Diabetes mellitus tied to CCRT complications in head and neck cancer

Diabetes mellitus (DM) may contribute to complications in head and neck cancer (HNC) patients undergoing concurrent chemoradiotherapy (CCRT), a recent study has found.

Researchers retrospectively assessed 556 HNC patients receiving CCRT treatment, of whom 84 had DM. The corresponding prevalence rate was 15.1 percent. DM participants tended to be older at diagnosis, but demographic characteristics at baseline were otherwise comparable. The distribution of T and N classifications, as well as of tumour site, were significantly different between groups.

Over the course of treatment, infections occurred significantly more commonly in DM patients in both the subgroups that received adjuvant (52.0 percent vs 30.5 percent) and primary (45.8 percent vs 22.9 percent) CCRT. Weight loss, rates of grade ≥3 haematotoxicity and rates of treatment-related deaths were all likewise more common in the DM vs non-DM patients, in those who received primary CCRT.

These outcomes were despite statistically comparable doses, fractions and lengths of radiotherapy, and a significantly lower cumulative dose of cisplatin in the DM group.

Moreover, DM patients also showed lower 1-year relapse-free (53.4 percent vs 66.4 percent; p=0.055) and overall (60.3 percent vs 77.0 percent; p=0.007) survival rates than their non-DM comparators. These effects were attenuated in the 2-year estimates. These calculations were performed on patients receiving adjuvant CCRT.

“Our study showed that DM significantly increased the treatment complication in terms of infection and haematotoxicity, leading to a greater weight loss, and caused a higher treatment-related mortality in patients with HNC patients undergoing CCRT,” said researchers. “Patients with DM and HNC need more careful supportive care throughout CCRT period.”