Hyperglycemia associated with 5-fluorouracil-based chemotherapy negatively impac
PUBLISHED: 2015-11-27  487 total views, 2 today

Li Min1, Jiang Hua2, Wang Lin-wei3, Li Ju-fen4, Sun Rui4, Gao Chang4Zhou Yong4, Lin Mei4, Su Yan-wei4, Feng Jue-ping4

1Department of Oncology, PuAi Hospital of Tongji Medical College, Huazhong University of Science and Technology, China, 2University of Science and Technology of China, School of Life Sciences and Medical Center, 3Zhongnan Hospital of Wuhan University, 4Huazhong University of Science and Technology, Wuhan PuAi Hospital of Tongji Medical College

 

Objective:To explore the association between 5-FU-basedchemotherapy associated hyperglycemia and 5-year outcome of CRC patients. Method: A retrospective analysis was performed in this study to explore the association between 5-FU-basedchemotherapy associated hyperglycemia and 5-year outcome of 564 cases CRC patients. Result: The secondary hyperglycemia was associated with worse 5-year overall survival (OS) (47.1% in hyperglycemia vs 60.2% in non-hyperglycemia, P=0.009). A significant difference in cancer-specific OS was observed in hyperglycemia vs non-hyperglycemia groups (50.6% vs 61.2%, P=0.032). Multivariate analysis identified that hyperglycemia were independent prognostic factors for both OS and progression-free survival (PFS) (P<0.001), wherein, diabetes have a higher death risk than IFG/ IGT (HR 2.025, 95% CI [1.335-3.070] vs HR 1.664, 95% CI [1.062-2.605]). The patients with hyperglycemia had a more prone to stopping chemotherapy or shifting to more tolerable therapies due to adverse events (AEs) (P=0.028).There was a higher incidence of non-cancer mortality (P=0.043), liver (P=0.036) and lung metastasis (P=0.002) in hyperglycemia than non-hyperglycemia groups. Conclusion: The secondary hyperglycemia, especially diabetes was a high-risk factor for both cancer-specific and non-cancer deaths for CRC patients, possible partially caused by the increased adverse events, decreased chemotherapy compliance, and increased liver and lung metastasis.

 

Key Words: colorectal cancer  5-fluorouracil  hyperglycemia


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