RISS 검색 - 국내학술지논문 상세보기

다국어 초록 (Multilingual 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 to 10.66; p < 0.01) and multivariable analysis (HR, 3.68; 95% CI, 1.42 to 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 to 17.30; p=0.04) and in patients with increased baseline HbA1c levels (HR, 35.83; 95% CI, 2.80 to 459.19; p=0.01). On multivariable analysis, RT significantly increased the risk of DEs (HR, 4.55; 95% CI, 1.08 to 19.19; p=0.04), even after adjusting baseline HbA1c level (HR, 40.97; 95% CI, 3.06 to 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.

다국어 초록 (Multilingual 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 to 10.66; p < 0.01) and multivariable analysis (HR, 3.68; 95% CI, 1.42 to 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 to 17.30; p=0.04) and in patients with increased baseline HbA1c levels (HR, 35.83; 95% CI, 2.80 to 459.19; p=0.01). On multivariable analysis, RT significantly increased the risk of DEs (HR, 4.55; 95% CI, 1.08 to 19.19; p=0.04), even after adjusting baseline HbA1c level (HR, 40.97; 95% CI, 3.06 to 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.

참고문헌 (Reference)

1 Marks LB, "Use of normal tissue complication probability models in the clinic" 76 (76): S10-S19, 2010

2 Pinnix CC, "Ultra-low-dose radiotherapy for definitive management of ocular adnexal B-cell lymphoma" 39 : 1095-1100, 2017

3 Sherwani SI, "Significance of HbA1c test in diagnosis and prognosis of diabetic patients" 11 : 95-104, 2016

4 Gemici C, "Risk of endocrine pancreatic insufficiency in patients receiving adjuvant chemoradiation for resected gastric cancer" 107 : 195-199, 2013

5 van Nimwegen FA, "Risk of diabetes mellitus in long-term survivors of Hodgkin lymphoma" 32 : 3257-3263, 2014

6 Groot HJ, "Risk of diabetes after para-aortic radiation for testicular cancer" 119 : 901-907, 2018

7 Konig L, "Response rates and recurrence patterns after low-dose radiotherapy with 4Gy in patients with low-grade lymphomas" 194 : 454-461, 2018

8 Giraud P, "Respiratory gating for radiotherapy : main technical aspects and clinical benefits" 97 : 847-856, 2010

9 Wagman R, "Respiratory gating for liver tumors : use in dose escalation" 55 : 659-668, 2003

10 Gunther JR, "Radiation therapy for salivary gland MALT lymphoma : ultra-low dose treatment achieves encouraging early outcomes and spares salivary function)" 61 : 171-175, 2020