Effects of a ketogenic diet on tumor metabolism and nutritional status in pediatric oncology patients: two case reports.
OBJECTIVE
Establish dietary-induced ketosis in pediatric oncology patients to determine if a ketogenic state would decrease glucose availability to certain tumors, thereby potentially impairing tumor metabolism without adversely affecting the patient's overall nutritional status.


METHODS
Case report.


METHODS
University Hospitals of Cleveland.


METHODS
Two female pediatric patients with advanced stage malignant Astrocytoma tumors.


METHODS
Patients were followed as outpatients for 8 weeks. Ketosis was maintained by consuming a 60% medium chain triglyceride oil-based diet.


METHODS
Tumor glucose metabolism was assessed by Positron Emission Tomography (PET), comparing [Fluorine-18] 2-deoxy-2-fluoro-D-glucose (FDG) uptake at the tumor site before and following the trial period.


RESULTS
Within 7 days of initiating the ketogenic diet, blood glucose levels declined to low-normal levels and blood ketones were elevated twenty to thirty fold. Results of PET scans indicated a 21.8% average decrease in glucose uptake at the tumor site in both subjects. One patient exhibited significant clinical improvements in mood and new skill development during the study. She continued the ketogenic diet for an additional twelve months, remaining free of disease progression.


CONCLUSIONS
While this diet does not replace conventional antineoplastic treatments, these preliminary results suggest a potential for clinical application which merits further research.
Nebeling
L C
LC
Nutrition Department, Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA.
Miraldi
F
F
Shurin
S B
SB
Lerner
E
E
D001254:Astrocytoma / Q000178:diet therapy* / Q000378:metabolism; D002528:Cerebellar Neoplasms / Q000178:diet therapy* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004032:Diet; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007662:Ketosis / Q000209:etiology / Q000378:metabolism*; D009752:Nutritional Status; D013120:Spinal Cord Neoplasms / Q000178:diet therapy* / Q000378:metabolism; D014280:Triglycerides / Q000008:administration & dosage
D004042:Dietary Fats, Unsaturated; D014280:Triglycerides