Cancer

Safety, Feasibility, and Effectiveness of Ketogenic Diet in Pediatric Patients with Brain Tumors: A Systematic Review

Researchers conducted a systematic review to assess the safety, feasibility, and potential effectiveness of a ketogenic diet in pediatric patients with brain tumors. The review included eight studies involving a total of 11 children, covering the classic ketogenic diet, modified Atkins, and low-carbohydrate variants.  Most patients were undergoing a ketogenic diet during disease progression or relapse, and many required enteral feeding. Intervention durations exceeded three months in all but one case.

Due to significant heterogeneity in study design, outcomes, and interventions, a meta-analysis was not feasible. Instead, the authors synthesized data narratively, focusing on tumor response, safety, nutritional status, and patient adherence.

Key Finding:

Safety:

• No serious adverse events attributed to KD were reported.
• Hypoglycemia and hyperketosis occurred in 3 patients; all were manageable.
• Mild side effects (vomiting, constipation, dyslipidemia) resolved with diet adjustments.

Feasibility:

• The ketogenic diet was generally well tolerated via both oral and enteral feeding.
• Adherence was high, particularly with a solid food-based ketogenic diet and added MCT oil.
• Therapy discontinuation was due to disease progression or personal choice, not side effects.

Effectiveness:

• 6 out of 11 patients showed positive tumor responses on imaging (MRI or PET).
• 5 patients reported improved neurological function, and 3 returned to school.
• Median overall survival (reported in 6 patients) was 17.6 months.

The authors concluded that a ketogenic diet is a potentially safe and feasible adjunct therapy for children with brain tumors, showing some evidence of benefit in tumor response and quality of life. However, the certainty of these findings is low due to small sample sizes, absence of control groups, and reliance on self-reported outcomes. Larger, well-controlled studies are needed to determine the clinical significance of KD in this patient population.