Poor glycemic control might compromise the efficacy of chemotherapy in non-small cell lung cancer patients with diabetes mellitus
Poor glycemic control might compromise the efficacy of chemotherapy in non-small cell lung cancer patients with diabetes mellitus
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血糖控制不佳可能会影响患有糖尿病的非小细胞肺癌患者的化疗效果
DOI：
10.1002/cam4.2750
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发表时间：
2019-12-12
期刊：
影响因子：
4
通讯作者：
Zhu, Bo
中科院分区：
文献类型：
--
作者：
Zeng, Xianghua;Xu, Cheng;Zhu, Bo
背景既往研究表明2型糖尿病（T2 DM）与肺癌风险增加有关，但其在非小细胞肺癌预后中的作用仍存在争议。本研究调查了血糖控制对接受含铂双联治疗的T2 DM NSCLC患者结局的影响。方法回顾性分析191例接受含铂化疗的T2 DM合并晚期NSCLC患者的临床病理及生存资料。根据化疗期间的血糖情况，将患者分为控制不良组（n = 84）和良好组（n = 107）。使用Kaplan-Meier方法评估无进展生存期（PFS）。结果血糖控制良好患者的中位PFS [197.0（95%CI：136.3-257.7）d]长于血糖控制不良患者[132.0（95%CI：112.5-151.5）d]（P = 0.0003）。肺鳞癌和腺癌患者的进一步亚组分析显示，控制良好组的中位PFS也明显长于控制不良组[179.0（95% CI：78.4-279.6）天vs 125.0（95% CI：110.9-139.1）天，P = .0014; 197.0（95% CI：124.3-269.7）天vs 154.0（95% CI：129.9-178.1）天，P = .0359;分别）。血糖控制良好者与血糖控制不良者的不良反应发生率相似（均P > 0.05）。结论在含铂化疗期间血糖控制良好可能为T2 DM合并NSCLC患者提供生存获益。需要进一步的研究来证实我们的发现。
Background Previous studies indicated that type 2 diabetes mellitus (T2DM) is related to an increased lung cancer risk, but its role in the prognosis of NSCLC remains conflicting. This study investigated the impact of blood glucose control on the outcomes in NSCLC patients with T2DM treated with platinum-based doublets. Methods Clinicopathological and survival data from 191 T2DM patients with advanced NSCLC, who received platinum-based chemotherapy, were retrospectively analyzed. Based on the blood glucose conditions during chemotherapy, patients were classified into poor (n = 84) and good control (n = 107) groups. Progression-free survival (PFS) was assessed using the Kaplan-Meier method. Results The median PFS among patients with good glycemic control [197.0 (95% CI: 136.3-257.7) days] was longer than that among those with poor control [132.0 (95% CI: 112.5-151.5) days] (P = .0003). Further subgroup analysis of lung squamous carcinoma and adenocarcinoma patients showed that the median PFS of the good control group was also significantly longer than that of the poor control group [179.0 (95% CI: 78.4-279.6) days vs 125.0 (95% CI: 110.9-139.1) days, P = .0014; 197.0 (95% CI: 124.3-269.7) days vs 154.0 (95% CI: 129.9-178.1) days, P = .0359; respectively]. The incidence rates of side effects were similar among patients with good glycemic control and those with poor glycemic control (all P > .05). Conclusions Satisfactory glycemic control during platinum-based chemotherapy might provide a survival benefit to T2DM patients with NSCLC. Further studies are warranted to confirm our findings.