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Long Term Survivals in Aggressive Primary Brain Malignancies Treated With an Adjuvant Ketogenic Diet

Aggressive primary brain tumors (APBT) glioblastoma multiforme and grade IV astrocytoma are treated with multimodality treatments that include surgery to remove as much tumor as possible without sacrificing neurological function followed by radiation therapy and chemotherapy usually temozolomide. Su...

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Autores principales: Schwartz, Kenneth A., Noel, Mary, Nikolai, Michele, Olson, Lawrence K., Hord, Norman G., Zakem, Micheal, Clark, Justin, Elnabtity, Mohamed, Figueroa, Bryan, Chang, Howard T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9112915/
https://www.ncbi.nlm.nih.gov/pubmed/35592625
http://dx.doi.org/10.3389/fnut.2022.770796
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author Schwartz, Kenneth A.
Noel, Mary
Nikolai, Michele
Olson, Lawrence K.
Hord, Norman G.
Zakem, Micheal
Clark, Justin
Elnabtity, Mohamed
Figueroa, Bryan
Chang, Howard T.
author_facet Schwartz, Kenneth A.
Noel, Mary
Nikolai, Michele
Olson, Lawrence K.
Hord, Norman G.
Zakem, Micheal
Clark, Justin
Elnabtity, Mohamed
Figueroa, Bryan
Chang, Howard T.
author_sort Schwartz, Kenneth A.
collection PubMed
description Aggressive primary brain tumors (APBT) glioblastoma multiforme and grade IV astrocytoma are treated with multimodality treatments that include surgery to remove as much tumor as possible without sacrificing neurological function followed by radiation therapy and chemotherapy usually temozolomide. Survivals in adults are in the range of 8–16 months. The addition of a ketogenic diet (KD) to rodents with transplanted brain tumors increased survival in nine of 11 animals to over 299 days compared to survival in untreated controls of 33 days and radiation only controls of 38 days. We treated humans with APBT with standard of care neurosurgery immediately followed by 6 weeks of an adjuvant ketogenic diet concurrent with radiation therapy and temozolomide. Twice daily measurements of blood ketones and glucose were recorded and the patients' diet was modified toward the goal of maintaining blood ketone levels approaching 3 mM. Of the nine patients who completed the protocol three younger patients age 32, 28, and 22 at enrollment are alive and employed with clinically stable disease and brain images 74, 58, and 52 months since diagnosis. All the six older patients mean age 55 have died with disease progression detected on average 8 months after Dx. In conclusion: 1. It is possible to implement and maintain dietary induced ketosis in patients with APBT; 2. The longer survivals observed in younger patients treated with KD need to be confirmed in larger studies that should be focused on younger patients possibly under age 40.
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spelling pubmed-91129152022-05-18 Long Term Survivals in Aggressive Primary Brain Malignancies Treated With an Adjuvant Ketogenic Diet Schwartz, Kenneth A. Noel, Mary Nikolai, Michele Olson, Lawrence K. Hord, Norman G. Zakem, Micheal Clark, Justin Elnabtity, Mohamed Figueroa, Bryan Chang, Howard T. Front Nutr Nutrition Aggressive primary brain tumors (APBT) glioblastoma multiforme and grade IV astrocytoma are treated with multimodality treatments that include surgery to remove as much tumor as possible without sacrificing neurological function followed by radiation therapy and chemotherapy usually temozolomide. Survivals in adults are in the range of 8–16 months. The addition of a ketogenic diet (KD) to rodents with transplanted brain tumors increased survival in nine of 11 animals to over 299 days compared to survival in untreated controls of 33 days and radiation only controls of 38 days. We treated humans with APBT with standard of care neurosurgery immediately followed by 6 weeks of an adjuvant ketogenic diet concurrent with radiation therapy and temozolomide. Twice daily measurements of blood ketones and glucose were recorded and the patients' diet was modified toward the goal of maintaining blood ketone levels approaching 3 mM. Of the nine patients who completed the protocol three younger patients age 32, 28, and 22 at enrollment are alive and employed with clinically stable disease and brain images 74, 58, and 52 months since diagnosis. All the six older patients mean age 55 have died with disease progression detected on average 8 months after Dx. In conclusion: 1. It is possible to implement and maintain dietary induced ketosis in patients with APBT; 2. The longer survivals observed in younger patients treated with KD need to be confirmed in larger studies that should be focused on younger patients possibly under age 40. Frontiers Media S.A. 2022-05-03 /pmc/articles/PMC9112915/ /pubmed/35592625 http://dx.doi.org/10.3389/fnut.2022.770796 Text en Copyright © 2022 Schwartz, Noel, Nikolai, Olson, Hord, Zakem, Clark, Elnabtity, Figueroa and Chang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Nutrition
Schwartz, Kenneth A.
Noel, Mary
Nikolai, Michele
Olson, Lawrence K.
Hord, Norman G.
Zakem, Micheal
Clark, Justin
Elnabtity, Mohamed
Figueroa, Bryan
Chang, Howard T.
Long Term Survivals in Aggressive Primary Brain Malignancies Treated With an Adjuvant Ketogenic Diet
title Long Term Survivals in Aggressive Primary Brain Malignancies Treated With an Adjuvant Ketogenic Diet
title_full Long Term Survivals in Aggressive Primary Brain Malignancies Treated With an Adjuvant Ketogenic Diet
title_fullStr Long Term Survivals in Aggressive Primary Brain Malignancies Treated With an Adjuvant Ketogenic Diet
title_full_unstemmed Long Term Survivals in Aggressive Primary Brain Malignancies Treated With an Adjuvant Ketogenic Diet
title_short Long Term Survivals in Aggressive Primary Brain Malignancies Treated With an Adjuvant Ketogenic Diet
title_sort long term survivals in aggressive primary brain malignancies treated with an adjuvant ketogenic diet
topic Nutrition
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9112915/
https://www.ncbi.nlm.nih.gov/pubmed/35592625
http://dx.doi.org/10.3389/fnut.2022.770796
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