生酮饮食治疗胰腺癌的研究进展
Research Progress of Ketogenic Diet for Pancreatic Cancer Treatment
DOI: 10.12677/acm.2025.153803, PDF,   
作者: 曲志鹏：内蒙古医科大学第一临床医学院，内蒙古 呼和浩特；申文凤*：内蒙古医科大学附属医院超声医学科，内蒙古 呼和浩特
关键词: 胰腺癌；生酮饮食；综述；Pancreatic Cancer； Ketogenic Diet； Overview
摘要: 胰腺癌是一种高死亡率的恶性肿瘤疾病，其发生与基因、生活环境、生活方式等多种因素相关。目前胰腺癌的治疗手段不断发展，但总体生存率仍不尽如人意。生酮饮食是一种高比例脂肪、低碳水化合物的饮食方式，产生酮体来供能，打破了肿瘤细胞正常供能方式，被认为有潜在的抗肿瘤作用。因此，本综述介绍生酮饮食在胰腺癌治疗过程中的作用机制及可能存在的问题，以期为临床治疗提供一定的参考价值。
Abstract: Pancreatic cancer is a malignant tumor disease with high mortality rate, and its occurrence is related to various factors such as genes, living environment, and lifestyle. Current treatments for pancreatic cancer continue to evolve, but overall survival is still unsatisfactory. The ketogenic diet, a high-ratio fat, low-carbohydrate diet that produces ketone bodies for energy supply, disrupts the normal way of energy supply for tumor cells, and is considered to have potential anti-tumor effects. Therefore, this review introduces the mechanism of action and possible problems of ketogenic diet in the treatment of pancreatic cancer, with a view to providing some reference value for clinical treatment.
文章引用：曲志鹏, 申文凤. 生酮饮食治疗胰腺癌的研究进展[J]. 临床医学进展, 2025, 15(3): 1768-1773. https://doi.org/10.12677/acm.2025.153803

参考文献

[1] Singh, S. and Sawal, A. (2024) Comprehensive Review on Pancreatic Head Cancer: Pathogenesis, Diagnosis, and Treatment Challenges in the Quest for Improved Survival. Cureus, 16, e54290. [Google Scholar] [CrossRef] [PubMed]
[2] Halbrook, C.J., Lyssiotis, C.A., Pasca di Magliano, M. and Maitra, A. (2023) Pancreatic Cancer: Advances and Challenges. Cell, 186, 1729-1754. [Google Scholar] [CrossRef] [PubMed]
[3] Shih, T. and Lindley, C. (2006) Bevacizumab: An Angiogenesis Inhibitor for the Treatment of Solid Malignancies. Clinical Therapeutics, 28, 1779-1802. [Google Scholar] [CrossRef] [PubMed]
[4] Arrington, A.K., Hsu, C., Schaefer, K.L., O’Grady, C.L., Khreiss, M. and Riall, T.S. (2021) Survival after Margin-Positive Resection in the Era of Modern Chemotherapy for Pancreatic Cancer: Do Patients Still Benefit? Journal of the American College of Surgeons, 233, 100-109. [Google Scholar] [CrossRef] [PubMed]
[5] Barenboim, A., Mercer, D., Sahnan, K., Gaffan, A., Goren, O., Halperin, S., et al. (2024) The Relationship between Treatment Response and Overall Survival in Borderline, Non-Resectable and Resectable Pancreatic Cancer Patients Treated with Neoadjuvant Folfirinox. Journal of Clinical Medicine, 13, Article 5206. [Google Scholar] [CrossRef] [PubMed]
[6] Mukherji, R., Debnath, D., Hartley, M.L. and Noel, M.S. (2022) The Role of Immunotherapy in Pancreatic Cancer. Current Oncology, 29, 6864-6892. [Google Scholar] [CrossRef] [PubMed]
[7] Wheless, J.W. (2008) History of the Ketogenic Diet. Epilepsia, 49, 3-5. [Google Scholar] [CrossRef] [PubMed]
[8] 苏敏凤, 曾诗惠, 高永峰, 等. 生酮饮食与肿瘤治疗研究进展[J]. 医学研究与战创伤救治, 2024, 37(3): 304-309.
