@article{article_650341, title={Preliminary results of metabolically supported chemotherapy combined with ketogenic diet, hyperthermia and hyperbaric oxygen therapy in stage II-IV rectal cancer}, journal={Archives of Clinical and Experimental Medicine}, volume={5}, pages={16–20}, year={2020}, DOI={10.25000/acem.650341}, author={İyikesici, Mehmet Salih}, keywords={rectal cancer,metabolically supported chemotherapy,ketogenic diet,hyperthermia,hyperbaric oxygen therapy,survival}, abstract={<p class="MsoNormal" style="line-height:200%;"> <b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">Aim: </span> </b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">Systemic chemotherapy is a part of multi-modality
treatment in patients with stage II-IV rectal cancer. In particular, patients
not eligible for curative resection at the time of diagnosis require more
efficient approaches to improve outcomes. Metabolically supported chemotherapy
(MSCT) is a novel approach targeting dysregulated energy mechanism of the tumor
cell. This study aimed to examine the efficacy of MSCT combined with ketogenic
diet, hyperthermia and hyperbaric oxygen therapy (HBOT) in patients with stage
II-IV rectal cancer not eligible for surgery at baseline. </span> </p> <p> </p> <p class="MsoNormal" style="line-height:200%;"> <b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">Methods: </span> </b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">Twenty-one patients diagnosed with stage II-IV rectal
carcinoma who received metabolically supported chemotherapy (MSCT) combined
with ketogenic diet, hyperthermia and HBOT were included. First-line
chemotherapy regimen was oxaliplatin-based, whereas second line regimen was
irinotecan-based. Overall survival and progression-free survival were estimated. <b> </b> </span> </p> <p> <b> </b> </p> <b> </b> <p class="MsoListParagraph" style="margin-left:0cm;line-height:200%;"> <b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">Results: </span> </b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">Mean duration of follow-up was 33.3±22.0 months.
Mean overall survival was 58.6 months (95% CI, 43.3 - 73.9) and corresponding
figure for progression-free survival was 45.1 months (95% CI, 28.9-61.2). Mean
overall survival for patients with metastatic disease was 35.7 months. Multivariate
analysis identified male gender and stage IV disease as independent predictors
of worse progression free survival. No other parameter effected survival
outcomes. </span> </p> <p> </p> <p class="MsoNormal" style="line-height:200%;"> <b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">Conclusion: </span> </b> <span lang="en-us" style="font-size:12pt;line-height:200%;font-family:’Times New Roman’, serif;" xml:lang="en-us">Findings of this study are promising for potential use
of this novel combinatorial protocol targeting multiple vulnerabilities of
tumor cells in patients with advanced rectal cancer, particularly for patients
with metastatic disease, without additional safety concerns. However, long term
results are warranted to draw firm conclusion.  </span> </p> <p> </p>}, number={1}, publisher={Mustafa HASBAHÇECİ}