生酮饮食可有益于局部晚期乳腺癌患者
创作:szx 审核:szx 2020年08月10日
  • 80名正在接受化疗的乳腺癌患者随机分为KD组及对照组,持续干预12周;
  • 干预结束后,相比于对照组患者,KD组患者血液中的TNF-α水平显著降低,IL-10水平显著升高,血清胰岛素显著减少;
  • KD组患者的肿瘤减小量显著高于对照组患者(27mm vs. 6mm);
  • 在局部晚期乳腺癌患者中,KD组患者的肿瘤进展阶段显著低于对照组;
  • 在乳腺癌转移患者中,2组之间的应答率无显著差异。
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szx
生酮饮食介导的生酮代谢疗法或可作为肿瘤管理的补充策略,但有关的临床试验报道较少。Clinical Nutrition上发表的一项RCT研究,对80名局部晚期或转移性乳腺癌患者进行12周的干预,发现在接受化疗的基础上,相比于摄入对照饮食,摄入生酮饮食可显著减小肿瘤,并抑制局部晚期患者的肿瘤进展。
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Effects of Ketogenic metabolic therapy on patients with breast cancer: A randomized controlled clinical trial

生酮代谢疗法对乳腺癌患者的影响:一项随机对照临床试验

10.1016/j.clnu.2020.06.028

2020-07-03, Article

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Background: Ketogenic metabolic therapy (KMT) using ketogenic diets (KD) is emerging as viable alternative or complementary strategy for managing cancer; however, few clinical trials have been reported. The present study aimed to evaluate the effects of a KD in patients with locally advanced and metastatic breast cancer receiving chemotherapy.
Methods: A total of 80 patients undergoing treatment with chemotherapy were randomly assigned to KD or control group for 12 weeks. Concurrent with the admission, midway point, and at 12 weeks, fasting blood samples were collected for evaluation of insulin, IGF-1, CEA, CA15-3, ESR, CRP, IL-10, and TNF-α. Sonography for patients with locally advanced disease and CT or MRI scans for patients with metastatic disease were done on admission and at 12 weeks. At the completion of the chemotherapy, patients with locally advanced disease underwent surgery and stage was recalculated. Also patients with metastases were evaluated for response rate.
Results: TNF- α decreased significantly after 12 weeks of treatment (MD: 0.64 [CI 95%: −3.7, 5] P < 0.001), while IL-10 increased (MD: 0.95 [CI 95%: −1,3] P < 0.001) in the intervention compared to the control group. Patients in the KD group had lower adjusted serum insulin compared to the control group (MD:-1.1 [CI 95%: −3,1] p < 0.002). KD lead to a reduction in tumor size in the KD compared to the control (27 vs 6 mm, P = 0.01). Stage decreased significantly in patients with locally advanced disease in the KD group after 12 weeks (P < 0.01). No significant differences in response rate were observed in patients with metastatic disease.
Conclusions: KMT in breast cancer patients might exert beneficial effects through decreasing TNF- α and insulin and increasing IL-10. KD may result in a better response through reductions in tumor size and downstaging in patients with locally advanced disease; however, more studies are needed to elucidate the potential beneficial effects of KD in patients with metastases.

First Authors:
Adeleh Khodabakhshi

Correspondence Authors:
Sayed Hossein Davoodi

All Authors:
Adeleh Khodabakhshi,Mohammad Esmaeil Akbari,Hamid Reza Mirzaei,Thomas N Seyfried,Miriam Kalamian,Sayed Hossein Davoodi

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