生酮饮食干预在恶性胶质瘤中的应用专家共识

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肿瘤代谢与营养电子杂志 ›› 2021, Vol. 8 ›› Issue (3) : 251-256.

共识、指南与标准

1李振水，1郝春满，1许英霞，2任晓辉，3王群，4于康，4陈伟，5郭瑞芳，6胡怀东，7李增宁，8李缨，

作者信息 +

Expert consensus on ketogenic diet intervention for patients with malignant glioma

1Li Zhenshui, 1Hao Chunman, 1Xu Yingxia, 2Ren Xiaohui, 3Wang Qun, 4Yu Kang, 4Chen Wei，5Guo Ruifang, 6Hu Huaidong, 7Li Zengn?

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摘要

恶性神经胶质瘤包括间变性胶质瘤（WHO Ⅲ级）和胶质母细胞瘤（WHO Ⅳ级），是常见的颅内肿瘤，30年来其发病率逐年递增，在老年人群中尤为明显。近年来，尽管手术治疗、放疗、替莫唑胺化学治疗及靶向治疗等均在不断进展，治疗方案在不断改进，但患者总体预后仍不佳，接受手术及放化疗后间变性星形细胞瘤和胶质母细胞瘤5年生存率低至5%~10%。生酮饮食（高脂肪、低碳水化合物、适量蛋白质及其他营养素的配方饮食）作为脑胶质瘤治疗的新方法，具有安全性及一定的有效性。但多数临床医师对生酮饮食疗法经验不足，管理水平普遍不高，本共识就生酮饮食干预恶性胶质瘤的理论依据、临床研究、生酮饮食类型、不良反应及对策、生酮启动及管理等进行讨论，参考最新的临床研究证据和国外发表的相关专家共识并密切结合我国实际，提出中国专家共识，为生酮饮食干预恶性胶质瘤提供参考和依据，以更好地指导生酮饮食在恶性胶质瘤中的临床应用。

Abstract

Gliomas are primary brain tumors and comprise anaplastic gliomas (WHO grade Ⅲ) and glioblastomas (grade Ⅳ). In the past 30 years, the incidence rate is increasing year by year, especially among the elderly. The standard treatment for glioblastomas, the most common and lethal subtype，is maximal surgical resection, followed by radiotherapy with concomitant and adjuvant temozolomide chemotherapy. Despite this aggressive policy, practically all patients develop disease progression or recurrence with limited second⁃line treatment options, resulting in a poor 5⁃year overall survival of 5%~10%. Diets with high fat, low carbohydrate, moderate amount of protein and other nutrients, such as ketogenic diet are hypothesized to reduce tumor growth and improve survival. However, most clinicians have insufficient experience in ketogenic diet therapy. The aim of this expert consensus is to summarize all clinical and early clinical data on ketogenic diet for the treatment of malignant gliomas, soas to better guide the ketogenic diet in malignant.

导出引用

1李振水，1郝春满，1许英霞，2任晓辉，3王群，4于康，4陈伟，5郭瑞芳，6胡怀东，7李增宁，8李缨，. 生酮饮食干预在恶性胶质瘤中的应用专家共识[J]. 肿瘤代谢与营养电子杂志. 2021, 8(3): 251-256

1Li Zhenshui, 1Hao Chunman, 1Xu Yingxia, 2Ren Xiaohui, 3Wang Qun, 4Yu Kang, 4Chen Wei，5Guo Ruifang, 6Hu Huaidong, 7Li Zengn?. Expert consensus on ketogenic diet intervention for patients with malignant glioma[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2021, 8(3): 251-256