Abstract #2907

Restricted ketogenic diet and fasting in combination with re-irradiation in glioblastoma impact intracellular pH and intracerebral metabolism

Katharina J. Wenger¹, Elke Hattingen¹, Joachim P. Steinbach², Johannes Rieger^2,3, Martin Voss², and Ulrich Pilatus¹

¹Institute of Neuroradiology, University Hospital, Goethe-University Frankfurt, Frankfurt, Germany, ²Dr. Senckenberg Institute of Neurooncology, University Hospital, Goethe-University Frankfurt, Frankfurt, Germany, ³Institute of Neurooncology, University Hospital Tübingen, Tübingen, Germany

Inhibition of glycolysis by decreasing blood glucoses levels and increasing ketone bodies (KB) could force tumor cells to shift their metabolism towards potentially impaired mitochondria. The aim of this study was to explore the combination of six days of calorie restricted ketogenic diet (crKD) and three days of fasting (as a possible radiosensitizer) with a re-irradiation therapy in patients with recurrent glioblastoma. Intracerebral concentrations of KB as well as pH_i and ATP were non-invasively monitored using MR-Spectroscopy. We were able to show evidence of intratumoral acetone using ¹H-MRS in some patients with malignant glioma at day 6 of crKD/fasting. Changes in pH_i and ATP during crKD/fasting will remain subject to preclinical studies.

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