Prognostic significance of body mass index and diabetes in patients with malignant glioma
Open Access
- 11 June 2020
- journal article
- Published by Veritas Publications LTD in Ortadoğu Tıp Dergisi
- Vol. 12 (2), 269-274
- https://doi.org/10.21601/ortadogutipdergisi.709170
Abstract
Tr en Amaç: Bu çalışma ile tedavi öncesi vücut kitle indeksi (VKI) ve diyabet ile sağ kalım arasında bir ilişki olup olmadığını belirlemeyi amaçladık. Gereç ve Yöntemler: Bu retrospektif çalışma ile 2010-2018 tarihleri arasında radyoterapi (RT) uygulanmış hastaların sonuçları değerlendirildi. VKI, 3 gruba kategorize edildi: normal (18,5-24,9 kg/m2), aşırı kilolu (25-29,9 kg/m2), obez (≥30 kg/m2). Diyabet varlığı, hastaların tedavi öncesi oral antidiyabetik kulanımı ve dosya bilgileri göz önüne alınarak değerlendirildi. Hasta, tedavi ve tümör karakteristikleri tanımlayıcı istatistikler ile değerlendirildi. Kaplan-Meirer, log-rank ve çoklu analizlerde cox-regresyon analizleri yapıldı. P<0,05 istatistiki anlamlı olarak kabul edildi. Bulgular: 174 olgunun sonuçları değerlendirildi. Diyabet hastaların 22’sinde (%12,6) mevcuttu. Tek değişkenli analizlerde, 65 yaş üstünde olmak (p<0,001), Karnofsky performans skorunun (KPS) 80’in altında olması (p<0,001), diyabet olması (p=0,017), grad 4 patolojiye sahip olmak (p<0,001), subtotal eksizyon/biopsi yapılması (p<0,001), hipofraksiyone/tüm beyin radyoterapisi uygulanması (p<0,001) ve adjuvan kemoterapi (KT) almamak (p<0,001) genel sağ kalım üzerinde olumsuz etkili idi. Çok değişkenli analizlerde ise, 65 yaş üstü olmak, grad 4 patolojiye sahip olmak, subtotal eksizyon/biopsi yapılması ve adjuvan KT almamak genel sağ kalım (GS) üzerine etkili olarak bulundu. Diyabetiklerde medyan genel sağkalım 9,65 ay iken diyabetik olmayanlarda 17,74 ay idi (p=0,017). VKI ile GS arasında istatistiki anlamlı bir ilişki gösterilemedi. Sonuç: Önceden var olan diyabet kötü sonuçlar açısından bir risk faktörüdür. Diyabet ve ilişkili durumların kontrol altında olması önemlidir. Aim: We aimed to determine whether there is a relationship between body mass index (BMI) and diabetes (DM) before treatment and survival with this study. Material and Methods: The results of patients who received radiotherapy between 2010 - 2018 were evaluated with this retrospective study. BMI was categorized into 3 groups: normal (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), obese (≥30 kg/m2). Presence of diabetes was evaluated by considering oral antidiabetic use and file information before treatment. Patient, treatment and tumor characteristics were evaluated with descriptive statistics. Kaplan-Meirer, log-rank and cox-regression analyzes were performed. P <0.05 was considered statistically significant. Results: The results of 174 cases were evaluated. Diabetes was present in 22 patients (12.6%). In univariate analyzes, being over the age of 65 (p <0.001), Karnofsky performance score (KPS) below 80 (p <0.001), diabetes (p = 0.017), having grad 4 pathology (p <0.001), performing subtotal excision / biopsy (p <0.001), hypofractioned / whole brain radiotherapy (p <0.001), and not receiving adjuvant chemotherapy (CT) (p <0.001) had a negative effect on overall survival (OS). In multivariate analyzes, being over 65 years old, having grad 4 pathology, performing subtotal excision / biopsy and not taking adjuvant CT were found to be effective on OS. Median overall survival in diabetics was 9.65 months and 17.74 months in non-diabetics (p = 0.017). No statistically significant relationship was found between BMI and OS. Conclusion: Pre-existing diabetes in malignant glioma patients is a risk factor for poor outcomes. It is important to control diabetes and related conditions.Keywords
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