Perspective: Do Fasting, Caloric Restriction, and Diets Increase Sensitivity to Radiotherapy? A Literature Review.

摘要: Caloric starvation, as well various diets, has been proposed to increase the oxidative DNA damage induced by radiotherapy (RT). However, some diets could have dual effects, sometimes promoting cancer growth, whereas proposing caloric restriction may appear counterproductive during RT considering that maintenance of weight is a major factor for success this therapy. A systematic review was performed via PubMed search on and fasting, or restriction, ketogenic diet (>75% fat-derived energy intake), protein amino acid Warburg effect. Twenty-six eligible original articles (17 preclinical studies 9 clinical noncontrolled low-carbohydrate, high-fat popularized representing total 77 patients) were included. Preclinical experiments suggest short period fasting prior radiation, and/or transient treatment course, can tumor responsiveness. These regimens promote accumulation lesions insufficient repair, subsequently leading cell death. Due their more flexible metabolism, healthy cells should be less sensitive, shifting metabolism support survival repair. Interestingly, these might stimulate an acute anticancer immune response, particular interest in tumors with high glucose uptake positron emission tomography scan, phenotype associated poor resistance RT. yielded conflicting results, perhaps because metabolize fatty acids ketone bodies. Randomized trials are awaited specify role each strategy according setting, although stringent definitions diet, nutritional status, consensual criteria response assessment needed. In conclusion, dietary interventions simple medically economical inexpensive method deserve tested improve efficiency radiation.