Open AccessPoor glycemic control might compromise the efficacy of chemotherapy in non‐small cell lung cancer patients with diabetes mellitus
Author(s) -
Zeng Xianghua,
Xu Cheng,
Cheng Jianan,
Sun Chengdu,
Wang Zhongyu,
Gong Zhihua,
Long Haixia,
Zhu Bo
Publication year - 2020
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.2750
Subject(s) - medicine , glycemic , lung cancer , diabetes mellitus , chemotherapy , adenocarcinoma , incidence (geometry) , type 2 diabetes mellitus , oncology , gastroenterology , cancer , surgery , insulin , endocrinology , physics , optics
Abstract 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.