生物与医学2020nature.com
禁食改善化疗效果并保护机体免受副作用
Fasting improves chemotherapy results and protects from side effects: study
进阶 · 约 30 分钟读完前置知识：肿瘤生物学基础、临床试验设计、代谢与营养基础
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这篇论文研究化疗期间禁食（或模拟禁食饮食）是否能改善治疗效果并减轻副作用。评论指出，研究中确实存在一定效应但并不极端，标题所称“防副作用”缺乏直接依据；依从性有限、试验因资金不足提前结束，仍需更大规模试验验证。
HN 关注点：禁食这一简单干预在癌症治疗中的潜力，同时质疑标题夸大结论、研究依从性和赞助方影响。
HN 评论精选
这几条评论里：质疑 2 亲历 1
质疑研究效应存在但不极端；标题所称防副作用缺乏依据；依从性有限，试验因资金提前终止，需更大规模研究。
这项研究很有意思，但一如既往有很多限定条件。我们最多能从中得出：值得进一步研究，效应存在但不极端。我不认同提交的标题声称它能防副作用；研究根本没提这一点，只是说禁食组尽管省略了地塞米松，副作用仍相似——地塞米松会增加食欲，若想依从率合理，省略它说得通。和所有禁食/节食研究一样，依从性充其量中等：总共12个化疗周期中，只有33%的患者至少4个周期依从，不过大多数人至少有一个周期依从。总之需要更大试验；这篇论文是在呼吁资助方这么做——试验因需纳入更多患者但资金不足而提前结束。我目前在做相似患者人群的研究，欢迎提问。
markus92查看英文原文
Interesting study with, as always, a lot of caveats. The most we can take from this is that it's worth to study more, the effect is existing but not extreme. I don't get the submitted title here claiming that it protects from side effects. The study does not mention this at all, just that the side effects are similar despite omission of dexamethason in the fasting arm of the trial - it increases appetite, so makes sense to omit it if you want any reasonable compliance rate. As with any fasting and dieting study, compliance is moderate at best. In this study, only 33% of patients were compliant for at least 4 cycles of chemotherapy, out of 12 cycles total. Most of them were compliant with at least once cycle though. Overall, we need some more research on this in a larger trial. This paper is a call for funders to do just that - the trial ended prematurely due to needing to include more patients but there was a lack of funding to do so. I'm currently doing research on a similar patient population, so open to answer any questions.
亲历癌症依赖糖且高能耗；亲历化疗因类固醇体重增加，考虑低热量低碳水饮食。
癌症需要糖。检测癌症的主要方式之一是用放射性葡萄糖示踪剂的PET-CT，葡萄糖摄取最高的地方会亮起来。文章谈到饥饿细胞进入防御修复模式，也谈到癌细胞非常耗能。我曾患淋巴瘤，做了三年化疗（主要是维持/预防，最初几个月就清除了）。我实际上体重增加很多，因为类固醇（还有我抽的大量大麻）让我饿得发狂。如果再遇到那种情况，我会努力大幅减少热量摄入，尤其是碳水，因为我读到很多关于饿死癌细胞的潜在好处。
caymanjim查看英文原文
Cancer needs sugar. One of the primary ways they detect cancer is via a PET-CT with a radioactive glucose tracer. It lights up where glucose uptake is the highest. This article talks about starving cells going into defensive repair mode, but also about how energy-hungry cancer cells are. I had cancer (lymphoma) and did three years of chemo (mostly maintenance/preventative, as it was wiped out in the first couple months). I actually gained an enormous amount of weight, because the steroids I was on (and all the weed I smoked) made me ravenously hungry. If I end up in that situation again, I'm going to make a concerted effort to dramatically reduce my calorie intake, and in particularly carbs, because I've read a lot about the potential benefits of starving the cancer out.
质疑指出研究可能由公司赞助，测试其Fasting Mimicking Diet，并询问使用经验。
看起来这项研究是由这家公司发起/赞助的，专门测试他们所谓的“模拟禁食饮食”的有效性。如果我没理解错，这是一种低热量饮食，比严格只喝水更容易坚持，但他们声称同样有效。他们还推荐健康人每月5天使用。有人有相关经验吗？
eperfa查看英文原文
Looks like this study was initiated/sponsored by this company, specifically testing the effectiveness on what they call Fasting Mimicking Diet. https://l-nutra.com/pages/fasting-mimicking-diet If I understand correctly this is a low-calorie diet, which is easier to follow than a strict water-only diet, but they claim it is equally effective. They recommend it also for healthy individuals, 5 days a month. Does anyone have experience with it?
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