Fasting plasma glucose is an independent predictor of survival in patients with locally advanced non-small cell lung cancer treated with concurrent chemoradiotherapy
Milana Bergamino,
Antonio J. Rullan,
Maria Saigí,
Inmaculada Peiró,
Eduard Montanya,
Ramón Palmero,
José Carlos Ruffinelli,
Arturo Navarro,
María Dolores Arnaiz,
Isabel Brao,
Samantha Aso,
Susana Padrones,
Felipe Cardenal,
Ernest Nadal
Affiliations
Milana Bergamino
Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of Oncology, Hospital Duran i Reynals
Antonio J. Rullan
Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of Oncology, Hospital Duran i Reynals
Maria Saigí
Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of Oncology, Hospital Duran i Reynals
Inmaculada Peiró
Clinical Nutrition Unit, Catalan Institute of Oncology, Hospital Duran i Reynals, L’Hospitalet
Eduard Montanya
Department of Endocrinology, Hospital Universitari de Bellvitge, L’Hospitalet
Ramón Palmero
Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of Oncology, Hospital Duran i Reynals
José Carlos Ruffinelli
Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of Oncology, Hospital Duran i Reynals
Arturo Navarro
Department of Radiation Oncology, Catalan Institute of Oncology, Hospital Duran i Reynals, L’Hospitalet
María Dolores Arnaiz
Department of Radiation Oncology, Catalan Institute of Oncology, Hospital Duran i Reynals, L’Hospitalet
Isabel Brao
Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of Oncology, Hospital Duran i Reynals
Samantha Aso
Department of Respiratory Medicine, Hospital Universitari de Bellvitge, L’Hospitalet
Susana Padrones
Department of Respiratory Medicine, Hospital Universitari de Bellvitge, L’Hospitalet
Felipe Cardenal
Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of Oncology, Hospital Duran i Reynals
Ernest Nadal
Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of Oncology, Hospital Duran i Reynals
Abstract Background Diabetes is related with increased cancer mortality across multiple cancer types. Its role in lung cancer mortality is still unclear. We aim to determine the prognostic value of fasting plasma glucose (FPG) and diabetes mellitus in patients with locally advanced non-small cell lung cancer (NSCLC) treated with concurrent chemoradiotherapy. Methods One-hundred seventy patients with stage III NSCLC received definitive concurrent chemoradiotherapy from 2010 to 2014. Clinico-pathological data and clinical outcome was retrospectively registered. Fifty-six patients (33%), met criteria for type 2 diabetes mellitus (T2DM) at baseline. The prognostic value of FPG and other clinical variables was assessed. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method and Cox proportional models and log-rank test were used. Results With a median follow-up of 36 months, median PFS was 8.0 months and median OS was 15.0 months in patients with FPG ≥7 mmol/L compared to 20 months (HR 1.13; 95% CI 1.07–1.19, p 8.5%) (HR 4.53; 95% CI 2.21–9.30; p < 0.001) and those receiving insulin (HR 3.22; 95% CI 1.90–5.46 p < 0.001) had significantly independent worse OS. Conclusion Baseline FPG level is an independent predictor of survival in our cohort of patients with locally advanced NSCLC treated with concurrent chemoradiotherapy. Studies in larger cohorts of patients are warranted to confirm this relevant association.
