Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy.
Centro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy.
Crit Rev Food Sci Nutr. 2022;62(4):1035-1045. doi: 10.1080/10408398.2020.1832955. Epub 2020 Oct 14.
Neuroendocrine neoplasms (NENs) are a heterogeneous group of neoplasms, whose incidence has rapidly increased in the last years. Nutrition plays an important role in their management; indeed, malnutrition negatively impacts on rates of complications, hospitalization, hospital stay, costs and mortality. Furthermore, it has been reported that a poor nutritional status could influence the outcome of patients with pancreatic NENs. Moreover, obesity, predisposing to insulin resistance and compensatory hyperinsulinemia, could stimulate the growth of these neoplasms. Ketogenic diet (KD), a high-fat, low-carbohydrate diet with adequate amounts of protein, has been reported to be a promising approach for the management of several types of cancer, mostly gynecological and neurological ones. Indeed, it appears to sensitize most cancers to standard treatment by exploiting the reprogramed metabolism of cancer cells and thus resulting in a promising candidate as an adjuvant cancer therapy. Thus, the aim of this review is to provide an overview on the importance of nutrition in cancer management and in particular in NENs' setting. Furthermore, we reported the current evidence on the efficacy of KD in the management of cancer and based on molecular mechanisms; we also hypothesize the potential use of this nutritional pattern in the management of NENs.
神经内分泌肿瘤（NENs）是一组异质性肿瘤，其发病率在过去几年中迅速增加。营养在其治疗中起着重要作用；事实上，营养不良会对并发症发生率、住院率、住院时间、成本和死亡率产生负面影响。此外，据报道，营养不良状况差可能会影响胰腺 NEN 患者的预后。此外，肥胖会导致胰岛素抵抗和代偿性高胰岛素血症，从而刺激这些肿瘤的生长。生酮饮食（KD）是一种高脂肪、低碳水化合物的饮食，含有足够数量的蛋白质，据报道，它是治疗多种癌症的一种很有前途的方法，主要是妇科和神经科癌症。事实上，它似乎通过利用癌细胞重编程的代谢使大多数癌症对标准治疗敏感，因此成为一种有前途的辅助癌症治疗候选药物。因此，本综述的目的是概述营养在癌症治疗中的重要性，特别是在 NEN 治疗中的重要性。此外，我们报告了 KD 在癌症管理中的有效性的最新证据，并基于分子机制；我们还假设这种营养模式在 NENs 治疗中的潜在用途。
