生酮饮食干预在恶性胶质瘤中的应用专家共识  

Expert consensus on ketogenic diet intervention for patients with malignant glioma

作　　者：李振水[1] 郝春满[1] 许英霞[1] 任晓辉[2] 王群[3] 于康[4] 陈伟[4] 郭瑞芳 胡怀东[6] 李增宁[7] 李缨[8] 柳鹏[9] 石汉平 杨勤兵[11] 周莉[12] 朱翠凤 林松[2] Li Zhenshui;Hao Chunman;Xu Yingxia;Ren Xiaohui;Wang Qun;Yu Kang;Chen Wei;Guo Ruifang;Hu Huaidong;Li Zengning;Li Ying;Liu Peng;Shi Hanping;Yang Qinbing;Zhou Li;Zhu Cuifeng;Li Song(Department of Clinical Nutrition,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Neurosurgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Neurology Center,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China;Department of Clinical Nutrition,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Clinical Nu-trition Center,Inner Mongolia People's Hospital,Hohhot 010000,Inner Mongolia,China;Department of Clinical Nutrition,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China;Department of Nutrition,the First Affiliated Hospital of Hebei Medical University,Shijiazhuang 050030,Hebei,China;Department of Nutrition,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Clinical Nutrition,Peking University People's Hospital,Beijing 100044,China;Department of Clinical Nutrition,Beijing Shijitan Hospital/Capital Medical University Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition/Department of Oncology,Capital Medical University,Beijing 100038;Department of Clinical Nu-trition,Beijing Tsinghua Changgung Hospital,Tsinghua University,Beijing 102218,China;Department of Nutrition,the First Affiliat-ed Hospital of Soochow University,Suzhou 215031,Jiangsu,China;Department of Clinical Nutrition,Shenzhen Hospital,Southern Medi-cal University,Shenzhen 518110,Guangdong,China)

机构地区：[1]首都医科大学附属北京天坛医院临床营养科,北京100070 [2]首都医科大学附属北京天坛医院神经外科,北京100070 [3]首都医科大学附属北京天坛医院神经病学中心,北京100070 [4]中国医学科学院北京协和医学院北京协和医院临床营养科,北京100730 [5]内蒙古自治区人民医院临床营养中心,呼和浩特010000 [6]重庆医科大学附属第二医院临床营养科,重庆400010 [7]河北医科大学附属第一医院营养科,石家庄050030 [8]首都医科大学宣武医院营养科,北京100053 [9]北京大学人民医院临床营养科,北京100044 [10]首都医科大学附属北京世纪坛医院临床营养科/肿瘤代谢与营养北京市国际科技合作基地/首都医科大学肿瘤学系,北京100038 [11]清华大学附属北京清华长庚医院,北京102218 [12]苏州大学附属第一医院营养科,江苏苏州215031 [13]南方医科大学深圳医院临床营养科,广东深圳518110

出　　处：《肿瘤代谢与营养电子杂志》2021年第3期251-256,共6页Electronic Journal of Metabolism and Nutrition of Cancer

摘　　要：恶性神经胶质瘤包括间变性胶质瘤(WHOⅢ级)和胶质母细胞瘤(WHOⅣ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。Gliomas are primary brain tumors and comprise anaplastic gliomas(WHO gradeⅢ)and glioblastomas(gradeⅣ).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,so as to better guide the ketogenic diet in malignant.

关 键 词：恶性胶质瘤 生酮饮食 专家共识 

分 类 号：R739.41[医药卫生—肿瘤] R459.3[医药卫生—临床医学]