Long-Term Survival in Three Cases with Pulmonary Metastases from Colorectal Cancer Given Low-Dose S-1 Under a Regimen Combining a Carbohydrate-Restricted Ketogenic Diet, Metformin, Vitamin D, Eicosapentaenoic Acid, and Other Complementary Therapies
Abstract
Chemotherapy is the standard treatment for patients with stage Ⅳ colorectal cancer. However, some patients are unable to continue standard chemotherapy because of adverse side effects, while others decline this treatment option to maintain a higher quality of life (QOL). To address the parallel needs for high QOL and disease control, we developed an alternative therapeutic approach termed"Coexistence Therapy for Cancer,"employing the combination of a carbohydrate-restricted ketogenic diet, metformin, vitamin-D, eicosapentaenoic acid (EPA) and additional complementary therapies, with S-1 (tegafur/gimeracil/oteracil potassium) at doses low enough to avoid side effects. Carbohydrate-restricted ketogenic diets, drugs, and other complementary therapies affect cancer cell metabolism, thereby limiting the growth of cancer cells and impairing their survival. An investigator-initiated clinical trial was conducted to evaluate the efficacy and safety of this approach. We assessed changes in the tumor size of the target lesions, serum carcinoembryonic antigen levels, and QOL. Our 3 patients with postoperative colorectal cancer with pulmonary metastases achieved long-term survival while maintaining a favorable QOL. These findings suggest that this therapeutic strategy may serve as a complementary treatment option for patients who are unable to tolerate standard chemotherapy. Further accumulation of clinical cases is required to validate the effectiveness of this approach.
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