Evidence map›Paper›PMID 41303051›Full record

ArticleJournal of clinical medicine2025

Modulating the Gut Microbiota via Rectal Ozone Insufflation in Gynecological Cancer Patients with Radiotherapy/Chemotherapy-Induced Pelvic Toxicity: A Proposed Clinical Study Protocol.

Bernardino Clavo, Elizabeth Córdoba-Lanús, Gregorio Martínez-Sánchez, Mario Federico, Ángeles Cánovas-Molina, José E Piñero, Ana M Vargas-Prado, Avinash Ramchandani, Marta Zajac, Ivone Ribeiro and 8 more

Registry-linked trialAbstract read
In one paragraph

Article in Journal of clinical medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07325851 (Prospective and Observational Study of Patients Referred to the Chronic Pain Unit for Palliative Treatment With Ozone Therapy Between 2026 and 2029. Prospective Study EPOOzo-2.), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07325851 not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Prospective and Observational Study of Patients Referred to the Chronic Pain Unit for Palliative Treatment With Ozone Therapy Between 2026 and 2029. Prospective Study EPOOzo-2.

Typeobservational_patient_registrySponsorBernardino Clavo, MD, PhDRan2026 to 2030Enrolled120ConditionsChemotherapy-Induced Peripheral Neuropathy, Radiation Toxicity, Chronic Pain, Delayed Wound HealingArmsOzone Therapy
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Bernardino ClavoResearch Unit, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain.ORCID 0000-0003-2522-1064
Elizabeth Córdoba-LanúsInstituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, 38296 La Laguna, Spain.ORCID 0000-0001-5534-8280
Gregorio Martínez-SánchezFundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), 35019 Las Palmas de Gran Canaria, Spain.ORCID 0000-0002-6628-7388
Mario FedericoResearch Unit, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain.ORCID 0000-0002-6184-9070
Ángeles Cánovas-MolinaResearch Unit, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain.ORCID 0000-0001-8557-860X
José E PiñeroInstituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, 38296 La Laguna, Spain.ORCID 0000-0001-6233-8224
Ana M Vargas-PradoMedical Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain.ORCID 0009-0003-5399-9831
Avinash RamchandaniMedical Oncology Department, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain.ORCID 0000-0002-9754-3903
Marta ZajacRadiation Oncology Department, Hospital Universitario Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain.
Ivone RibeiroRadiation Oncology Department, Hospital Universitario Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain.
Minerva NavarroChronic Pain Unit, Dr. Negrín University Hospital, 35019 Las Palmas de Gran Canaria, Spain.
Ignacio J JorgeChronic Pain Unit, Dr. Negrín University Hospital, 35019 Las Palmas de Gran Canaria, Spain.ORCID 0000-0001-7178-5691
Jesús M González-MartínResearch Unit, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain.ORCID 0000-0001-6816-4157
Ruth Martín-AlfaroClinical Analysis Department, Hospital Universitario Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain.
María Fernández-TagarroClinical Analysis Department, Hospital Universitario Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain.
Juan A Díaz-GarridoResearch Unit, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain.ORCID 0000-0001-9713-8177
Jacob Lorenzo-MoralesInstituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, 38296 La Laguna, Spain.ORCID 0009-0008-1736-0471
Francisco Rodríguez-EsparragónResearch Unit, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain.ORCID 0000-0003-1663-3673

Funding

Cabildo de Gran Canaria, Las Palmas, Spain CIGC'23-24Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas, Spain. PIFIISC24/37Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas, Spain. PIFIISC25/52
6 · The paper itself

Abstract

backgroundChronic pelvic toxicity induced by radiotherapy and/or chemotherapy (R/CIPT) is a debilitating sequela in gynecological cancer survivors, often refractory to conventional treatments and potentially linked to gut microbiota dysbiosis. Ozone therapy (OT), particularly rectal insufflation, demonstrates anti-inflammatory and redox-modulating effects through hormetic mechanisms (Nrf2 activation/NF-κB inhibition). We hypothesize that its clinical benefit is mediated, in part, by restoring gut microbial homeostasis.

objectiveThis manuscript proposes a clinical study to evaluate the impact of rectal OT on the gut microbiota of patients with gynecological cancers and chronic R/CIPT. Proposed Methods: A prospective, observational study of 38 patients is outlined: 19 with CTCAE v5.0 Grade ≥2 chronic R/CIPT receiving compassionate rectal OT (~40 sessions over 4 months), and 19 matched controls without toxicity. Stool samples for 16S rRNA sequencing will be collected from the OT group pre- and post-intervention and once from controls. Primary endpoints are changes in microbiota composition/diversity and pelvic toxicity scores (CTCAE v5.0, EORTC QLQ-CX24). Secondary endpoints include quality of life (EORTC QLQ-C30, EQ-5D-5L), anxiety/depression (HADS), and serum inflammatory/oxidative stress biomarker analysis. Anticipated Results and Conclusion: This will be the first study to prospectively investigate whether rectal OT's effect correlates with a beneficial shift in the gut microbiota, specifically an increase in commensals (e.g., short-chain fatty acids producers) and a decrease in pathobionts. If successful, OT could be assessed as a novel, microbiota-targeting intervention for R/CIPT. The findings from this pilot study will provide the necessary groundwork for a future randomized controlled trial to definitively establish causality and efficacy.

Indexed as

chemotherapy toxicitydysbiosisgut microbiotagynecological cancerozone therapyradiotherapy toxicitysupportive care

Identifiers

PMID41303051
PMCPMC12653057

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.