Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Radiation Oncology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Cancer Res Treat. 2022 Jan;54(1):294-300. doi: 10.4143/crt.2021.073. Epub 2021 Apr 1.
This study aimed to evaluate the effect of radiotherapy (RT) on the risk of diabetes by assessing hemoglobin A1c (HbA1c) levels in patients with gastroduodenal indolent lymphoma.
This retrospective study included patients with stage I extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue or follicular lymphoma of the gastroduodenal region who were treated with Helicobacter pylori eradication and/or RT between 2000 and 2019 in our institution. Of total 79 patients with HbA1c test, 17 patients received RT (RT group), while 62 patients did not receive RT (control group). A diabetes-associated event (DAE) was defined as a ≥ 0.5% increase in HbA1c levels from baseline, and diabetes event (DE) were defined as HbA1c level of ≥ 6.5%.
During the median follow-up of 49 months, no local failure occurred after RT and no patients died of lymphoma. The RT group had significantly higher risk for DAEs on univariable analysis (hazard ratio [HR], 4.18; 95% confidence interval [CI], 1.64 to 10.66; p < 0.01) and multivariable analysis (HR, 3.68; 95% CI, 1.42 to 9.56; p=0.01). Further, the DE risk was significantly higher in the RT group than in the control group (HR, 4.32; 95% CI, 1.08 to 17.30; p=0.04) and in patients with increased baseline HbA1c levels (HR, 35.83; 95% CI, 2.80 to 459.19; p=0.01). On multivariable analysis, RT significantly increased the risk of DEs (HR, 4.55; 95% CI, 1.08 to 19.19; p=0.04), even after adjusting baseline HbA1c level (HR, 40.97; 95% CI, 3.06 to 548.01; p=0.01).
Patients who received RT for gastroduodenal indolent lymphoma had an increased risk of diabetes compared to those who did not.
本研究旨在通过评估胃十二指肠惰性淋巴瘤患者的糖化血红蛋白（HbA1c）水平，评估放疗（RT）对糖尿病风险的影响。
本回顾性研究纳入了 2000 年至 2019 年期间在我院接受幽门螺杆菌根除和/或 RT 治疗的 I 期结外黏膜相关淋巴组织边缘区淋巴瘤或胃十二指肠滤泡淋巴瘤患者。在总共有 HbA1c 检测结果的 79 例患者中，有 17 例患者接受了 RT（RT 组），而 62 例患者未接受 RT（对照组）。糖尿病相关事件（DAE）定义为 HbA1c 水平较基线升高≥0.5%，糖尿病事件（DE）定义为 HbA1c 水平≥6.5%。
在中位随访 49 个月期间，RT 后无局部失败，也无患者死于淋巴瘤。单因素分析显示，RT 组发生 DAE 的风险显著更高（风险比[HR]，4.18；95%置信区间[CI]，1.64 至 10.66；p<0.01），多因素分析也显示（HR，3.68；95%CI，1.42 至 9.56；p=0.01）。此外，RT 组的 DE 风险明显高于对照组（HR，4.32；95%CI，1.08 至 17.30；p=0.04），以及基线 HbA1c 水平升高的患者（HR，35.83；95%CI，2.80 至 459.19；p=0.01）。多因素分析显示，即使调整了基线 HbA1c 水平，RT 也显著增加了 DEs 的风险（HR，4.55；95%CI，1.08 至 19.19；p=0.04）。
与未接受 RT 的患者相比，接受胃十二指肠惰性淋巴瘤 RT 的患者发生糖尿病的风险增加。
