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Abstract
Purpose: This study aimed to evaluate the effect of radiotherapy (RT) on the risk of diabetes by assessing hemoglobin A1c (HbA1c) levels in patients with gastroduodenal indolent lymphoma.

Materials and methods: This retrospective study included patients with stage I extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue or follicular lymphoma of the gastroduodenal region who were treated with Helicobacter pylori eradication and/or RT between 2000 and 2019 in our institution. Of total 79 patients with HbA1c test, 17 patients received RT (RT group), while 62 patients did not receive RT (Control group). A Diabetes-associated event (DAE) was defined as a ≥ 0.5% increase in HbA1c levels from baseline, and diabetes event (DE) were defined as HbA1c level of ≥ 6.5%.

Results: During the median follow-up of 49 months, no local failure occurred after RT and no patients died of lymphoma. The RT group had significantly higher risk for DAEs on univariable analysis (hazard ratio [HR]=4.18; 95% confidence interval [CI]=1.64-10.66; p < 0.01) and multivariable analysis (HR=3.68; 95% CI=1.42-9.56; p=0.01). Further, the DE risk was significantly higher in the RT group than in the control group (HR=4.32; 95% CI=1.08-17.30; p=0.04) and in patients with increased baseline HbA1c levels (HR=35.83; 95% CI=2.80-459.19; p=0.01). On multivariable analysis, RT significantly increased the risk of DEs (HR=4.55; 95% CI=1.08-19.19; p=0.04), even after adjusting baseline HbA1c level (HR=40.97; 95% CI=3.06-548.01; p=0.01).

Conclusion: Patients who received RT for gastroduodenal indolent lymphoma had an increased risk of diabetes compared to those who did not.

Affiliations

Jong Yun Baek  1 , Do Hoon Lim  1 , Dongryul Oh  1 , Heerim Nam  2 , Jae J Kim  3 , Jun Haeng Lee  3 , Byung-Hoon Min  3 , Hyuk Lee  3
1 Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2 Department of Radiation Oncology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
3 Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.