were randomly categorized into the experimental group (n = 65) or control group (n = 65). While both groups received CyberKnife treatment for pulmonary lesions, the experimental group additionally received CBLEBTL (0.5 g/dose, thrice daily). The primary endpoint was to determine the incidence of RP, and secondary endpoints included onset time of RP and Eastern Cooperative Oncology Group performance status (ECOG PS) scores.

RESULTS

RP incidence was significantly lower in the experimental group (6/61 [9.8%]) than in the control group (16/62 [25.8%]) (χ² = 5.340, P = 0.021). The mean onset time of RP was significantly delayed in the experimental group than in the control group (176.9 vs. 166.6 days; hazard ratio = 0.34, 95% confidence interval: 0.15-0.80, P < 0.05). ECOG PS of the experimental group was significantly lower than that of the control group at 2, 4 and 6 months post-CyberKnife treatment (P < 0.05).

CONCLUSION

CBLEBTL effectively reduced the incidence of CyberKnife-associated RP among patients with pulmonary malignancies, delayed RP onset, and improved their quality of life.

TRIAL REGISTRATION

This prospective trial was registered retrospectively (after patient enrollment began) because of delays in institutional approval processes. The retrospective registration was approved by the Ethics Committee of The First Hospital of Hebei Medical University (Approval No. [2025]074). The trial is registered at: WHO-primary registry ChiCTR (No. ChiCTR2500104615; Date: 19-Jun-2025), accessible via WHO ICTRP ( https://trialsearch.who.int/ ); China's National Public Health Security Information Platform (No. MR-13-25-043029; Date: 09-Jun-2025). All study procedures followed the original protocol without modifications.

Address: Department of Oncology, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Yuhua District, Shijiazhuang, 050000, Hebei Province, China.; Department of Oncology, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Yuhua District, Shijiazhuang, 050000, Hebei Province, China. [email protected].; Department of Medical Imaging, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Yuhua District, Shijiazhuang, 050000, Hebei Province, China. [email protected].

DOI: 10.1186/s12941-025-00833-4

MeSH Terms: Humans, Lung Neoplasms, Male, Female, Middle Aged, Bacillus cereus, Aged, Probiotics, Radiation Pneumonitis, Lactobacillus, Enterococcus, Radiosurgery, Tablets, Adult