Oudmaijer Christiaan A J, van den Boogaard Winnie M C, Komninos Daphne S J, Verwaaijen Emma J, van Santen Hanneke M, Lilien Marc R, Hoeijmakers Jan H J, Wijnen Marc H W, van den Heuvel-Eibrink Marry M, Vermeij Wilbert P
Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.
Oncode Institute, Utrecht, Netherlands.
Front Pediatr. 2022 Jan 27;10:828615. doi: 10.3389/fped.2022.828615. eCollection 2022.
Childhood renal tumors account for around 6% of all childhood cancers and 90% of these cases are Wilms tumor. In Europe, the SIOP-RTSG approach is considered standard of care and has resulted in five-year survival rates of over 90%. Efforts to decrease toxicity are now being pursued. Short-term fasting (STF), a short but strong reduction in calorie-intake, is associated with improved fitness, enhanced coping with acute physical stress and a lower risk of age-associated diseases. STF temporarily reduces growth to boost resilience, maintenance, and defense-mechanisms, by which toxic side-effects of (oxidative) damage and inflammation are largely prevented. Renal surgery for Wilms tumor carries a risk of acute kidney injury (AKI) and pediatric patients that had an episode of AKI are at increased risk for developing chronic renal disease. STF could mitigate surgery-induced stress and could further improve outcomes. We aim to investigate the effect of STF on renal function recovery after renal tumor surgery by conducting a single-center, prospective, randomized, non-blinded, intervention study. Children diagnosed with a unilateral renal tumor and opting for curative treatment are eligible for inclusion. The main study objective is to investigate the potential decrease in occurrence of AKI due to STF. Secondary objectives include renal function recovery, child's wellbeing, physical functioning, and feasibility of and adherence to STF in children with cancer.
儿童肾肿瘤约占所有儿童癌症的6%，其中90%为肾母细胞瘤。在欧洲，SIOP-RTSG方法被视为标准治疗方案，五年生存率超过90%。目前正在努力降低毒性。短期禁食（STF），即短期内大幅减少热量摄入，与身体状况改善、应对急性身体应激能力增强以及患与年龄相关疾病的风险降低有关。短期禁食会暂时减缓生长，以增强恢复力、维持能力和防御机制，从而在很大程度上预防（氧化）损伤和炎症的毒性副作用。肾母细胞瘤的肾脏手术存在急性肾损伤（AKI）风险，经历过一次急性肾损伤的儿科患者患慢性肾病的风险会增加。短期禁食可以减轻手术引起的应激，并可能进一步改善治疗结果。我们旨在通过开展一项单中心、前瞻性、随机、非盲法干预研究，调查短期禁食对肾肿瘤手术后肾功能恢复的影响。被诊断为单侧肾肿瘤并选择根治性治疗的儿童符合纳入条件。主要研究目标是调查短期禁食导致急性肾损伤发生率的潜在降低情况。次要目标包括肾功能恢复、儿童健康状况、身体功能以及癌症患儿短期禁食的可行性和依从性。
