Study On Chemotherapy-Induced Glucose Metabolic Disorders In Patients With Non-Small Cell Lung Cancer

Study on Chemotherapy-Induced Glucose Metabolic Disorders in Patients with Non-Small Cell Lung CancerBackground and Objective:Systemic chemotherapy is the main treatment for non-small cell lung cancer (NSCLC) after operation. A lot of clinical trials have showed that systemic chemotherapy could prolong survival time and improve quality of life. Cisplatin plus one new drug is effective chemotherapy regime for NSCLC at present. However, with the extensive use of chemotherapy, we find that some patients with NSCLC appear impaired glucose tolerance even diabetes in clinical work. These appearances affect heavily the progress of chemotherapy and patient's quality of life. This study investigated whether chemotherapy could cause fasting glucose levels changes and even diabetes before and after chemotherapy in patients with NSCLC. We further compared the difference in fasting plasma glucose between cisplatin plus etoposide group and cisplatin plus vinorelbine group. Especially, we discuss how to avoid these adverse reactions.Materials and Methods:58 postoperative patients with stageâ…¡B/â…¢A confirmed NSCLC by pathology. Patients were between 44 and 68 years old, the median age was 55 years old. Cisplatin plus etoposide group had 11 cases of squamous cell carcinoma,18 cases of adenocarcinoma. Patients in this group were given Cisplatin with 100mg/m2, intravenous drip, first day; etoposide with 100mg/m2, intravenous drip, the first three days. These patients were given drugs every 4 weeks (one cycle). Each patient was given at least 4 chemotherapy cycles. Cisplatin plus vinorelbine group had 13 cases of squamous cell carcinoma,16 cases of adenocarcinoma. Patients in this group were given cisplatin with 75mg/m2, intravenous drip, first day; vinorelbine with 25mg/m2, intravenous drip,1 st,8th day. All these patients were given drugs every 4 weeks (one cycle). Each patient was given at least 4 chemotherapy cycles. Medication 12 hours before cisplatin infusion, all patients were given isotonic glucose solution 2000ml intravenous, using the day of cisplatin, all patients were given isotonic saline 3000ml intravenous hydration, and appropriate potassium chloride, mannitol and furosemide. We payed attention to urine output in the 2000-3000ml. Diagnostic criteria for diabetes mellitus accorded with version 6 of scientific diagnostic criteria for diabetes.Results:1,Two groups of patients compared in gender, age, body mass index, clinical stage, pathological type, and whether the merger of cardiovascular disease before chemotherapy, there was no statistical significance (P>0.05)2,58 patients with NSCLC received chemotherapy. Their fasting blood glucose was normal before treatment. Compared fasting blood glucose both before chemotherapy and after 4 cycles of chemotherapy, there were statistical significances(P< 0.05).7(12.07%) cases had elevated fasting blood glucose level after chemotherapy.3 (5.17%) cases were diagnosed as diabetes mellitus.3,3(10.34%) cases had elevated fasting blood glucose level after chemotherapy in cisplatin plus etoposide group.4(13.79%) cases had elevated fasting blood glucose level after chemotherapy in cisplatin plus vinorelbine group. Compared the incidence of elevated blood glucose in both groups, there was no statistical significance (P>0.05)4,1(3.45%)cases were diagnosed as diabetes mellitus in cisplatin plus etoposide group. 2(6.90%) cases were diagnosed as diabetes mellitus in cisplatin plus vinorelbine group. Compared the incidence of diabetes in both groups, there was no statistical significance (P> 0.05)5,We described the changes in fasting blood glucose from 2 to 4 chemotherapy cycles. It showed that the blood glucose levels increased with the changes in treatment. But Further comparison of the two regimens in patients, there was no statistical significance (P>0.05)Conclusion:Chemotherapy may induce disorders of glucose metabolism in patients with NSCLC. Compared this effect in cisplatin plus etoposide group and cisplatin plus vinorelbine group, there was no statistical significance.