Ketogenic Diet Adjunctive to Salvage Chemotherapy for Recurrent Glioblastoma:a Pilot Study

Inclusion Criteria: 1. Age 18-60 2. Karnovsky Performance Score of 60 or more. 3. histologically confirmed glioblastoma multiforme, grade 4 4. Ability and willingness to signed informed consent form. 5. Documented recurrence or progression after surgical resection/debulking, radiation and temozolomide chemotherapy. 6. normal function of liver and kidney Exclusion Criteria: 1. Any systemic illness or unstable medical condition that might pose additional risk, including: cardiac, unstable metabolic or endocrine disturbances, renal or liver disease, past history of renal calculi, hyperuricemia, hypercalcemia, mitochondrial disease, known disorder of fatty acid metabolism, porphyria, carnitine deficiency and pancreatitis 2. History of uncontrolled hyperlipidemia or hyperglycemia. 3. History of human immunodeficiency virus, or hepatitis C 4. Pregnancy or breastfeeding 5. Inability or unwillingness of subject to give written informed consent