Safdie Fernando M, Dorff Tanya, Quinn David, Fontana Luigi, Wei Min, Lee Changhan, Cohen Pinchas, Longo Valter D
Andrus Gerontology Center and Department of Biological Sciences, University of Southern California, Los Angeles, CA 90089, USA.
Aging (Albany NY). 2009 Dec 31;1(12):988-1007. doi: 10.18632/aging.100114.
Short-term fasting (48 hours) was shown to be effective in protecting normal cells and mice but not cancer cells against high dose chemotherapy, termed Differential Stress Resistance (DSR), but the feasibility and effect of fasting in cancer patients undergoing chemotherapy is unknown. Here we describe 10 cases in which patients diagnosed with a variety of malignancies had voluntarily fasted prior to (48-140 hours) and/or following (5-56 hours) chemotherapy. None of these patients, who received an average of 4 cycles of various chemotherapy drugs in combination with fasting, reported significant side effects caused by the fasting itself other than hunger and lightheadedness. Chemotherapy associated toxicity was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) of the National Cancer Institute (NCI). The six patients who underwent chemotherapy with or without fasting reported a reduction in fatigue, weakness, and gastrointestinal side effects while fasting. In those patients whose cancer progression could be assessed, fasting did not prevent the chemotherapy-induced reduction of tumor volume or tumor markers. Although the 10 cases presented here suggest that fasting in combination with chemotherapy is feasible, safe, and has the potential to ameliorate side effects caused by chemotherapies, they are not meant to establish practice guidelines for patients undergoing chemotherapy. Only controlled-randomized clinical trials will determine the effect of fasting on clinical outcomes including quality of life and therapeutic index.
短期禁食（48小时）已被证明能有效保护正常细胞和小鼠免受高剂量化疗的影响，但对癌细胞无效，这被称为差异应激抵抗（DSR），但禁食对接受化疗的癌症患者的可行性和效果尚不清楚。在此，我们描述了10例被诊断患有各种恶性肿瘤的患者，他们在化疗前（48 - 140小时）和/或化疗后（5 - 56小时）自愿禁食。这些患者平均接受了4个周期的各种化疗药物联合禁食治疗，除了饥饿和头晕外，没有报告禁食本身引起的显著副作用。化疗相关毒性根据美国国立癌症研究所（NCI）的不良事件通用术语标准（CTCAE）进行分级。6例接受化疗时禁食或不禁食的患者报告，在禁食期间疲劳、虚弱和胃肠道副作用有所减轻。在那些癌症进展可以评估的患者中，禁食并未阻止化疗引起的肿瘤体积或肿瘤标志物的减少。尽管这里呈现的10个病例表明禁食与化疗联合是可行、安全的，并且有可能改善化疗引起的副作用，但它们并非旨在为接受化疗的患者制定实践指南。只有对照随机临床试验才能确定禁食对包括生活质量和治疗指数在内的临床结果的影响。
