Effect of different chemotherapy combined with radiotherapy for the treatment of non-small cell lung cancer complicated with type 2 diabetes

Abstract

Objective To evaluate the effect and the incidence of adverse reaction of different chemotherapy combined with radiotherapy for the treatment of non-small cell lung cancer (NSCLC) complicated with type 2 diabetes. Methods A total of 123 midterm advanced NSCLC patients complicated with type 2 diabetes were randomly divided into A, B, C three groups through the random number generated by computer, and each group was 41 cases. Three groups of patients were treated with three-dimensional conformal radiotherapy and synchronous chemotherapy. Group A received gemcitabine and cisplatin, group B received paclitaxel and cisp-latin, and group C received pemetrexed and cisplatin. The treatment efficiency, time to tumor progression, median survival time, survival rate and incidence of adverse reaction were observed and compared. Results The total effective rates of group A, B and C were 82.93%, 78.05% and 80.49%, with no statistically significant difference (χ2=0.365, P=0.357). The times to tumor progression of the three groups were (6.54±1.23) months, (5.96±1.27) months, (6.27±1.08) months, with no statistically significant difference (F=1.235, P=0.314); the median survival times of the three groups were (16.54±1.87) months, (15.36±1.25) months, (16.29±2.08) months respectively, with no statistically significant difference (F=2.226, P=0.245); 1-year survival rates of the three groups were 80.49%, 82.93%, 85.37% respectively, with no statistically significant difference (χ2=1.234, P=0.665); 2-year survival rates were 48.78%, 51.22%, 43.90%, with no statistically significant difference (χ2=2.354, P=0.451). The incidence rates of radioactive pneumonia and bone marrow suppression in group C were 24.39% and 24.39%, those were significantly lower than 31.71%, 53.66% of group B (χ2=18.687, P=0.017; χ2=25.336, P=0.011) and 41.46%, 31.71% of group A (χ2=17.543, P=0.019; χ2=24.358, P=0.013). Conclusion The clinical efficacy of the three groups are similar, but the incidence rate of adverse reaction in pemetrexed and cisplatin plus radiotherapy group is the lowest. Therefore, pemetrexed plus cisplatin is the safe and effective treatment for the previously untreated patients with NSCLC. Key words: Carcinoma, non-small-cell lung; Diabetes mellitus, type 2; Radiotherapy; Drug therapy; Adverse reaction