경희의대 / 공문규*, 임유진
Abstract
Background: Plasma glucose levels might be associated with the severity of tumor hypoxia in patients with cancer. In our previous study, we found that chronic hyperglycemia significantly increased the risk of locoregional recurrence in patients with non-small cell lung cancer treated with radical radiotherapy (RT). Here, we evaluated the association between plasma glucose levels in terms of hemoglobin A1c (HbA1c) and locoregional recurrence-free survival in patients with limited-stage small cell lung cancer treated with radical RT.
Methods: We retrospectively analyzed the clinical data of 59 patients with small cell lung cancer. HbA1c levels were measured 1 week before the start of RT. Survival outcomes were analyzed according to HbA1c levels. Multivariable analysis was conducted to identify whether HbA1c level was a significant prognostic factor for survival.
Results: The 1-, 2-, and 3-year locoregional recurrence-free survival rates were 90.9, 86.1, and 78.9%, respectively, in the low HbA1c group, and 45.1, 27.1, and 20.3%, respectively, in the high HbA1c group (p < 0.001). The 1-, 2-, and 3-year distant metastasis-free survival rates were 67.2, 57, and 57%, respectively, in the low HbA1c group, while it was 56.6, 24.9, and 24.9%, respectively, in the high HbA1c group (p = 0.024). HbA1c level remained a significant prognostic factor for locoregional recurrence-free survival in the multivariable analysis (p = 0.010).
Conclusions: Chronic hyperglycemia is a significant prognostic factor for locoregional recurrence-free survival in patients with limited-stage small cell lung cancer treated with radical RT. Routine monitoring of plasma glucose levels and aggressive glycemic control should be conducted to prevent locoregional recurrence.
Affiliation
Moonkyoo Kong 1, Yu Jin Lim 1
1Department of Radiation Oncology, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
편집위원
본 논문은 혈당과 방사선치료 효과 사이의 관계를 규명한 연구로 2021년 비소세포 폐암 환자를 대상으로 했던 연구의 후속으로 소세포 폐암 환자 59명을 대상으로 혈당 수치와 방사선치료 반응 사이에 고혈당이 장시간 지속되면 방사선치료 후 재발율이 증가함을 입증하였다. 임상 현장에서 폐암 환자의 혈당관리는 중요하며, 혈당은 간단히 검사할 수 있으므로 국소 재발 예후인자의 활용도가 높을 것으로 기대가 된다.
2022-10-06 16:06:33