Michael C LeCompte1, Emory R McTyre1, Roy E Strowd2, Claire Lanier1, Michael H Soike1, Ryan T Hughes1, Adrianna H Masters1, Christina K Cramer1, Michael Farris1, Jimmy Ruiz3,4, Kounosuke Watabe5, Adrian W Laxton6, Stephen B Tatter6, Karen M Winkfield1, Michael D Chan1. 1. Department of Radiation Oncology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA. 2. Department of Neurology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27517, USA. 3. Department of Medicine (Hematology and Oncology), Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA. 4. W.G. (Bill) Hefner Veteran Administration Medical Center, Cancer Center, 1601 Brenner Ave, Salisbury, NC, 28144, USA. 5. Department of Cancer Biology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA. 6. Department of Neurosurgery, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA.
Abstract
PURPOSE: To determine the influence of diabetes mellitus (DM) on outcomes in patients with brain metastasis treated with stereotactic radiosurgery (SRS). METHODS: We retrospectively reviewed 498 patients with brain metastasis treated at our institution with SRS between January 2012 and March 2017. RESULTS: Eight-four patients (16.9%) held a diagnosis of DM prior to SRS treatment. Diabetics compared to nondiabetics had worse overall survival (OS). DM was found to be a significant predictor of OS on multivariate analysis (HR: 1.41, CI: 1.03-1.92, p = 0.03). When stratified by DM diagnosis, there were no significant differences in incidence of radiation necrosis (p = 0.82), radiation-induced edema (p = 0.88), cerebrospinal fluid leak (p = 0.49), or postoperative infection (p = 0.68). CONCLUSIONS: DM diagnosis was a significant predictor of poorer OS in patients treated for brain metastasis with SRS. Diabetics and nondiabetics experienced similar rates of radiation-associated brain toxicities.
PURPOSE: To determine the influence of diabetes mellitus (DM) on outcomes in patients with brain metastasis treated with stereotactic radiosurgery (SRS). METHODS: We retrospectively reviewed 498 patients with brain metastasis treated at our institution with SRS between January 2012 and March 2017. RESULTS: Eight-four patients (16.9%) held a diagnosis of DM prior to SRS treatment. Diabetics compared to nondiabetics had worse overall survival (OS). DM was found to be a significant predictor of OS on multivariate analysis (HR: 1.41, CI: 1.03-1.92, p = 0.03). When stratified by DM diagnosis, there were no significant differences in incidence of radiation necrosis (p = 0.82), radiation-induced edema (p = 0.88), cerebrospinal fluid leak (p = 0.49), or postoperative infection (p = 0.68). CONCLUSIONS: DM diagnosis was a significant predictor of poorer OS in patients treated for brain metastasis with SRS. Diabetics and nondiabetics experienced similar rates of radiation-associated brain toxicities.
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