Platinum 제제가 포함된 항암화학요법을 받은 부인암 환자에서의 당뇨병 발생 위험

Abstract

Objective: To assess the association between platinum-based chemotherapy for gynecologic malignancy and the risk of diabetes mellitus. Material and Methods: We analyzed retrospectively the association between platinum-based chemotherapy and diabetes mellitus. Out of the 449 patients who received the chemotherapy in Severance Hospital from January 2002 to December 2005, 169 patients with serial measurements of fasting blood glucose throughout the chemotherapy period were enrolled in this study. The parameters that were analyzed included age, past history, family history, body mass index (BMI), serum glucose, type of cancer, chemotherapy regimen, dose cycle, time after cycle. We performed binomial test to compare the incidence in our patients with that of general population. Results: In 8 patients (4.8%) diabetes mellitus developed during the treatment period. The median age of patients was 57 years, and the mean BMI was 27.0 kg/m2. All patients received platinum-based chemotherapy and seven of them received cisplatin based regimen and two patient was given carboplatin based regimen. Median cisplatin cumulative dose up until the diabetes mellitus occurred was 252 mg/m2 and that of carboplatin was 812 mg/m2. Median time until the diagnosis of diabetes mellitus after administration of the first chemotherapy cycle was 7 months. The overall incidence of hyperglycemia (4.8%) in patients treated with platinum-based chemotherapy is higher than the incidence of diabetes mellitus in the general population (2.1%). Conclusion: We suggest that regular monitoring of serum glucose levels which is not generally included in the pre-chemo lab values in patients receiving chemotherapy with platinum based regimen should be considered.