Preoperative short-term fasting in paediatric cancer care is safe, feasible and activates protective responses
Background: Paediatric cancer patients often face treatment-induced complications significantly affecting Quality of Life. Short-term fasting (STF) could mitigate therapy-related adverse toxicity by triggering a protective survival response. While STF and other nutritional interventions have shown c...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-12-01
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| Series: | EJC Paediatric Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772610X25000984 |
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| author | D.S.J. Komninos C.A.J. Oudmaijer R.A. Ozinga K. Smit J.N.M. Ijzermans J.H.J. Hoeijmakers R.C. Minnee M.M. van den Heuvel-Eibrink W.P. Vermeij |
| author_facet | D.S.J. Komninos C.A.J. Oudmaijer R.A. Ozinga K. Smit J.N.M. Ijzermans J.H.J. Hoeijmakers R.C. Minnee M.M. van den Heuvel-Eibrink W.P. Vermeij |
| author_sort | D.S.J. Komninos |
| collection | DOAJ |
| description | Background: Paediatric cancer patients often face treatment-induced complications significantly affecting Quality of Life. Short-term fasting (STF) could mitigate therapy-related adverse toxicity by triggering a protective survival response. While STF and other nutritional interventions have shown clinical benefits in adults, application in paediatric cancer remains unexplored. This study aims to explore the safety and feasibility of incorporating STF into the treatment regimen for children with renal cancer, while simultaneously showing a protective transcriptomic signature. Methods: Here we selected children with a localized renal tumour at the Princess Máxima Center. In a randomized controlled setting preceding surgery (FIURTT-study), these children fasted for 10–18 h, depending on age, during which patient/parent experiences and blood measurements were collected. To investigate the STF-induced effects on enhancing postoperative recovery, kidney tissue was used for transcriptome analysis, and compared to a well-defined 2.5-day fasting response in adults. Results: Blood measurements of 13 patients revealed significantly decreased glucose levels after STF, without occurrence of hypoglycaemia. Questionnaires demonstrated that patients and parents experienced no obvious burden and described the intervention as highly feasible. RNA-expression patterns in normal kidney tissue unveiled distinctions between cases with STF and those without, displaying significant difference in relevant pathways linked to activated protective-responses, resembling those in adults. Conclusion: Our results indicate pre-operative STF to be safe and feasible in children with cancer. Also, we observed induction of the survival response at the transcriptional level, suggesting that STF induced a protective gene expression profile already after relatively short fasting periods. |
| format | Article |
| id | doaj-art-2c9398407a3f4c2dbf72c477d4077248 |
| institution | OA Journals |
| issn | 2772-610X |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EJC Paediatric Oncology |
| spelling | doaj-art-2c9398407a3f4c2dbf72c477d40772482025-08-20T02:39:07ZengElsevierEJC Paediatric Oncology2772-610X2025-12-01610030910.1016/j.ejcped.2025.100309Preoperative short-term fasting in paediatric cancer care is safe, feasible and activates protective responsesD.S.J. Komninos0C.A.J. Oudmaijer1R.A. Ozinga2K. Smit3J.N.M. Ijzermans4J.H.J. Hoeijmakers5R.C. Minnee6M.M. van den Heuvel-Eibrink7W.P. Vermeij8Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Oncode Institute, Utrecht, the NetherlandsPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Oncode Institute, Utrecht, the Netherlands; Erasmus MC Transplant Institute, department of Surgery, division of Hepatobiliary and Transplantation Surgery, Erasmus University Medical Center, Rotterdam, the NetherlandsPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Oncode Institute, Utrecht, the NetherlandsPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Oncode Institute, Utrecht, the NetherlandsErasmus MC Transplant Institute, department of Surgery, division of Hepatobiliary and Transplantation Surgery, Erasmus University Medical Center, Rotterdam, the NetherlandsPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Oncode Institute, Utrecht, the Netherlands; Erasmus MC Cancer Institute, department of Molecular Genetics, Erasmus University Medical Center Rotterdam, the Netherlands; Institute for Genome Stability in Ageing and Disease, Medical Faculty, University of Cologne, Germany, and Cologne Excellence Cluster for Cellular Stress Responses in Aging-Associated Diseases (CECAD), Centre for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, GermanyErasmus MC Transplant Institute, department of Surgery, division of Hepatobiliary and Transplantation Surgery, Erasmus University Medical Center, Rotterdam, the NetherlandsPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; University of Utrecht, and Wilhelmina Childrens Hospital, division of Child health, Utrecht, the NetherlandsPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Oncode Institute, Utrecht, the Netherlands; Correspondence to: Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht 3584 CS, the Netherlands.Background: Paediatric cancer patients often face treatment-induced complications significantly affecting Quality of Life. Short-term fasting (STF) could mitigate therapy-related adverse toxicity by triggering a protective survival response. While STF and other nutritional interventions have shown clinical benefits in adults, application in paediatric cancer remains unexplored. This study aims to explore the safety and feasibility of incorporating STF into the treatment regimen for children with renal cancer, while simultaneously showing a protective transcriptomic signature. Methods: Here we selected children with a localized renal tumour at the Princess Máxima Center. In a randomized controlled setting preceding surgery (FIURTT-study), these children fasted for 10–18 h, depending on age, during which patient/parent experiences and blood measurements were collected. To investigate the STF-induced effects on enhancing postoperative recovery, kidney tissue was used for transcriptome analysis, and compared to a well-defined 2.5-day fasting response in adults. Results: Blood measurements of 13 patients revealed significantly decreased glucose levels after STF, without occurrence of hypoglycaemia. Questionnaires demonstrated that patients and parents experienced no obvious burden and described the intervention as highly feasible. RNA-expression patterns in normal kidney tissue unveiled distinctions between cases with STF and those without, displaying significant difference in relevant pathways linked to activated protective-responses, resembling those in adults. Conclusion: Our results indicate pre-operative STF to be safe and feasible in children with cancer. Also, we observed induction of the survival response at the transcriptional level, suggesting that STF induced a protective gene expression profile already after relatively short fasting periods.http://www.sciencedirect.com/science/article/pii/S2772610X25000984Short-term fastingPaediatric oncologyFeasibilityRenal tumourSurgery |
| spellingShingle | D.S.J. Komninos C.A.J. Oudmaijer R.A. Ozinga K. Smit J.N.M. Ijzermans J.H.J. Hoeijmakers R.C. Minnee M.M. van den Heuvel-Eibrink W.P. Vermeij Preoperative short-term fasting in paediatric cancer care is safe, feasible and activates protective responses EJC Paediatric Oncology Short-term fasting Paediatric oncology Feasibility Renal tumour Surgery |
| title | Preoperative short-term fasting in paediatric cancer care is safe, feasible and activates protective responses |
| title_full | Preoperative short-term fasting in paediatric cancer care is safe, feasible and activates protective responses |
| title_fullStr | Preoperative short-term fasting in paediatric cancer care is safe, feasible and activates protective responses |
| title_full_unstemmed | Preoperative short-term fasting in paediatric cancer care is safe, feasible and activates protective responses |
| title_short | Preoperative short-term fasting in paediatric cancer care is safe, feasible and activates protective responses |
| title_sort | preoperative short term fasting in paediatric cancer care is safe feasible and activates protective responses |
| topic | Short-term fasting Paediatric oncology Feasibility Renal tumour Surgery |
| url | http://www.sciencedirect.com/science/article/pii/S2772610X25000984 |
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