[9] Zahra, A., Fath, M.A., Opat, E., Mapuskar, K.A., Bhatia, S.K., Ma, D.C., et al. (2017) Consuming a Ketogenic Diet While Receiving Radiation and Chemotherapy for Locally Advanced Lung Cancer and Pancreatic Cancer: The University of Iowa Experience of Two Phase 1 Clinical Trials. Radiation Research, 187, 743-754. [Google Scholar] [CrossRef] [PubMed]
[10] Yang, L., TeSlaa, T., Ng, S., Nofal, M., Wang, L., Lan, T., et al. (2022) Ketogenic Diet and Chemotherapy Combine to Disrupt Pancreatic Cancer Metabolism and Growth. Med, 3, 119-136.e8. [Google Scholar] [CrossRef] [PubMed]
[11] Klement, R.J. (2024) Anti-tumor Effects of Ketogenic Diets and Their Synergism with Other Treatments in Mice: Bayesian Evidence Synthesis of 1755 Individual Mouse Survival Data. Biomedical Journal, 47, Article ID: 100609. [Google Scholar] [CrossRef] [PubMed]
[12] Cortez, N., Lanzi, C., Vahmani, P., Matsukuma, K. and Mackenzie, G. (2023) Hepatic Safety Profile of Pancreatic Cancerbearing Mice Fed a Ketogenic Diet in Combination with Gemcitabine. Oncology Letters, 26, Article No. 479. [Google Scholar] [CrossRef] [PubMed]
[13] Ok, J.H., Lee, H., Chung, H., Lee, S.H., Choi, E.J., Kang, C.M., et al. (2018) The Potential Use of a Ketogenic Diet in Pancreatobiliary Cancer Patients after Pancreatectomy. Anticancer Research, 38, 6519-6527. [Google Scholar] [CrossRef] [PubMed]
[14] Hsu, P.P. and Sabatini, D.M. (2008) Cancer Cell Metabolism: Warburg and Beyond. Cell, 134, 703-707. [Google Scholar] [CrossRef] [PubMed]
[15] Ji, S., Qin, Y., Shi, S., Liu, X., Hu, H., Zhou, H., et al. (2015) ERK Kinase Phosphorylates and Destabilizes the Tumor Suppressor FBW7 in Pancreatic Cancer. Cell Research, 25, 561-573. [Google Scholar] [CrossRef] [PubMed]
[16] Yang, J., Ren, B., Yang, G., Wang, H., Chen, G., You, L., et al. (2019) The Enhancement of Glycolysis Regulates Pancreatic Cancer Metastasis. Cellular and Molecular Life Sciences, 77, 305-321. [Google Scholar] [CrossRef] [PubMed]
[17] Zarei, M., Tahhan, S., Gallagher, P., Beegan, W., Loftus, A., Lebo, K., et al. (2024) Abstract B050: Determining the Anti-Cancer Properties of a Ketogenic Diet against Pancreatic Cancer. Cancer Research, 84, B050. [Google Scholar] [CrossRef] 
[18] Cortez, N.E., Lanzi, C.R., et al. (2022) A Ketogenic Diet in Combination with Gemcitabine Increases Survival in Pancreatic Cancer KPC Mice. Cancer Research Communications, 2, 951-965.
[19] Mikolaskova, I., Crnogorac-Jurcevic, T., Smolkova, B. and Hunakova, L. (2023) Nutraceuticals as Supportive Therapeutic Agents in Diabetes and Pancreatic Ductal Adenocarcinoma: A Systematic Review. Biology, 12, Article 158. [Google Scholar] [CrossRef] [PubMed]
[20] Reske, S.N., Grillenberger, K.G., Glatting, G., et al. (1997) Overexpression of Glucose Transporter 1 and Increased FDG Uptake in Pancreatic Carcinoma. Journal of Nuclear Medicine, 38, 1344-1348.
