简介：Headandneckcancers(HNCs)areaggressivetumorsthattypicallydemonstrateahighglycolyticrate,whichresultsinresistancetocytotoxictherapyandpoorprognosis.Duetotheirlocationthesetumorsspecificallyimpairfoodintakeandqualityoflife,sothatpreventionofweightlossthroughnutritionsupportbecomesanimportanttreatmentgoal.Dietaryrestrictionofcarbohydrates(CHOs)andtheirreplacementwithfat,mostlyinformofaketogenicdiet(KD),havebeensuggestedtoaccommodateforboththealteredtumorcellmetabolismandcancer-associatedweightloss.Inthisreview,IpresentthreespecificrationalesforCHOrestrictionandnutritionalketosisassupportivetreatmentoptionsfortheHNCpatient.Theseare(1)targetingtheoriginandspecificaspectsoftumorglycolysis;(2)protectingnormaltissuefrombutsensitizingtumortissuetoradiation-andchemotherapyinducedcellkill;(3)supportingbodyandmusclemassmaintenance.WhilemostofthesebenefitsofCHOrestrictionapplytocanceringeneral,specificaspectsofimplementationarediscussedinrelationtoHNCpatients.WhileCHOrestrictionseemsfeasibleinHNCpatientstheavailableevidenceindicatesthatitsrolemayextendbeyondfightingmalnutritiontofightingHNCitself.
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