Lerner Michael Zvi, Mor Niv, Paek Hyung, Blitzer Andrew, Strome Marshall
1 Department of Otolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York, USA.
2 Maimonides Medical Center, Voice and Swallowing Disorders, Division of Otolaryngology-Head and Neck Surgery, Brooklyn, New York, USA.
Ann Otol Rhinol Laryngol. 2017 Apr;126(4):340-343. doi: 10.1177/0003489416688478. Epub 2017 Jan 19.
Metformin is an oral anti-hyperglycemic agent used to treat type 2 diabetes mellitus (DM). In vitro and animal models have shown that metformin can prevent the progression of oral lesions to carcinoma; however, there is conflicting data in the clinical literature regarding risk reduction for malignancy in head and neck cancer (HNC).
Case series.
We present 3 cases in which adjuvant metformin therapy was used to treat recurrent and multifocal dysplastic lesions in previously treated nondiabetic HNC patients.
Patients included 1 with a history of oral cavity squamous cell carcinoma (SCC) and 2 with a history of laryngeal SCC. Follow-up time ranged between 3 and 33 months. All 3 patients showed complete or partial regression of the remaining mucosal lesions and did not require any additional surgeries.
We present 3 cases of nondiabetic HNC patients with field cancerization who showed a good response to adjuvant therapy with metformin. The nondiabetic population is not affected by confounding factors such as increased risk of malignancy and decreased overall survival that is itself associated with abnormal glucose metabolism and is therefore an excellent cohort in which to study the use of adjuvant metformin therapy in HNC patients.
二甲双胍是一种用于治疗2型糖尿病（DM）的口服抗高血糖药物。体外和动物模型研究表明，二甲双胍可预防口腔病变发展为癌症；然而，临床文献中关于头颈部癌（HNC）患者恶性肿瘤风险降低的数据存在矛盾。
病例系列研究。
我们报告3例既往接受治疗的非糖尿病HNC患者，使用辅助性二甲双胍治疗复发性多灶发育异常病变。
患者包括1例有口腔鳞状细胞癌（SCC）病史和2例有喉SCC病史。随访时间为3至33个月。所有3例患者剩余黏膜病变均出现完全或部分消退，且无需任何额外手术。
我们报告3例有场癌化的非糖尿病HNC患者，其对二甲双胍辅助治疗反应良好。非糖尿病人群不受诸如恶性肿瘤风险增加和总体生存率降低等混杂因素影响，这些因素本身与糖代谢异常相关，因此是研究HNC患者辅助性二甲双胍治疗应用的理想队列。
