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.
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Acknowledgments
This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIP) (2014R1A2A2A01004362).
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This study protocol was approved by the Institutional Review Board in Samsung Medical Center. An individual consent for this analysis was not needed, because this retrospective study does not include patient identifiers.
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Oh, B.Y., Park, Y.A., Huh, J.W. et al. Metformin enhances the response to radiotherapy in diabetic patients with rectal cancer. J Cancer Res Clin Oncol 142, 1377–1385 (2016). https://doi.org/10.1007/s00432-016-2148-x
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DOI: https://doi.org/10.1007/s00432-016-2148-x