[21] Basturk, O., Singh, R., Kaygusuz, E., Balci, S., Dursun, N., Culhaci, N., et al. (2011) GLUT-1 Expression in Pancreatic Neoplasia: Implications in Pathogenesis, Diagnosis, and Prognosis. Pancreas, 40, 187-192. [Google Scholar] [CrossRef] [PubMed]
[22] Zhong, G., Li, Q., Yang, P., Wang, Y., Hao, F., Wang, K., et al. (2021) Low-Carbohydrate Diets and the Risk of Pancreatic Cancer: A Large Prospective Cohort Study. Carcinogenesis, 42, 724-732. [Google Scholar] [CrossRef] [PubMed]
[23] Lien, E.C., Westermark, A.M., Zhang, Y., Yuan, C., Li, Z., Lau, A.N., et al. (2021) Low Glycaemic Diets Alter Lipid Metabolism to Influence Tumour Growth. Nature, 599, 302-307. [Google Scholar] [CrossRef] [PubMed]
[24] Sen, U., Coleman, C. and Sen, T. (2023) Stearoyl Coenzyme a Desaturase-1: Multitasker in Cancer, Metabolism, and Ferroptosis. Trends in Cancer, 9, 480-489. [Google Scholar] [CrossRef] [PubMed]
[25] Ye, Z., Zhuo, Q., Hu, Q., Xu, X., Mengqi liu,, Zhang, Z., et al. (2021) FBW7-NRA41-SCD1 Axis Synchronously Regulates Apoptosis and Ferroptosis in Pancreatic Cancer Cells. Redox Biology, 38, Article ID: 101807. [Google Scholar] [CrossRef] [PubMed]
[26] Klaunig, J.E. (2019) Oxidative Stress and Cancer. Current Pharmaceutical Design, 24, 4771-4778. [Google Scholar] [CrossRef] [PubMed]
[27] Yang, Y., Karakhanova, S., Hartwig, W., D’Haese, J.G., Philippov, P.P., Werner, J., et al. (2016) Mitochondria and Mitochondrial ROS in Cancer: Novel Targets for Anticancer Therapy. Journal of Cellular Physiology, 231, 2570-2581. [Google Scholar] [CrossRef] [PubMed]
[28] Abdel Hadi, N., Reyes-Castellanos, G. and Carrier, A. (2021) Targeting Redox Metabolism in Pancreatic Cancer. International Journal of Molecular Sciences, 22, Article 1534. [Google Scholar] [CrossRef] [PubMed]
[29] Vaziri-Gohar, A., Hue, J.J., Abbas, A., Graor, H.J., Hajihassani, O., Zarei, M., et al. (2023) Increased Glucose Availability Sensitizes Pancreatic Cancer to Chemotherapy. Nature Communications, 14, Article No. 3823. [Google Scholar] [CrossRef] [PubMed]
[30] Kong, X., Cheng, D., Xu, X., Zhang, Y., Li, X. and Pan, W. (2024) IFN-γ Induces Apoptosis in Gemcitabin-Resistant Pancreatic Cancer Cells. Molecular Medicine Reports, 29, Article No. 76. [Google Scholar] [CrossRef] [PubMed]
[31] Shi, X.Y., Zhang, X.L., Shi, Q.Y., Qiu, X., Wu, X.B., Zheng, B.L., et al. (2022) IFN-γ Affects Pancreatic Cancer Properties by MACC1-AS1/MACC1 Axis via Akt/mTOR Signaling Pathway. Clinical and Translational Oncology, 24, 1073-1085. [Google Scholar] [CrossRef] [PubMed]
[32] Argilés, J.M., Busquets, S., Stemmler, B. and López-Soriano, F.J. (2014) Cancer Cachexia: Understanding the Molecular Basis. Nature Reviews Cancer, 14, 754-762. [Google Scholar] [CrossRef] [PubMed]
[33] Arneson‐Wissink, P.C., Mendez, H., Pelz, K., Dickie, J., Bartlett, A.Q., Worley, B.L., et al. (2024) Hepatic Signal Transducer and Activator of Transcription‐3 Signalling Drives Early‐stage Pancreatic Cancer Cachexia via Suppressed Ketogenesis. Journal of Cachexia, Sarcopenia and Muscle, 15, 975-988. [Google Scholar] [CrossRef] [PubMed]
[34] Padoan, A., Plebani, M. and Basso, D. (2019) Inflammation and Pancreatic Cancer: Focus on Metabolism, Cytokines, and Immunity. International Journal of Molecular Sciences, 20, Article 676. [Google Scholar] [CrossRef] [PubMed]
[35] Yakovenko, A., Cameron, M. and Trevino, J.G. (2018) Molecular Therapeutic Strategies Targeting Pancreatic Cancer Induced Cachexia. World Journal of Gastrointestinal Surgery, 10, 95-106. [Google Scholar] [CrossRef] [PubMed]
[36] Tan, C.R., Yaffee, P.M., Jamil, L.H., Lo, S.K., Nissen, N., Pandol, S.J., et al. (2014) Pancreatic Cancer Cachexia: A Review of Mechanisms and Therapeutics. Frontiers in Physiology, 5, Article 88. [Google Scholar] [CrossRef] [PubMed]
[37] Miriam, F., Miriam, F., Nicholas, M., et al. (2023) Ketogenic Diet Promotes Tumor Ferroptosis but Induces Relative Corticosterone Deficiency That Accelerates Cachexia. Cell Metabolism, 35, 1147-1162.e7.

为你推荐