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在雄激素剥夺治疗基础上加用二甲双胍对合并2型糖尿病的前列腺癌患者的影响。

Metformin addition to androgen deprivation therapy effect on cancer prostate patients with type 2 diabetes.

作者信息

Aboelnaga Engy M, Aboelnaga Mohamed M, Elkalla Hend Mhr

机构信息

Professor of Clinical Oncology and Nuclear Medicine Department, Mansoura University Hospital, Mansoura, Egypt.

Associate Professor of Endocrinology and diabetes unit, Faculty of Medicine, Mansoura University, Egypt.

出版信息

Diabetes Metab Syndr. 2021 Sep-Oct;15(5):102251. doi: 10.1016/j.dsx.2021.102251. Epub 2021 Aug 18.

Abstract

AIMS

Patients with prostate cancer (PC) have a higher rate of non-cancer mortality than cancer-related, which could be partially attributed to the treatment they receive. We aimed to evaluate the effect of metformin addition to androgen deprivation therapy (ADT) among cancer prostate patients with type 2 DM.

METHODOLOGY

This prospective, two-arm study included 95 PC patients with type 2 DM who had ADT. The patients were divided into 2 groups: the Metformin group includes 48 patients and the non-metformin group includes 47 patients. We compared the anthropometric, diabetic status; tumour status, survival rate, and biochemical relapse between metformin and non-metformin groups.

RESULTS

We observed significant differences in fold changes of anthropometric parameters including weight, BMI, and waist circumference between both groups. We found significant differences in fold change of PSA levels in metformin groups in comparison with non-metformin groups. Overall survival comparison between metformin users and non-users showed better statistically insignificant survival in the metformin users group. We observed a significantly lower relapse rate in the metformin group in comparison with the non-metformin.

CONCLUSION

Metformin could decrease some of the unfavourable metabolic consequences of ADT. Moreover, Metformin could enhance the tumour-suppressive effect of ADT and decrease the PSA relapse rate.

摘要

目的

前列腺癌(PC)患者的非癌症死亡率高于癌症相关死亡率,这可能部分归因于他们接受的治疗。我们旨在评估在接受雄激素剥夺治疗(ADT)的2型糖尿病前列腺癌患者中添加二甲双胍的效果。

方法

这项前瞻性双臂研究纳入了95例接受ADT的2型糖尿病PC患者。患者分为两组:二甲双胍组包括48例患者,非二甲双胍组包括47例患者。我们比较了二甲双胍组和非二甲双胍组之间的人体测量学、糖尿病状况、肿瘤状况、生存率和生化复发情况。

结果

我们观察到两组之间包括体重、BMI和腰围在内的人体测量学参数的变化倍数存在显著差异。与非二甲双胍组相比,我们发现二甲双胍组的PSA水平变化倍数存在显著差异。二甲双胍使用者和非使用者之间的总生存比较显示,二甲双胍使用者组的生存情况在统计学上无显著更好。与非二甲双胍组相比,我们观察到二甲双胍组的复发率显著更低。

结论

二甲双胍可以减少ADT的一些不利代谢后果。此外,二甲双胍可以增强ADT的肿瘤抑制作用并降低PSA复发率。

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