Diabetes Is Associated with High Risk of Severe Adverse Events during Chemotherapy for Cancer Patients: a Single-Center Study
Menée en France auprès de 609 patients atteints d'un cancer, cette étude rétrospective analyse l'association entre la présence d'un diabète (119 cas) et la survenue d'événements indésirables sévères pendant la chimiothérapie
Diabetes mellitus (DM) is a common comorbidity among cancer patients, but its impact on chemotherapy tolerance has not been widely studied. We aimed to compare the occurrence of severe grade 3/4 adverse events (G3/4 AEs) within 90 days of starting chemotherapy between patients with and without diabetes. We conducted a retrospective single-center study in Lille University Hospital Oncology Department, France. Patients who received the first cycle of chemotherapy for gastrointestinal, gynecological, or cancer of unknown primary source between May 1, 2013, and May 1, 2016, were included. Overall, 609 patients were enrolled: 490 patients without diabetes (80.5%) and 119 patients with diabetes (19.5%). Within 90 days of starting chemotherapy, patients with diabetes had a significantly higher occurrence of AEs G3/4 compared to those with no diabetes (multivariate odds ratio [OR]: 1.57 [1.02; 2.42], p=0.04). More frequent G3/4 AEs in patients with diabetes were infection (26%), hematological disorders (13%), endocrine disorders (13%), and deterioration of the general condition (13%). In the year following the beginning of chemotherapy, patients with diabetes were twice as likely to be hospitalized as those without diabetes (univariate OR: 2.1 [1.40; 3.15], p= 0.0003). After multivariate adjustment, diabetes was no longer significantly associated with the risk of hospitalization (p=0.051). There were no differences between patients with and without diabetes regarding dose reduction and chemotherapy treatment delays (p=0.61 and p=0.30, respectively). Our study suggests the need for better consideration of DM in the personalized care plan to improve chemotherapy tolerance and quality of life of patients with DM.