Impact of diabetes on cancer chemotherapy outcome: A retrospective analysis.

Attili, V. Satya Suresh; Bapsy, P. P.; Dadhich, Hemant K.; Batra, Ullas; Lokanatha, D.; Babu, K. Govind

BACKGROUND: Diabetes mellitus (DM) and cancer are common causes of morbidity and mortality. This study was designed to retrospectively study from hospital data the treatment outcome in three common cancers among our diabetic population. METHODOLOGY: Patients with histologically-proven breast, lung, or colorectal cancers were analyzed. Patients were stratified into those with or without diabetes. Duration of diabetes, end-organ damage and glycemic control were recorded from the case records. "Response Evaluation Criteria In Solid Tumors. (RECIST) criteria were used to assess response. Common Toxicity Criteria, version 3.0, was used to assess toxicity. Disease-free and overall survival, as well as toxicity, were calculated for both groups and compared using the Student's t test. RESULTS: A total of 119 diabetic patients who presented to the department of medical oncology over a 6-year period between 2000 and 2005, and who met the inclusion criteria, were analyzed. One control was chosen for each case randomly from the same population. Both groups were matched for baseline characteristics. The mean duration of diabetes was 2.6 years in the present study. Diabetics have significantly lower response rates and poor overall and disease-free survival. The toxicity profile is not different in both the groups. CONCLUSION: Our data supports the concept that DM is associated with an increase in mortality and poor response rates. This mechanism is probably independent of the glycemic control, comorbid conditions, or the treatment modality used for control of diabetics. We did not find any significant increase in the complication rates in our diabetic patients. The possible reason for this clinical paradox could be the relatively good glycemic control: all the diabetics in the present study have near-normal blood sugar levels throughout.

CANCER chemotherapy; DIABETES; PEOPLE with diabetes; ONCOLOGY; BLOOD sugar

International Journal of Diabetes in Developing Countries, 2007, Vol 27, Issue 4, p122

0973-3930

Academic Journal

10.4103/0973-3930.38631