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

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

TLDR

  • A ketogenic diet may be a promising alternative therapy for Glioblastoma multiforme, improving 3-year survival rate and overall patient outcomes.

Abstract

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. 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. 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. 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.

Overview

  • The study aimed to investigate the impact of a ketogenic diet on tumor progression in patients with Glioblastoma multiforme (GBM).
  • A total of 18 patients with GBM, aged between 34 and 75 years, participated in a prospective study from 2016 to 2021.
  • The primary objective was to assess the effect of the ketogenic diet on 3-year survival rate and overall adherence beyond 6 months.

Comparative Analysis & Findings

  • Among the 18 patients, 6 patients adhered to the ketogenic diet for more than 6 months, with a 3-year survival rate of 66.7%.
  • The remaining 12 patients did not adhere to the diet, with a 3-year survival rate of 8.3%. The difference between the two groups was statistically significant.
  • Patients who adhered to the diet had a longer average survival time (24.2 months) compared to those who did not (15.7 months).

Implications and Future Directions

  • The study suggests that a ketogenic diet may be a promising alternative therapy for GBM, particularly in patients with advanced disease.
  • However, the results are limited by the small sample size and lack of control group, emphasizing the need for larger, randomized controlled trials.
  • Future research should investigate the optimal duration of ketogenic diet therapy, potential interactions with conventional treatment, and the underlying mechanisms of its beneficial effects.
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