饮食干预是否增加放疗敏感性?
创作:王文东 审核:Lexi 06月22日
  • 回顾26篇低碳高脂生酮饮食(KDs)临床相关文献,发现放疗(RT)前短期禁食(SF)或治疗过程中短暂热量限制(CR)可增加肿瘤反应性;
  • 这些干预可促进氧化损伤的积累和修复不足,最终导致癌细胞死亡;
  • 但鉴于目前临床前研究的矛盾结果,一些研究者建议在发现更多更可靠的证据之前,癌症患者不要使用KDs;
  • 人体试验应严格定义每日热量摄入、饮食组成、安慰剂饮食、评估葡萄糖饥饿的生物学参数、酮症以及预先指定的评估肿瘤反应的标准。
主编推荐语
Lexi
最新发表在《Advances in Nutrition》的综述文章回顾了研究生酮饮食(KDs)的17项临床前研究和9项临床非对照研究。尽管约70%基于动物模型的研究证明了KDs的抗肿瘤功效,但临床前研究的结果发现KDs并未带来临床形势的改变。尽管在放射治疗过程中调节营养是一种简单、经济、廉价的方法,可以通过利用肿瘤细胞增加的辐射敏感性来提高放射治疗的效率,同时减少辐射对健康组织的损伤,但需要更多更可靠的证据证明KDs能显著改善癌症患者的放疗效率。
关键字
延伸阅读本研究的原文信息和链接出处,以及相关解读和评论文章。欢迎读者朋友们推荐!

Perspective: Do Fasting, Caloric Restriction, and Diets Increase Sensitivity to Radiotherapy? A Literature Review

观点:禁食、热量限食和饮食增加对放疗的敏感性?一篇文献综述

10.1093/advances/nmaa062

06-03, Article

Abstract & Authors:展开

Abstract:收起
Caloric starvation, as well as various diets, has been proposed to increase the oxidative DNA damage induced by radiotherapy (RT). However, some diets could have dual effects, sometimes promoting cancer growth, whereas proposing caloric restriction may appear counterproductive during RT considering that the maintenance of weight is a major factor for the success of this therapy. A systematic review was performed via a PubMed search on RT and fasting, or caloric restriction, ketogenic diet (>75% of fat-derived energy intake), protein starvation, amino acid restriction, as well as the Warburg effect. Twenty-six eligible original articles (17 preclinical studies and 9 clinical noncontrolled studies on low-carbohydrate, high-fat diets popularized as ketogenic diets, representing a total of 77 patients) were included. Preclinical experiments suggest that a short period of fasting prior to radiation, and/or transient caloric restriction during treatment course, can increase tumor responsiveness. These regimens promote accumulation of oxidative lesions and insufficient repair, subsequently leading to cancer cell death. Due to their more flexible metabolism, healthy cells should be less sensitive, shifting their metabolism to support survival and repair. Interestingly, these regimens might stimulate an acute anticancer immune response, and may be of particular interest in tumors with high glucose uptake on positron emission tomography scan, a phenotype associated with poor survival and resistance to RT. Preclinical studies with ketogenic diets yielded more conflicting results, perhaps because cancer cells can sometimes metabolize fatty acids and/or ketone bodies. Randomized trials are awaited to specify the role of each strategy according to the clinical setting, although more stringent definitions of proposed diet, nutritional status, and consensual criteria for tumor response assessment are needed. In conclusion, dietary interventions during RT could be a simple and medically economical and inexpensive method that may deserve to be tested to improve efficiency of radiation.

First Authors:
Philippe Icard

Correspondence Authors:
Philippe Icard

All Authors:
Philippe Icard,Luc Ollivier,Patricia Forgez,Joelle Otz,Marco Alifano,Ludovic Fournel,Mauro Loi,Juliette Thariat

评论