Second Department of Internal Medicine, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Department of Oncology, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Medicina (Kaunas). 2022 Jun 29;58(7):872. doi: 10.3390/medicina58070872.
Background and Objectives: In the last decades there has been an increasing body of research identifying the positive correlation between diabetes mellitus (DM) and solid malignancies, moreover, having shown DM as an independent risk factor for colorectal cancer (CRC). The aim of the present study was to assess the impact of DM on metastatic CRC (mCRC), and to identify possible predictive factors in the successful treatment of mCRC. Materials and Methods: 468 patients with mCRC were included in this retrospective, observational study. A total of 8669 oncological treatment cycles related to 988 distinct chemotherapy lines were analyzed. Data regarding lines of treatment and blood panel values were obtained from the Oncohelp Hospital database. Results: The presence of DM in male patients >70 years was a negative predictor (RR = 1.66 and a p = 0.05). DM seemed to have a detrimental effect in patients whose treatment included bevacizumab (median time to treatment failure -TTF- 94 days for DM+ cases compared to 114 days for DM-patients, p = 0.07). Analysis of treatments including bevacizumab based on DM status revealed lower values of mean TTF in DM+ female patients versus DM-(81.08 days versus 193.09 days, p < 0.001). It was also observed that DM+ patients had a higher mean TTF when undergoing anti-EGFR (epidermal growth factor) therapy (median TTF 143 days for DM+ patients versus 97.5 days for those without DM, p = 0.06). Conclusions: The favorable predictive factors identified were the inclusion of antiangiogenic agents, a higher hemoglobin value, a higher lymphocyte count, the inclusion of anti-EGFR treatment for DM+ patients, a higher creatinine, and a higher lymphocyte count in treatment lines that included anti-EGFR treatment. Unfavorable predictive factors were represented by the presence of DM in female patients undergoing antiangiogenic treatment, neutropenia in male patients, the association of oxaliplatin and antiangiogenic agents, and a higher monocyte count in the aforementioned treatment lines.
在过去几十年中，越来越多的研究表明糖尿病（DM）与实体恶性肿瘤之间存在正相关关系，并且DM 是结直肠癌（CRC）的独立危险因素。本研究旨在评估 DM 对转移性结直肠癌（mCRC）的影响，并确定 mCRC 成功治疗的可能预测因素。
本回顾性观察性研究纳入了 468 例 mCRC 患者。共分析了与 988 条不同化疗线相关的 8669 个肿瘤治疗周期的数据。治疗线和血液指标数据均来自 Oncohelp 医院数据库。
男性患者>70 岁时患有 DM 是一个负面预测因素（RR=1.66，p=0.05）。在接受贝伐珠单抗治疗的患者中，DM 似乎有不利影响（DM+病例的中位治疗失败时间-TTF-为 94 天，DM-患者为 114 天，p=0.07）。基于 DM 状态对包含贝伐珠单抗的治疗进行分析，DM+女性患者的平均 TTF 值低于 DM-患者（81.08 天比 193.09 天，p<0.001）。还观察到，接受抗 EGFR（表皮生长因子）治疗的 DM+患者的 TTF 平均值更高（DM+患者的中位 TTF 为 143 天，无 DM 患者为 97.5 天，p=0.06）。
本研究确定的有利预测因素包括抗血管生成药物的应用、较高的血红蛋白值、较高的淋巴细胞计数、DM+患者接受抗 EGFR 治疗、较高的肌酐值和抗 EGFR 治疗中较高的淋巴细胞计数。不利的预测因素包括接受抗血管生成治疗的女性患者中存在 DM、男性患者中性粒细胞减少症、奥沙利铂和抗血管生成药物的联合应用以及上述治疗线中较高的单核细胞计数。
