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饮食性生酮代谢疗法在胶质母细胞瘤患者中的成功应用:一项临床研究。

Successful application of dietary ketogenic metabolic therapy in patients with glioblastoma: a clinical study.

作者信息

Kiryttopoulos Andreas, Evangeliou Athanasios E, Katsanika Irene, Boukovinas Ioannis, Foroglou Nikolaos, Zountsas Basilios, Cheva Angeliki, Nikolopoulos Vaios, Zaramboukas Thomas, Duraj Tomas, Seyfried Thomas N, Spilioti Martha

机构信息

Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Division of Child Neurology, St Luke's Hospital, Thessaloniki, Greece.

出版信息

Front Nutr. 2025 Feb 18;11:1489812. doi: 10.3389/fnut.2024.1489812. eCollection 2024.

Abstract

INTRODUCTION

Glioblastoma multiforme (GBM) ranks as one of the most aggressive primary malignant tumor affecting the brain. The persistent challenge of treatment failure and high relapse rates in GBM highlights the need for new treatment approaches. Recent research has pivoted toward exploring alternative therapeutic methods, such as the ketogenic diet, for GBM.

METHODS

A total of 18 patients with GBM, 8 women and 10 men, aged between 34 and 75 years participated in a prospective study, examining the impact of ketogenic diet on tumor progression. The pool of patients originated from our hospital during the period from January 2016 until July 2021 and were followed until January 2024. As an assessment criterion, we set an optimistic target for adherence to the ketogenic diet beyond 6 months. We considered the therapeutic combination successful if the survival reached at least 3 years.

RESULTS

Among the 18 patients participating in the study, 6 adhered to the ketogenic diet for more than 6 months. Of these patients, one patient passed away 43 months after diagnosis, achieving a survival of 3 years; another passed away at 36 months, narrowly missing the 3-year survival mark; and one is still alive at 33 months post-diagnosis but has yet to reach the 3-year milestone and is, therefore, not included in the final survival rate calculation. The remaining 3 are also still alive, completing 84,43 and 44 months of life, respectively. Consequently, the survival rate among these patients is 4 out of 6, or 66.7%. Of the 12 patients who did not adhere to the diet, only one reached 36 months of survival, while the rest have died in an average time of 15.7 ± 6.7 months, with a 3-year survival rate of 8.3%. Comparing the survival rates of the two groups, we see that the difference is 58.3% (66.7% versus 8.3%) and is statistically significant with  < 0.05 (0.0114) and X = 6.409.

DISCUSSION

The outcomes observed in these patients offer promising insights into the potential benefits of the ketogenic diet on the progression of glioblastoma multiforme when compared to those who did not follow the diet consistently.

摘要

引言

多形性胶质母细胞瘤(GBM)是侵袭性最强的原发性脑恶性肿瘤之一。GBM治疗失败和高复发率这一持续挑战凸显了新治疗方法的必要性。最近的研究已转向探索GBM的替代治疗方法,如生酮饮食。

方法

共有18例GBM患者(8名女性和10名男性,年龄在34至75岁之间)参与了一项前瞻性研究,考察生酮饮食对肿瘤进展的影响。这些患者来自我院2016年1月至2021年7月期间,并随访至2024年1月。作为评估标准,我们设定了一个乐观目标,即坚持生酮饮食超过6个月。如果生存期至少达到3年,我们认为治疗组合成功。

结果

在参与研究的18例患者中,6例坚持生酮饮食超过6个月。在这些患者中,1例患者在诊断后43个月去世,生存期为3年;另1例在36个月去世,差一点达到3年生存期标准;1例在诊断后33个月仍存活,但尚未达到3年里程碑,因此未纳入最终生存率计算。其余3例也仍存活,分别度过了84、43和44个月。因此,这些患者的生存率为6例中的4例,即66.7%。在12例未坚持饮食的患者中,只有1例生存期达到36个月,其余患者平均在15.7±6.7个月内死亡,3年生存率为8.3%。比较两组的生存率,我们发现差异为58.3%(66.7%对8.3%),具有统计学意义,P<0.05(0.0114),X²=6.409。

讨论

与未持续遵循饮食的患者相比,这些患者观察到的结果为生酮饮食对多形性胶质母细胞瘤进展的潜在益处提供了有前景的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d13d/11876051/8f354836bc37/fnut-11-1489812-g001.jpg

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