Mercier Benjamin D, Tizpa Eemon, Philip Errol J, Feng Qianhua, Huang Ziyi, Thomas Reeny M, Pal Sumanta K, Dorff Tanya B, Li Yun R
Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, 1500 E Duarte Rd, Duarte, CA 91010, USA.
Department of Medical Oncology, City of Hope Comprehensive Cancer Center, 1500 E Duarte Rd, Duarte, CA 91010, USA.
Cancers (Basel). 2022 Oct 20;14(20):5149. doi: 10.3390/cancers14205149.
Chemotherapy and radiotherapy are first-line treatments in the management of advanced solid tumors. Whereas these treatments are directed at eliminating cancer cells, they cause significant adverse effects that can be detrimental to a patient's quality of life and even life-threatening. Diet is a modifiable risk factor that has been shown to affect cancer risk, recurrence, and treatment toxicity, but little information is known how diet interacts with cancer treatment modalities. Although dietary interventions, such as intermittent fasting and ketogenic diets, have shown promise in pre-clinical studies by reducing the toxicity and increasing the efficacy of chemotherapeutics, there remains a limited number of clinical studies in this space. This review surveys the impact of dietary interventions (caloric restriction, intermittent and short-term fasting, and ketogenic diet) on cancer treatment outcomes in both pre-clinical and clinical studies. Early studies support a complementary role for these dietary interventions in improving patient quality of life across multiple cancer types by reducing toxicity and perhaps a benefit in treatment efficacy. Larger, phase III, randomized clinical trials are ultimately necessary to evaluate the efficacy of these dietary interventions in improving oncologic or quality of life outcomes for patients that are undergoing chemotherapy or radiotherapy.
化疗和放疗是晚期实体瘤治疗的一线方法。虽然这些治疗旨在消除癌细胞，但它们会产生严重的不良反应，可能损害患者的生活质量，甚至危及生命。饮食是一个可改变的风险因素，已被证明会影响癌症风险、复发和治疗毒性，但关于饮食如何与癌症治疗方式相互作用的信息却知之甚少。尽管饮食干预，如间歇性禁食和生酮饮食，在临床前研究中已显示出通过降低毒性和提高化疗药物疗效而带来的前景，但该领域的临床研究数量仍然有限。本综述调查了饮食干预（热量限制、间歇性和短期禁食以及生酮饮食）在临床前和临床研究中对癌症治疗结果的影响。早期研究支持这些饮食干预在通过降低毒性改善多种癌症类型患者生活质量方面的补充作用，并且可能对治疗效果有益。最终需要更大规模的III期随机临床试验来评估这些饮食干预对正在接受化疗或放疗的患者在改善肿瘤学或生活质量结果方面的疗效。
