Type 2 Diabetes mellitus and chemotherapy toxicity in older adults with prostate cancer

Authors

  • Fernando M. Runzer-Colmenares Universidad de San Martín de Porres. Facultad de Medicina Humana. Centro de Investigación del Envejecimiento. Lima.
  • Diego Chambergo-Michilot Universidad Científica del Sur. Escuela de Medicina Humana. Lima. https://orcid.org/0000-0002-3904-7514
  • Geraldine A. Espinoza-Gutierrez Universidad Científica del Sur. Escuela de Medicina Humana. Lima.
  • Rodrigo Corcuera-Ciudad Universidad Científica del Sur. Escuela de Medicina Humana. Lima.
  • Ana F. Patiño-Villena Universidad Científica del Sur. Escuela de Medicina Humana. Lima.
  • Rosmery Paima-Olivari Universidad Científica del Sur. Escuela de Medicina Humana. Lima.
  • Maria G. Luján Peche Universidad Científica del Sur. Escuela de Medicina Humana. Lima.
  • Manuel Cabrera-Lopez Universidad de San Martín de Porres. Facultad de Medicina Humana. Lima.
  • José F. Parodi Universidad de San Martín de Porres, Facultad de Medicina Humana. Lima.

Keywords:

diabetes mellitus, toxicidad, quimioterapia, adultos mayores, cáncer, próstata, cohorte

Abstract

Introduction: Prostate cancer is considered a predominant type of neoplasia and aging is a factor for chemotherapeutic toxicity, which can increase due to chronic diseases, particularly diabetes. Despite all this knowledge, there are no studies to evaluate the association between diabetes and the risk of chemotherapeutic toxicity in these patients.

Objective: To determine the association between Type 2 Diabetes Mellitus and the risk of chemotherapy toxicity in in older adults with prostate cancer in the Geriatric Service of the Peruvian Naval Medical Center.

Material and methods: Analytical retrospective cohort study and secondary database analysis.  The adverse effects of chemotherapy and the associated factors of 161 retired sailors with prostate cancer were evaluated between 2013 and 2015. Cox Regression Model for Adjusted Toxicity was constructed for antecedents of diabetes, age, pathological antecedents, smoking antecedents, calf circumference, physical activity, dependence on ABVD, falls, polypharmacy, fragility, and vulnerability.

Results: The 23.6% of patients had diabetes. The prevalence of fragility was 39.7% and the one of vulnerability was 24.2% (G8) and 26.71% (VES-13). The frequent adverse effects were: gastrointestinal (13.04%) and hematological (8.07%). The most significant associations by adjusted regression model were the antecedent of Type 2 Diabetes Mellitus, 3 or more pathological antecedents, smoking antecedents, calf circumference, physical activity, dependence on ABVD, falls, polypharmacy, fragility, and vulnerability.

Conclusions: The antecedent of Type 2 Diabetes Mellitus is a predictive factor for the risk of chemotherapy toxicity in older adults with prostate cancer.

Keywords: Diabetes Mellitus, toxicity, chemotherapy, older adults, cancer, prostate, cohort.

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Author Biographies

Geraldine A. Espinoza-Gutierrez, Universidad Científica del Sur. Escuela de Medicina Humana. Lima.

Estudiante de medicina humana de la Universidad Científica del Sur

Rodrigo Corcuera-Ciudad, Universidad Científica del Sur. Escuela de Medicina Humana. Lima.

Estudiante de medicina humana de la Universidad Científica del Sur

References

1. Heidenreich A, Bastian P, Bellmunt J, Bolla M, Joniau S, Van Der Kwast T et al. EAU Guidelines on Porstate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent-Update 2013. European Urology [Internet]. 2014 [cited: 3/11/2018];65(1):124-137.Available from: https://www.europeanurology.com/article/S0302-2838(13)01040-3/fulltext

2. Heidenreich A, Bastian P, Bellmunt J, Bolla M, Joniau S, Van Der Kwast T et al. EAU Guidelines on Prostate Cancer. Part II: Treatment of Advanced Relapsing, and Castration-Resistant Prostate Cancer. European Urology [Internet]. 2014 [cited: 3/11/2018]; 65(2): 467-479. Available from:https://www.europeanurology.com/article/S0302-2838(13)01199-8/fulltext

3. Nieuweboer A, S. de Morrée E, M. de Graan A, Sparreboom A, De Wit R, Mathijssen R. Inter-patient variability in docetaxel pharmacokinetics: A review. Cancer Treat Rev [Internet]. 2015[cited: 3/11/2018]; 41(7):605-613. Available from : https://www.sciencedirect.com/science/article/pii/S030573721500081X

