Abstract
In this retrospective study, we investigated the impact of diabetes mellitus (DM) on patients with head and neck cancer (HNC) undergoing concurrent chemoradiotherapy (CCRT). We analyzed the demographic and clinical characteristics, treatment tolerance, and toxicities of patients with HNC undergoing primary or adjuvant CCRT with or without DM between 2007 and 2016. Of the 556 patients undergoing CCRT, 84 (15.1%) had DM. Compared with patients without DM, patients with DM were significantly older (56.2 ± 11.2 vs. 51.9 ± 9.5 years, P < 0.001), received lower doses of cisplatin (adjuvant CCRT: 175.30 ± 84.03 vs. 214.88 ± 68.25, P = 0.014; primary CCRT: 142.84 ± 79.49 vs. 187.83 ± 76.19, P < 0.001), and experienced higher rates of infection (adjuvant CCRT: 52% vs. 30.5%, P = 0.042; primary CCRT: 45.8% vs. 22.9%, P < 0.001). Among patients undergoing primary CCRT, compared with those without DM, the patients with DM experienced significantly higher rates of hematologic toxicity (65.7% vs. 39.3%, P = 0.004) and treatment-related deaths (10.2% vs. 3.5%, P = 0.051); and a greater weight loss (−6.17 ± 9.27% vs. −4.49 ± 6.84, P = 0.078). Patients with HNC and DM undergoing CCRT, compared with patients without DM, experienced higher rates of infection and hematotoxicity, loss of body weight, and higher treatment-related mortality.
Highlights
Compared with patients without Diabetes mellitus (DM), a trend of greater weight loss was observed in patients with DM undergoing primary concurrent chemoradiotherapy (CCRT) ( − 6.17 ± 9.27 vs. −4.49 ± 6.84, P = 0.078)
Regardless of DM status, the mean age at head and neck cancer (HNC) diagnosis in our studied was 9 to 13 years younger than other country[15]. This lower age at diagnosis of HNC in our study population could be due to the widespread use of betel quid, which is a Group I carcinogen listed by the International Agency for Research on Cancer that interacts synergistically with tobacco www.nature.com/scientificreports
Our study demonstrated that in patients with HNC receiving either adjuvant or primary CCRT, the presence of DM was related to significantly higher infection susceptibility
Summary
We aimed to assess the relationship between DM and the outcomes of CCRT in patients with HNC
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