生酮饮食帮助治疗多形性胶质母细胞瘤 – 病例报告

Ketogenic Diet Helps Standard Therapy to Fight Glioblastoma Multiforme

Dr. Thomas N Seyfried at Boston University and colleagues reported a case in Nutrition & Metabolism in 2010 suggesting that calorie-restricted ketogenic diet may be used to help the standard therapy to get glioblastoma multiforme into regression quickly.

Glioblastoma multiforme is difficult to treat using standard therapy (radiation with temozolomide chemotherapy) alone.  Dr. Seyfried and colleagues conducted the study and proved that a calorie-restricted ketogenic diet can enhance the therapeutic effect of the standard treatment against the brain cancer.

Ketogenic diet includes high fat but low carbohydrate and protein.  This diet has been used in children to treat refractory epilepsy.  The rationale for this diet to be used to treat cancer, particularly brain cancer is that cancer cells need sugar as their energy source.  This diet allows healthy cells to have plenty of fat as their energy source while severely limiting sugar for cancerous cells.  In this way, the cancer cells stop growing or even die eventually.

In this case, a 65-year-old woman sought medical attention after suffering typical symptoms of glioblastoma multiforme including progressive memory loss, chronic headaches, and nausea.

MRI exams revealed a right hemisphere multi-centric tumor in the brain.  As a treatment, much of the tumor was removed surgically but not completely.  Examinations led to diagnosis of glioblastoma multiforme which expressed hypermethylation of the MGMT gene promoter.

Before the standard therapy, the patients performed water-only therapeutic fasting for three days for ketosis induction and then followed for 14 days a calorie-restricted ketogenic diet with 600 kcal per day and the ratio of fat to the sum of carbohydrate and protein at 4 to 1.   The calorie-restricted ketogenic diet was fortified with some fibers and vitamin B and minerals.

Afterwards, the patients received the standard therapy along with the calorie-restricted ketogenic diet for two months.

Then, MRI exams did not show any discernible brain tumor tissue using either FDG-PET or MRI imaging.  Ten weeks after suspension of the calorie-restricted ketogenic diet therapy, the tumor came back.

A rapid regression of glioblastoma multiforme is rare in older patients who received surgery and the standard therapy.  This case indicated that the calorie-restricted ketogenic diet played a beneficial role in the regression of the disease. （Dr. Lu）

Source:

Giulio ZuccoliEmail author, Norina Marcello, Anna Pisanello, Franco Servadei, Salvatore Vaccaro, Purna Mukherjee and Thomas N Seyfried, Metabolic management of glioblastoma multiforme using standard therapy together with a restricted ketogenic diet: Case Report, Nutrition & Metabolism 2010 7:33
https://doi.org/10.1186/1743-7075-7-33©