4. Burris H, Irvin R, Kuhn J, Kalter S, Smith L, Shaffer D et al. Phase I clinical trial of taxotere administered as either a 2-hour or 6-hour intravenous infusion. J Clin Oncol [Internet]. 1993[cited: 3/11/2018]; 11(5):950-958. Available from: http://ascopubs.org/doi/abs/10.1200/JCO.1993.11.5.950

5. Klepin H, Pitcher B, Ballman K, Kornblitch A, Hurria A, Winer E. Comorbidity, Chemotherapy Toxicity, and Outcomes Among Older Women Receiving Adjuvant Chemotherapy for Breast Cancer on a Clinical Trial: CALGB 49907 and CALGB 361004 (Alliance). J Oncol Pract [Internet]. 2014 [cited: 3/11/2018]; 10(5):e285-e292. Available from: http://ascopubs.org/doi/abs/10.1200/jop.2014.001388

6. Kalyani R, Corriere M, Ferrucci L. Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases. The Lancet Diabetes & Endocrinology [Internet]. 2014[cited: 3/11/2018]; 2(10):819-829. Available from: https://www.sciencedirect.com/science/article/pii/S2213858714700348

7. Tsilidis K, Kasimis K, Lopez D, Ntzani E, Ioannidis J. Type 2 diabetes and cancer: umbrella review of meta-analyses of observational studies. Bmj [Internet]. 2015 [cited: 3/11/2018];350:g7607. Available from: https://www.bmj.com/content/350/bmj.g7607

8. Runzer-Colmenares FM, Urrunaga-Pastor D, Aguirre LG, Reategui-Rivera CM, Parodi JF, Taype-Rondan A. Fragilidad y vulnerabilidad como predictores de radiotoxicidad en adultos mayores: un estudio longitudinal en Perú. Med Clin [Internet]. 2017[cited: 3/11/2018]; 149(8):325-330. Available from: https://www.sciencedirect.com/science/article/pii/S0025775317301860

9. US DEPARTMENT OF HEALTH AND HUMAN SERVICES. National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE), v4. 0. NIH Publication. 2017, no 09-5410.

10. Lilamand M, Kelaiditi E, Cesari M, Raynaud-Simon A, Ghisolfi A, Guyonnet S et al. Validation of the Mini Nutritional Assessment-Short Form in a population of frail elders without disability. Analysis of the Toulouse Frailty Platform population in 2013. J Nutr Health Aging [Internet]. 2015[cited: 3/11/2018]; 19(5):570-574. Available from: https://link.springer.com/article/10.1007/s12603-015-0457-4

11. Arnadottir S. Physical Activity Scale for the Elderly (PASE) to capture habitual physical activity patterns of older clients receiving health promoting visits. Physiotherapy [Internet]. 2016 [cited: 3/11/2018]; 102:e208. Available from: https://www.physiotherapyjournal.com/article/S0031-9406(16)30328-5/abstract

12. Collin C, Wade DT, Davies S, Horne V. The Barthel ADL Index: a reliability study. Int Disabil Studies [Internet]. 1988[cited: 3/11/2018]; 0:61-63. Available from: https://www.tandfonline.com/doi/abs/10.3109/09638288809164103

13. Wastesson J, Cedazo A, Fastbom J, Maioli S, Johnell K. The composition of polypharmacy: A registerbased study of Swedes aged 75 years and older. PloS one [Internet]. 2018 [cited: 3/11/2018]; 13(3):e0194892. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0194892

14. Fried LP, Tangen C, Walston J, Newman A, Hirsch C, Gottdiener J et al. Frailty in Older Adults: Evidence for a Phenotype. J Gerontol Series A: Biological Sciences and Medical Sciences [Internet]. 2001[cited: 3/11/2018]; 56(3):M146-M157. Available from: https://academic.oup.com/biomedgerontology/article/56/3/M146/545770

15. Luciani A, Biganzoli L, Colloca G, Falci C, Castagneto B, Floriani I et al. Estimating the risk of chemotherapy toxicity in older patients with cancer: The role of the Vulnerable Elders Survey-13 (VES-13). J Geriatr Oncol [Internet]. 2015 [cited: 3/11/2018];6(4):272-279.Available from: https://www.sciencedirect.com/science/article/pii/S1879406815000521

16. Kanesvaran R, Zi-Ling O, Chan A, Krishna L, Tan T, Rajasekaran T et al. 539P The use of G8 as a screening tool in a tertiary Asian cancer centre. Ann Oncol [Internet]. 2016[cited: 3/11/2018]; 27(9). Available from: https://academic.oup.com/annonc/article/27/suppl_9/mdw599.018/2920096

