Klinik Für Innere Medizin II, Hämatologie Und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
Clin Exp Med. 2021 Nov;21(4):501-536. doi: 10.1007/s10238-021-00710-2. Epub 2021 Apr 3.
Ketogenic diets are a widely known, yet controversial treatment for cancer patients. In this review, we summarize the clinical evidence for anti-tumor effects, as well as the effects on anthropometry, quality of life, adverse events and adherence in cancer patients. In April 2019, a systematic search was conducted searching five electronic databases (EMBASE, Cochrane, PsychInfo, CINAHL and Medline) to find studies analyzing the use, effectiveness and potential harm of a ketogenic diet in cancer patients of any age as sole or complementary therapy. From all 19.211 search results, 46 publications concerning 39 studies with 770 patients were included in this systematic review. The therapy concepts included all forms of diets with reduced carbohydrate intake, that aimed to achieve ketosis for patients with different types of cancer. Most studies had a low quality, high risk of bias and were highly heterogeneous. There was no conclusive evidence for anti-tumor effects or improved OS. The majority of patients had significant weight loss and mild to moderate side effects. Adherence to the diet was rather low in most studies. Due to the very heterogeneous results and methodological limitations of the included studies, clinical evidence for the effectiveness of ketogenic diets in cancer patients is still lacking.
生酮饮食是一种广为人知但颇具争议的癌症治疗方法。在这篇综述中，我们总结了生酮饮食在癌症患者中的抗肿瘤作用、人体测量学、生活质量、不良反应和依从性方面的临床证据。2019 年 4 月，我们进行了系统检索，在五个电子数据库（EMBASE、Cochrane、PsychInfo、CINAHL 和 Medline）中搜索了分析癌症患者使用、有效性和潜在危害的研究，这些患者接受生酮饮食作为单一或补充治疗，年龄不限。从所有 19211 个检索结果中，纳入了 46 篇涉及 39 项研究的文献，共纳入 770 名患者。这些治疗方案包括所有形式的低碳水化合物饮食，旨在使不同类型癌症患者达到酮症状态。大多数研究的质量较低，存在高偏倚风险，且高度异质性。目前尚无明确证据表明生酮饮食具有抗肿瘤作用或能改善 OS。大多数患者体重显著减轻，出现轻度至中度副作用。大多数研究中患者对饮食的依从性较低。由于纳入研究的结果非常异质且方法学局限性较大，生酮饮食在癌症患者中的有效性的临床证据仍不足。
