Kiryttopoulos · Frontiers in nutrition 2024 · prospective non-randomized cohort study · n=18

Successful application of dietary ketogenic metabolic therapy in patients with glioblastoma: a clinical study.

Level 3 - non-randomized controlled study

Non-randomized prospective cohort study comparing adherent vs non-adherent patients

PubMed 40041752 · doi:10.3389/fnut.2024.1489812 · record verified 2026-08-26

What was done

A prospective cohort of 18 patients with glioblastoma multiforme (8 women, 10 men, aged 34–75 years) treated between January 2016 and July 2021 was followed until January 2024 to evaluate the impact of a ketogenic diet on tumor progression. The primary assessment criterion was dietary adherence for >6 months, with therapeutic success defined as reaching at least 3-year overall survival.

What was found

Six of 18 patients adhered to the ketogenic diet for >6 months. In this adherent group, 4 of 6 patients (66.7%) achieved 3-year survival (3 alive at 43, 44, and 84 months; 1 deceased at 43 months; 1 deceased at 36 months; and 1 alive at 33 months). Among the 12 non-adherent patients, 1 reached 3-year survival (8.3%), while the rest died with an average survival of 15.7 ± 6.7 months. The 58.3% difference in 3-year survival was statistically significant (66.7% vs 8.3%, p = 0.0114, X² = 6.409).

Why it matters

This study provides preliminary observational data on long-term survival in glioblastoma patients attempting dietary ketogenic metabolic therapy alongside standard care.

Limits

The sample size is very small (n = 18 total, 6 adherent). The non-randomized comparison based on adherence introduces substantial immortal time bias (patients had to survive long enough to adhere for 6 months) and healthy-adherer bias. The abstract omits tumor genetics (such as IDH status or MGMT promoter methylation), concurrent oncologic treatments, and dietary composition details.

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