Chemotherapy-associated steroid use and its effect on blood glucose, nephro-, and other toxicity of chemotherapy for non-diabetic oncological patients

Abstract

e20721 Background: Gynecologic cancer chemotherapy regimen include prechemotherapy, intrachemotherapy, and postchemotherapy administration of glucocorticoid steroids, which introduce the risk of hyperglycemia. Some studies have suggested that hyperglycemia is associated with increased chemotherapy toxicity. We evaluated the effects of dexamethasone as part of ovarian cancer and cervical cancer chemotherapy on blood glucose and its subsequent effect on nephrotoxicity in non-diabetic patients. Methods: We conducted a retrospective chart review of patients diagnosed with ovarian cancer and cervical cancer and received steroids as part of their chemotherapy during 2006–2008. Subjects who had elevated glucose detected at any time during treatment were compared with controls who had normal glucose levels. Pre- and post treatment serum BUN, creatinine, and blood glucose level were obtained. Results: 17 non-diabetic patients who received cisplatin or paclitaxel or both were studied (median age 50 years; range 42–60); All of the patients received 10 -20 mg of DEX intravenously before cisplatin/taxol. Glucose was only mildly elevated in 4 patients (110–200 mg/dl). None of the four cases with elevated glucose levels had any toxicity. One of the eight controls (12.5%) had elevation of creatinine. In all of the 17 patients, only one had evidence of mild nephrotoxicity, however her median blood glucose was not elevated while on therapy. Conclusions: This preliminary study did not show that current steroid regimens prescribed with chemotherapy have a significant overall effect on glucose elevation and subsequent increased nephrotoxicity of chemotherapy. Additional patients will be presented. No significant financial relationships to disclose.