Klement · International journal of radiation biology 2019 · narrative review · n=?

The influence of ketogenic therapy on the 5 R's of radiobiology.

Level 5 - mechanism / opinion, no new human data

Narrative review of biological mechanisms and preclinical hypotheses without new empirical data

PubMed 28905672 · doi:10.1080/09553002.2017.1380330 · record verified 2026-08-26

What was done

This narrative review synthesized preclinical evidence and theoretical mechanisms regarding how ketogenic therapy (ketogenic diets and short-term fasting) affects the five classic radiobiological determinants of treatment outcome: reoxygenation, DNA repair, radiosensitivity, cell cycle redistribution, and repopulation.

What was found

The abstract reports no numerical findings or pooled effect estimates. It outlines mechanistic rationale: shifting metabolism away from glycolysis toward mitochondrial respiration increases reactive oxygen species and impairs ATP synthesis in cancer cells, while elevated ketone bodies (notably beta-hydroxybutyrate as an endogenous class-I histone deacetylase inhibitor) and reduced glucose induce differential stress resistance, protecting normal cells while sensitizing tumors to radiation damage.

Why it matters

It establishes a conceptual framework for using dietary metabolic interventions as a low-cost, non-toxic adjuvant to potentially increase the therapeutic ratio of radiotherapy in solid tumors.

Limits

The paper is a non-systematic narrative review based primarily on preclinical models and theoretical mechanisms without controlled human clinical outcome data or quantitative analysis.

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