Abstract
BackgroundThe aim of this study was to assess the correlations between the levels of blood glucose (BG) and the dose of radiation therapy (RT) to the central gustatory system (GS) in glioblastoma multiforme (GBM) patients.MethodsThirty-seven GBM patients with regular blood glucose measurements were investigated retrospectively. 59.5% were female and 40.5% male with a median age of 64.3 years (range 27.4–85.6). Diabetes mellitus type 2 (DM2) history, BG levels and dexamethasone (DEXA) medication were assessed. The analyzed central gustatory structures were: solitary tract and nucleus, ventral posteromedial nucleus of the thalamus, sensory tongue area of the postcentral gyrus, anterior part of the insula, frontal operculum, amygdala, hypothalamus. These structures were delineated on magnetic resonance tomographies (MRIs) registered to planning-CTs. All GS doses were transformed in equivalent doses in 2 Gy fraction (EQD2).ResultsTwenty one patients (56.8%) had at least one BG values over 200 mg/dl during RT. There was a difference between average BG in DM2: 192.8 mg/dl (±24.4) and non-DM2 patients: 145.7 mg/dl (±39.5; p = 0.01) but no significant difference in daily DEXA medication – DM2 patients: 7.9 mg/d (±1.9) vs. non-DM2: 9.3 mg/dl (±5.7; p = 0.29). The EQD2 Dmean to the total GS was 36.0Gy (±8.6 Gy). There was a tendency for a higher increase in maximum BG values with more radiation dose to the total GS (b = 1.9, R2 = 0.103, p = 0.06).ConclusionBG levels in GBM patients are in direct correlation to the dose of RT applied to the central GS. GBM patients that undergo RT should thus be closely monitored for changes in BG levels during and after the radiation.
Highlights
The aim of this study was to assess the correlations between the levels of blood glucose (BG) and the dose of radiation therapy (RT) to the central gustatory system (GS) in glioblastoma multiforme (GBM) patients
A total of 37 patients with regular BG testing treated in our institute between 09/2010 and 03/2016 with histologically proven GBM were included into the study
In the GBM cohort used in this study, the average daily dose of DEXA was 9.0 mg (±5.2 mg) and the total cumulative dose during the whole treatment time was 281.0 mg (±211.0)
Summary
The aim of this study was to assess the correlations between the levels of blood glucose (BG) and the dose of radiation therapy (RT) to the central gustatory system (GS) in glioblastoma multiforme (GBM) patients. We aimed to assess whether RT doses to the gustatory system (GS), a major brain network that orchestrates our sensation of sensing, recognizing and interpreting tastes, can have a clinical impact on BG levels during RT. Tasting food in the oral cavity leads to an increase in circulating insulin, before there is any increase in post absorptive circulating glucose. This is called the cephalic phase of insulin secretion [15, 16]. Extrathalamic fibers are connected to the dorsal nucleus of the vagus, hypothalamus and amygdala for visceral and behavioral reflexes and creating emotions [17]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have