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J Cancer Res Clin Oncol. 2016 Jun;142(6):1377-85. doi: 10.1007/s00432-016-2148-x. Epub 2016 Mar 24.

Metformin enhances the response to radiotherapy in diabetic patients with rectal cancer.

Author information

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.

KEYWORDS:

Diabetes; Metformin; Radiotherapy; Rectal cancer; Tumor response

PMID:
27011019
DOI:
10.1007/s00432-016-2148-x
[Indexed for MEDLINE]

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