17. Fraenkel M, Ketzinel-Gilad M, Ariav Y, Pappo O, Karaca M, Castel J et al. mTOR Inhibition by Rapamycin Prevents β-Cell Adaptation to Hyperglycemia and Exacerbates the Metabolic State in Type 2 Diabetes. Diabetes [Internet]. 2008[cited: 3/11/2018]; 57(4):945-957. Available from: http://diabetes.diabetesjournals.org/content/57/4/945.short

18. Tannock I, De Wit R, Berry W, Horti J, Pluzanska A, Oudard S et al. Docetaxel plus Prednisone or Mitoxantrone plus Prednisone for Advanced Prostate Cancer. N Engl J Med [Internet]. 2004[cited: 3/11/2018]; 351(15):1502-1512. Available from: https://www.nejm.org/doi/full/10.1056/nejmoa040720

19. Du Y, Rayner C, Jones K, Talley N, Horowitz M. Gastrointestinal Symptoms in diabetes: prevalence, assessment, pathogenesis, and management. Diabetes Care [Internet]. 2018 [cited: 3/11/2018]; 41(3):627-637. Available from: http://care.diabetesjournals.org/content/41/3/627

20. Lutz S, Hennenlotter J, Scharpf M, Sailer C, Fritsche L, Schmid V et al. Androgen receptor overexpression in prostate cancer in type 2 diabetes. Molecular Metabolism [Internet]. 2018[cited: 3/11/2018]; 8:158-166. Available from: https://www.sciencedirect.com/science/article/pii/S2212877817306841

21. Abizanda P, Romero L, Sanchez-Jurado PM, Martinez-Reig M, Alfonso-Silguero SA, Rodriguez-Manas L. Age, frailty, disability, institutionalization, multimorbidity or comorbidity. Which are the main targets in older adults? The Journal of Nutrition, Health & Aging [Internet]. 2014[cited: 3/11/2018]; 18(6):622. Available from: https://link.springer.com/article/10.1007/s12603-014-0033-3

22. Bechis SK, Carroll PR, Cooperberg MR. Impact of Age at Diagnosis on Prostate Cancer Treatment and Survival. J Clin Oncol [Internet]. 2011[cited: 3/11/2018]; 29(2):235-241. Available from:

http://ascopubs.org/doi/full/10.1200/JCO.2010.30.2075

23. Thompson IM, Ankerst DP, Chi C, Goodman P, Tangen C, Scott M et al. Assessing Prostate Cancer Risk: Results from the Prostate Cancer Prevention Trial. JNCI J Natl Cancer Inst [Internet]. 2006[cited: 3/11/2018]; 98(8):529-534. Available from: https://academic.oup.com/jnci/article/98/8/529/2522069

24. Menon A, Handattu S, Shetty J, Shanmukha B. Study of cutaneous adverse effects of cancer chemotherapy. Clin Dermatol Rev [Internet]. 2018[cited: 3/11/2018]; 2(1):19. Available from: http://www.cdriadvlkn.org/article.asp?issn=2542-551X;year=2018;volume=2;issue=1;spage=19;epage=24;aulast=Menon

25. Galbraith G, Pandey J. Tumor necrosis factor alpha (TNF-α) gene polymorphism in alopecia areata. Human Genetics [Internet]. 1995[cited: 3/11/2018]; 96(4):433-436. Available from: https://link.springer.com/article/10.1007/BF00191802

26. Gosney M. Clinical assessment of elderly people with cancer. The Lancet Oncology [Internet]. 2005[cited: 3/11/2018]; 6(10):790-797. Available from: https://www.sciencedirect.com/science/article/pii/S1470204505703892

27. Angulo J, El Assar M, Rodríguez-Mañas L. Frailty and sarcopenia as the basis for the phenotypic manifestation of chronic diseases in older adults. Mol Aspects Med [Internet]. 2016[cited: 3/11/2018]; 50:1-32. Available from: https://www.sciencedirect.com/science/article/pii/S0098299716300097

28. Decoster L, Van Puyvelde K, Mohile S, Wedding U, Basso U, Colloca G et al. Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: an update on SIOG recommendations. Ann Oncol [Internet]. 2014[cited: 3/11/2018]; 26(2):288-300. Available from: https://academic.oup.com/annonc/article/26/2/288/2800578

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Published

2019-01-10

How to Cite

1.
Runzer-Colmenares FM, Chambergo-Michilot D, Espinoza-Gutierrez GA, Corcuera-Ciudad R, Patiño-Villena AF, Paima-Olivari R, et al. Type 2 Diabetes mellitus and chemotherapy toxicity in older adults with prostate cancer. Rev haban cienc méd [Internet]. 2019 Jan. 10 [cited 2025 Jul. 1];18(1):74-87. Available from: https://revhabanera.sld.cu/index.php/rhab/article/view/2451

Issue

Vol. 18 No. 1: January-February 2019

Section

Clinical and pathological sciences

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