Increased Risk of Diabetes after Definitive Radiotherapy in Patients with Indolent Gastroduodenal Lymphoma
	    		
		   		
		   			
		   		
	    	
    	- Author:
	        		
		        		
		        		
			        		Jong Yun BAEK
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Do Hoon LIM
			        		
			        		;
		        		
		        		
		        		
			        		Dongryul OH
			        		
			        		;
		        		
		        		
		        		
			        		Heerim NAM
			        		
			        		;
		        		
		        		
		        		
			        		Jae J KIM
			        		
			        		;
		        		
		        		
		        		
			        		Jun Haeng LEE
			        		
			        		;
		        		
		        		
		        		
			        		Byung-Hoon MIN
			        		
			        		;
		        		
		        		
		        		
			        		Hyuk LEE
			        		
			        		
		        		
		        		
		        		
			        		
			        		Author Information
			        		
 - Publication Type:Original Article
 - From:Cancer Research and Treatment 2022;54(1):294-300
 - CountryRepublic of Korea
 - Language:English
 - 
		        	Abstract:
			       	
			       		
				        
				        	 Purpose:This study aimed to evaluate the effect of radiotherapy (RT) on the risk of diabetes by assessing hemoglobin A1c (HbA1c) levels in patients with gastroduodenal indolent lymphoma. 
				        	
Materials and Methods:This retrospective study included patients with stage I extranodal marginal zone lymphoma of the mucosa-associated lymphoid tissue or follicular lymphoma of the gastroduodenal region who were treated with Helicobacter pylori eradication and/or RT between 2000 and 2019 in our institution. Of total 79 patients with HbA1c test, 17 patients received RT (RT group), while 62 patients did not receive RT (control group). A diabetes-associated event (DAE) was defined as a ≥ 0.5% increase in HbA1c levels from baseline, and diabetes event (DE) were defined as HbA1c level of ≥ 6.5%.
Results:During the median follow-up of 49 months, no local failure occurred after RT and no patients died of lymphoma. The RT group had significantly higher risk for DAEs on univariable analysis (hazard ratio [HR], 4.18; 95% confidence interval [CI], 1.64 to 10.66; p < 0.01) and multivariable analysis (HR, 3.68; 95% CI, 1.42 to 9.56; p=0.01). Further, the DE risk was significantly higher in the RT group than in the control group (HR, 4.32; 95% CI, 1.08 to 17.30; p=0.04) and in patients with increased baseline HbA1c levels (HR, 35.83; 95% CI, 2.80 to 459.19; p=0.01). On multivariable analysis, RT significantly increased the risk of DEs (HR, 4.55; 95% CI, 1.08 to 19.19; p=0.04), even after adjusting baseline HbA1c level (HR, 40.97; 95% CI, 3.06 to 548.01; p=0.01).
Conclusion:Patients who received RT for gastroduodenal indolent lymphoma had an increased risk of diabetes compared to those who did not. 
            