Elles J T M van der Louw1, Roel E Reddingius2, Joanne F Olieman1, Rinze F Neuteboom3, Coriene E Catsman-Berrevoets3. 1. Department of Dietetics, Erasmus MC Sophia Children's Hospital, University Medical Centre, Rotterdam, the Netherlands. 2. Princess Maxima Centre for Paediatric Oncology, Utrecht, the Netherlands. 3. Department of Paediatric Neurology, Erasmus MC Sophia Children's Hospital, University Medical Centre, Rotterdam, the Netherlands.
Abstract
BACKGROUND: The mean overall survival rate of children with diffuse intrinsic pontine glioma (DIPG) is 9-11 months, with current standard treatment with fractionated radiotherapy and adjuvant chemotherapy. So far, novel therapeutic strategies have not yet resulted in significantly better survival. The main source of energy for glioblastoma cells is glucose. Therefore, metabolic alterations induced by the use of the extremely carbohydrate-restricted ketogenic diet (KD) as adjuvant therapy are subject of interest in cancer research. PROCEDURE: This study explores the safety and feasibility of the KD in children with recurrent DIPG and no remaining treatment options. Safety was defined as the number of adverse effects. Feasibility was defined as the number of patients who were able to use the KD for three months. Coping of patients and parents was measured with questionnaires. RESULTS: Three of 14 children referred to our hospital between 2010 and 2015 were included. Two patients completed the study, and one died before the end of the study. Hospitalizations were needed for placing a nasogastric tube (n = 1) and epileptic seizures (n = 1). Adverse effects related to the diet were mild and transient. Parents were highly motivated during the study. CONCLUSION: Use of KD is safe and feasible, but the effect on survival has to be proven in a larger cohort of children who start the KD earlier after diagnosis, preferably as adjuvant therapy to fractionated radiotherapy.
BACKGROUND: The mean overall survival rate of children with diffuse intrinsic pontine glioma (DIPG) is 9-11 months, with current standard treatment with fractionated radiotherapy and adjuvant chemotherapy. So far, novel therapeutic strategies have not yet resulted in significantly better survival. The main source of energy for glioblastoma cells is glucose. Therefore, metabolic alterations induced by the use of the extremely carbohydrate-restricted ketogenic diet (KD) as adjuvant therapy are subject of interest in cancer research. PROCEDURE: This study explores the safety and feasibility of the KD in children with recurrent DIPG and no remaining treatment options. Safety was defined as the number of adverse effects. Feasibility was defined as the number of patients who were able to use the KD for three months. Coping of patients and parents was measured with questionnaires. RESULTS: Three of 14 children referred to our hospital between 2010 and 2015 were included. Two patients completed the study, and one died before the end of the study. Hospitalizations were needed for placing a nasogastric tube (n = 1) and epilepticseizures (n = 1). Adverse effects related to the diet were mild and transient. Parents were highly motivated during the study. CONCLUSION: Use of KD is safe and feasible, but the effect on survival has to be proven in a larger cohort of children who start the KD earlier after diagnosis, preferably as adjuvant therapy to fractionated radiotherapy.
Authors: Elles J T M van der Louw; Joanne F Olieman; Patricia M L A van den Bemt; Jacoline E C Bromberg; Esther Oomen-de Hoop; Rinze F Neuteboom; Coriene E Catsman-Berrevoets; Arnaud J P E Vincent Journal: Ther Adv Med Oncol Date: 2019-06-21 Impact factor: 8.168
Authors: Alexandre Perez; Elles van der Louw; Janak Nathan; Moatasem El-Ayadi; Hadrien Golay; Christian Korff; Marc Ansari; Coriene Catsman-Berrevoets; Andre O von Bueren Journal: Cancer Rep (Hoboken) Date: 2021-05-03