Abstract

BACKGROUND: Hypertension and diabetes mellitus (DM) are both the risk factors for cancer. This study aimed to explore the prognostic value of fasting blood glucose (FBG) and hypertension in type 2 DM (T2DM) patients with advanced non-small cell lung cancer (NSCLC) who had received chemotherapy treatment.

MATERIAL AND METHODS: There were 181 advanced NSCLC patients with T2DM between 2010 and 2019 included in this study. Their laboratory and clinical data were retrospectively analyzed. The predictive value of FBG and hypertension was evaluated. The Kaplan-Meier method was used to evaluate progression-free survival (PFS).

RESULTS: The median PFS was 168.0 days (95% CI: 137.9–198.7 days) in patients with FBG ≥7 mmol/L compared to 154.0 days (95% CI: 126.7–181.3 days) for patients with FBG <7 mmol/L (hazard ratio [HR]=1.054; 95% CI: 0.7669–1.452; P=0.7447). Median PFS was longer in non-hypertensive patients than in hypertensive patients [179.0 days (95% CI: 137.3–220.7 days) versus 128.0 days (95% CI: 96.3–159.7 days); P=0.0189]. The existence of hypertension (HR=1.478; 95% CI: 1.063–2.055; P=0.020) was an independent predictor for shorter PFS in the multivariate analysis. Decreased hemoglobin was the major adverse event (over 95% patients). The incidence of all grades of adverse reactions was similar between hypertensive and non-hypertensive patients (all P>0.05) except diarrhea (P=0.020).

CONCLUSIONS: Complication of hypertension might confer a poor survival for advanced NSCLC patients with T2DM. Further prospective research is needed to confirm these findings.

Keywords: Carcinoma, Non-Small-Cell Lung, Diabetes Mellitus, Type 2, Disease-Free Survival, Fasting, Hypertension, Aged, Blood Glucose, China, Incidence, Kaplan-Meier Estimate, Lung Neoplasms, Male, Middle Aged, Prognosis, Proportional Hazards Models, Retrospective Studies, Risk Factors