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J Radiosurg SBRT. 2018;5(4):285-291.

Impact of diabetes mellitus on outcomes in patients with brain metastasis treated with stereotactic radiosurgery.

Author information

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.

KEYWORDS:

Gamma Knife; brain metastasis; diabetes mellitus; radiation necrosis; stereotactic radiosurgery

PMID:
30538889
PMCID:
PMC6255719

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