Diabetes Mellitus Is a Strong Independent Negative Prognostic Factor in Patients with Brain Metastases Treated with Radiotherapy
Background: Brain metastases (BM) cause relevant morbidity and mortality in cancer patients. The presence of cerebrovascular diseases can alter the tumor microenvironment, cellular proliferation and treatment resistance. However, it is largely unknown if the presence of distinct cerebrovascular risk...
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MDPI AG
2023-10-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/19/4845 |
| _version_ | 1797576143255109632 |
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| author | Seong Jeong Soniya Poudyal Sabine Klagges Thomas Kuhnt Kirsten Papsdorf Peter Hambsch Johannes Wach Erdem Güresir Franziska Nägler Alexander Rühle Nils H. Nicolay Clemens Seidel |
| author_facet | Seong Jeong Soniya Poudyal Sabine Klagges Thomas Kuhnt Kirsten Papsdorf Peter Hambsch Johannes Wach Erdem Güresir Franziska Nägler Alexander Rühle Nils H. Nicolay Clemens Seidel |
| author_sort | Seong Jeong |
| collection | DOAJ |
| description | Background: Brain metastases (BM) cause relevant morbidity and mortality in cancer patients. The presence of cerebrovascular diseases can alter the tumor microenvironment, cellular proliferation and treatment resistance. However, it is largely unknown if the presence of distinct cerebrovascular risk factors may alter the prognosis of patients with BM. Methods: Patients admitted for the radiotherapy of BM at a large tertiary cancer center were included. Patient and survival data, including cerebrovascular risk factors (diabetes mellitus (DM), smoking, arterial hypertension, peripheral arterial occlusive disease, hypercholesterolemia and smoking) were recorded. Results: 203 patients were included. Patients with DM (<i>n</i> = 39) had significantly shorter overall survival (OS) (HR 1.75 (1.20–2.56), <i>p</i> = 0.003, log-rank). Other vascular comorbidities were not associated with differences in OS. DM remained prognostically significant in the multivariate Cox regression including established prognostic factors (HR 1.92 (1.20–3.06), <i>p</i> = 0.006). Furthermore, subgroup analyses revealed a prognostic role of DM in patients with non-small cell lung cancer, both in univariate (HR 1.68 (0.97–2.93), <i>p</i> = 0.066) and multivariate analysis (HR 2.73 (1.33–5.63), <i>p</i> = 0.006), and a trend in melanoma patients. Conclusion: DM is associated with reduced survival in patients with BM. Further research is necessary to better understand the molecular mechanisms and therapeutic implications of this important interaction. |
| first_indexed | 2024-03-10T21:48:04Z |
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| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T21:48:04Z |
| publishDate | 2023-10-01 |
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| record_format | Article |
| series | Cancers |
| spelling | doaj.art-d8f0ed076a974da18e39b80dc3366ac22023-11-19T14:11:24ZengMDPI AGCancers2072-66942023-10-011519484510.3390/cancers15194845Diabetes Mellitus Is a Strong Independent Negative Prognostic Factor in Patients with Brain Metastases Treated with RadiotherapySeong Jeong0Soniya Poudyal1Sabine Klagges2Thomas Kuhnt3Kirsten Papsdorf4Peter Hambsch5Johannes Wach6Erdem Güresir7Franziska Nägler8Alexander Rühle9Nils H. Nicolay10Clemens Seidel11Department of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, GermanyDepartment of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, GermanyClinical Cancer Registry, 04103 Leipzig, GermanyDepartment of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, GermanyDepartment of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, GermanyDepartment of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, GermanyComprehensive Cancer Center Central Germany, Partner Site Leipzig, 04103 Leipzig, GermanyComprehensive Cancer Center Central Germany, Partner Site Leipzig, 04103 Leipzig, GermanyDepartment of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, GermanyDepartment of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, GermanyDepartment of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, GermanyDepartment of Radiation Oncology, University of Leipzig Medical Center, 04103 Leipzig, GermanyBackground: Brain metastases (BM) cause relevant morbidity and mortality in cancer patients. The presence of cerebrovascular diseases can alter the tumor microenvironment, cellular proliferation and treatment resistance. However, it is largely unknown if the presence of distinct cerebrovascular risk factors may alter the prognosis of patients with BM. Methods: Patients admitted for the radiotherapy of BM at a large tertiary cancer center were included. Patient and survival data, including cerebrovascular risk factors (diabetes mellitus (DM), smoking, arterial hypertension, peripheral arterial occlusive disease, hypercholesterolemia and smoking) were recorded. Results: 203 patients were included. Patients with DM (<i>n</i> = 39) had significantly shorter overall survival (OS) (HR 1.75 (1.20–2.56), <i>p</i> = 0.003, log-rank). Other vascular comorbidities were not associated with differences in OS. DM remained prognostically significant in the multivariate Cox regression including established prognostic factors (HR 1.92 (1.20–3.06), <i>p</i> = 0.006). Furthermore, subgroup analyses revealed a prognostic role of DM in patients with non-small cell lung cancer, both in univariate (HR 1.68 (0.97–2.93), <i>p</i> = 0.066) and multivariate analysis (HR 2.73 (1.33–5.63), <i>p</i> = 0.006), and a trend in melanoma patients. Conclusion: DM is associated with reduced survival in patients with BM. Further research is necessary to better understand the molecular mechanisms and therapeutic implications of this important interaction.https://www.mdpi.com/2072-6694/15/19/4845brain metastasisradiotherapysystemic therapydiabetes mellitusvascular risk factorsvascular comorbidities |
| spellingShingle | Seong Jeong Soniya Poudyal Sabine Klagges Thomas Kuhnt Kirsten Papsdorf Peter Hambsch Johannes Wach Erdem Güresir Franziska Nägler Alexander Rühle Nils H. Nicolay Clemens Seidel Diabetes Mellitus Is a Strong Independent Negative Prognostic Factor in Patients with Brain Metastases Treated with Radiotherapy Cancers brain metastasis radiotherapy systemic therapy diabetes mellitus vascular risk factors vascular comorbidities |
| title | Diabetes Mellitus Is a Strong Independent Negative Prognostic Factor in Patients with Brain Metastases Treated with Radiotherapy |
| title_full | Diabetes Mellitus Is a Strong Independent Negative Prognostic Factor in Patients with Brain Metastases Treated with Radiotherapy |
| title_fullStr | Diabetes Mellitus Is a Strong Independent Negative Prognostic Factor in Patients with Brain Metastases Treated with Radiotherapy |
| title_full_unstemmed | Diabetes Mellitus Is a Strong Independent Negative Prognostic Factor in Patients with Brain Metastases Treated with Radiotherapy |
| title_short | Diabetes Mellitus Is a Strong Independent Negative Prognostic Factor in Patients with Brain Metastases Treated with Radiotherapy |
| title_sort | diabetes mellitus is a strong independent negative prognostic factor in patients with brain metastases treated with radiotherapy |
| topic | brain metastasis radiotherapy systemic therapy diabetes mellitus vascular risk factors vascular comorbidities |
| url | https://www.mdpi.com/2072-6694/15/19/4845 |
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