Bo Young Oh1, Yoon Ah Park1, Jung Wook Huh1, Yong Beom Cho1, Seong Hyeon Yun1, Woo Yong Lee1, Hee Chul Park2, Doo Ho Choi2, Young Suk Park3, Hee Cheol Kim4. 1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea. 2. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 3. Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 4. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, Korea. hckim@skku.edu.
Abstract
PURPOSE: Metformin may have anticancer effects and could improve response to radiotherapy in several malignancies. We aimed to investigate the effect of metformin on response to radiotherapy in rectal cancer. METHODS: A total of 543 rectal cancer patients who were treated with neoadjuvant chemoradiotherapy followed by radical surgery from January 2007 to December 2011 were reviewed. Patients were divided into three groups: diabetics taking metformin (n = 42), diabetics not taking metformin (n = 29), and non-diabetics (n = 472). Tumor response and survival were compared between groups. RESULTS: The rates of N downstaging and tumor regression grades (TRG) 3-4 were significantly higher in diabetics taking metformin (p = 0.006 and p = 0.029, respectively). There were no significant differences between groups in terms of T downstaging and pathologic complete response. On multivariate analysis, metformin use was associated with increased rates of N downstaging and TRG 3-4 (p = 0.003 and p = 0.019, respectively). Recurrence-free survival, disease-free survival, and overall survival rates were not significantly different between groups. CONCLUSIONS: Metformin is associated with higher tumor response rates to radiotherapy in rectal cancer, especially in patients with diabetes.
PURPOSE:Metformin may have anticancer effects and could improve response to radiotherapy in several malignancies. We aimed to investigate the effect of metformin on response to radiotherapy in rectal cancer. METHODS: A total of 543 rectal cancerpatients who were treated with neoadjuvant chemoradiotherapy followed by radical surgery from January 2007 to December 2011 were reviewed. Patients were divided into three groups: diabetics taking metformin (n = 42), diabetics not taking metformin (n = 29), and non-diabetics (n = 472). Tumor response and survival were compared between groups. RESULTS: The rates of N downstaging and tumor regression grades (TRG) 3-4 were significantly higher in diabetics taking metformin (p = 0.006 and p = 0.029, respectively). There were no significant differences between groups in terms of T downstaging and pathologic complete response. On multivariate analysis, metformin use was associated with increased rates of N downstaging and TRG 3-4 (p = 0.003 and p = 0.019, respectively). Recurrence-free survival, disease-free survival, and overall survival rates were not significantly different between groups. CONCLUSIONS:Metformin is associated with higher tumor response rates to radiotherapy in rectal cancer, especially in patients with diabetes.
Authors: Sao Jiralerspong; Shana L Palla; Sharon H Giordano; Funda Meric-Bernstam; Cornelia Liedtke; Chad M Barnett; Limin Hsu; Mien-Chie Hung; Gabriel N Hortobagyi; Ana M Gonzalez-Angulo Journal: J Clin Oncol Date: 2009-06-01 Impact factor: 44.544
Authors: Vanessa E Zannella; Alan Dal Pra; Hala Muaddi; Trevor D McKee; Shawn Stapleton; Jenna Sykes; Rachel Glicksman; Selim Chaib; Paul Zamiara; Michael Milosevic; Bradly G Wouters; Robert G Bristow; Marianne Koritzinsky Journal: Clin Cancer Res Date: 2013-10-18 Impact factor: 12.531
Authors: Heath D Skinner; Matthew R McCurdy; Alfredo E Echeverria; Steven H Lin; James W Welsh; Michael S O'Reilly; Wayne L Hofstetter; Jaffer A Ajani; Ritsuko Komaki; James D Cox; Vlad C Sandulache; Jeffrey N Myers; Thomas M Guerrero Journal: Acta Oncol Date: 2012-09-05 Impact factor: 4.089
Authors: Frederik J van der Sluis; Henderik L van Westreenen; Boudewijn van Etten; Barbara L van Leeuwen; Geertruida H de Bock Journal: Int J Colorectal Dis Date: 2017-12-15 Impact factor: 2.571
Authors: Marta K Powell; Dana Cempirkova; Pavel Dundr; Tereza Grimmichova; Ferdinand Trebicky; Robert E Brown; Jana Gregorova; Martina Litschmannova; Katerina Janurova; Michal Pesta; Petr Heneberg Journal: Transl Oncol Date: 2019-12-30 Impact factor: 4.243