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  • [Cancer Manag Res.] Diabetes mellitus is a predictive factor for radiation pneumonitis after thoracic radiotherapy in patients with lung cancer.

    경희의대 / 공문규, 정원규*

  • 출처
    Cancer Manag Res.
  • 등재일
    2019 Jul 26
  • 저널이슈번호
    11:7103-7110. doi: 10.2147/CMAR.S210095. eCollection 2019.
  • 내용

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    Abstract
    Purpose:
    We evaluated the effects of diabetes mellitus (DM) and DM-related serologic factors (HbA1c and fasting glucose) on the development of radiation pneumonitis in patients with lung cancer.

    Methods:
    We retrospectively analyzed the clinical data of 123 patients with lung cancer treated with radiotherapy. Radiation pneumonitis was scored according to the toxicity criteria of the Radiation Therapy Oncology Group. We used binary logistic regression analysis to find significant predictive factors for the development of grade ≥3 radiation pneumonitis.

    Results:
    On univariable analysis, V20, mean lung dose, DM, HbA1c, and fasting glucose level were significantly associated with the development of grade ≥3 radiation pneumonitis. On multivariable analysis, V20, mean lung dose, DM, HbA1c, and fasting glucose level remained significant predictive factors for grade ≥3 radiation pneumonitis. The incidence of grade ≥3 radiation pneumonitis was 44.4% in patients with DM and 20.7% in patients without DM. The incidence of grade ≥3 radiation pneumonitis was 12.7% for HbA1c level ≤6.15% and 41.5% for HbA1c level >6.15%. The incidence of grade ≥3 radiation pneumonitis was 17.2% for fasting glucose level ≤121 mg/dL and 35.5% for fasting glucose level >121 mg/dL.

    Conclusion:
    DM, HbA1c, and fasting glucose level are significant predictive factors for the development of grade ≥3 radiation pneumonitis in patients with lung cancer. Patients with DM, patients who have HbA1c >6.15%, and patients who have fasting glucose >121 mg/dL should be treated with greater caution.

     


    Author information

    Kong M1, Lim YJ1, Kim Y1, Chung MJ2, Min S1, Shin DO1, Chung W2.
    1
    Department of Radiation Oncology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Republic of Korea.
    2
    Department of Radiation Oncology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Republic of Korea.

  • 키워드
    diabetes mellitus; lung cancer; radiation pneumonitis; radiotherapy
  • 연구자

    DM이 방사선 폐렴 발생에 관여한다는 사실을 세계 최초로 입증한 연구로, DM 환자 방사선 치료 시 좀 더 주의해서 치료해야 한다는 경각심을 불러일으키는 연구입니다. 좀 더 많은 환자수로 확증 연구를 추가로 진행하면 좋겠습니다.

    2019-10-04 15:41:46

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