Department of Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
Department of Medical Oncology, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
Br J Cancer. 2018 Oct;119(7):901-907. doi: 10.1038/s41416-018-0248-x. Epub 2018 Oct 9.
While the risk of diabetes is increased following radiation exposure to the pancreas among childhood cancer survivors, its association among testicular cancer (TC) survivors has not been investigated.
Diabetes risk was studied in 2998 1-year TC survivors treated before 50 years of age with orchidectomy with/without radiotherapy between 1976 and 2007. Diabetes incidence was compared with general population rates. Treatment-specific risk of diabetes was assessed using a case-cohort design.
With a median follow-up of 13.4 years, 161 TC survivors were diagnosed with diabetes. Diabetes risk was not increased compared to general population rates (standardised incidence ratios (SIR): 0.9; 95% confidence interval (95% CI): 0.7-1.1). Adjusted for age, para-aortic radiotherapy was associated with a 1.66-fold (95% CI: 1.05-2.62) increased diabetes risk compared to no radiotherapy. The excess hazard increased with 0.31 with every 10 Gy increase in the prescribed radiation dose (95% CI: 0.11-0.51, P = 0.003, adjusted for age and BMI); restricted to irradiated patients the excess hazard increased with 0.33 (95% CI: -0.14 to 0.81, P = 0.169) with every 10 Gy increase in radiation dose.
Compared to surgery only, para-aortic irradiation is associated with increased diabetes risk among TC survivors.
儿童癌症幸存者接受胰腺放射治疗后，患糖尿病的风险会增加，但尚未研究睾丸癌（TC）幸存者的这种关联。
研究了 2998 名年龄在 50 岁以下、于 1976 年至 2007 年间接受过睾丸切除术联合/不联合放射治疗的 TC 幸存者的糖尿病风险。将糖尿病的发病率与一般人群的发病率进行了比较。采用病例-队列设计评估了特定治疗方法的糖尿病风险。
中位随访 13.4 年后，161 名 TC 幸存者被诊断患有糖尿病。与一般人群相比，糖尿病风险没有增加（标准化发病比（SIR）：0.9；95%置信区间（95%CI）：0.7-1.1）。校正年龄后，与未接受放射治疗相比，腹主动脉旁放射治疗与糖尿病风险增加 1.66 倍（95%CI：1.05-2.62）。随着规定放射剂量每增加 10Gy，超额危险度增加 0.31（95%CI：0.11-0.51，P=0.003，校正年龄和 BMI）；将仅限于接受放射治疗的患者，随着放射剂量每增加 10Gy，超额危险度增加 0.33（95%CI：-0.14 至 0.81，P=0.169）。
与单纯手术相比，腹主动脉旁照射与 TC 幸存者的糖尿病风险增加相关。
