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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2021.073    [Accepted]
Increased Risk of Diabetes after Definitive Radiotherapy in Patients with Indolent Gastroduodenal Lymphoma
Jong Yun Baek1, Do Hoon Lim1, Dongryul Oh1, Heerim Nam2, Jae J Kim3, Jun Haeng Lee3, Byung-Hoon Min3, Hyuk Lee3
1Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Radiation Oncology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
3Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence  Do Hoon Lim ,Tel: 82-2-3410-2603, Fax: 82-2-3410-2619, Email: dh8lim@skku.edu
Received: January 17, 2021;  Accepted: March 31, 2021.  Published online: April 1, 2021.
ABSTRACT
Purpose
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.
Materials and Methods
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%.
Results
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]=1.64–10.66; p < 0.01) and multivariable analysis (HR=3.68; 95% CI=1.42–9.56; p=0.01). Further, the DE risk was significantly higher in the RT group than in the control group (HR=4.32; 95% CI=1.08–17.30; p=0.04) and in patients with increased baseline HbA1c levels (HR=35.83; 95% CI=2.80–459.19; p=0.01). On multivariable analysis, RT significantly increased the risk of DEs (HR=4.55; 95% CI=1.08–19.19; p=0.04), even after adjusting baseline HbA1c level (HR=40.97; 95% CI=3.06–548.01; p=0.01).
Conclusion
Patients who received RT for gastroduodenal indolent lymphoma had an increased risk of diabetes compared to those who did not.
Key words: Lymphoma, Radiotherapy, Stomach, Duodenum, Diabetes mellitus
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