Impact of diabetes mellitus on outcomes in patients with brain metastasis treated with stereotactic radiosurgery
Michael C. Lecompte, Emory R. McTyre, Roy E. Strowd, Claire Lanier, Michael H. Soike, Ryan T. Hughes, Adrianna H. Masters, Christina K. Cramer, Michael Farris, Jimmy Ruiz, Kounosuke Watabe, Adrian W. Laxton, Stephen B. Tatter, Karen M. Winkfield and Michael D. Chan
Purpose: To determine the influence of diabetes mellitus (DM) on outcomes in patients with brain metastasis treated with stereotactic radiosurgery (SRS).
Methods: We retrospectively reviewed 498 patients with brain metastasis treated at our institution with SRS between January 2012 and March 2017.
Results: Eight-four patients (16.9%) held a diagnosis of DM prior to SRS treatment. Diabetics compared to nondiabetics had worse overall survival (OS). DM was found to be a significant predictor of OS on multivariate analysis (HR: 1.41, CI: 1.03-1.92, p = 0.03). When stratified by DM diagnosis, there were no significant differences in incidence of radiation necrosis (p = 0.82), radiation-induced edema (p = 0.88), cerebrospinal fluid leak (p = 0.49), or postoperative infection (p = 0.68).
Conclusions: DM diagnosis was a significant predictor of poorer OS in patients treated for brain metastasis with SRS. Diabetics and nondiabetics experienced similar rates of radiation-associated brain toxicities.
Keywords: brain metastasis, diabetes mellitus, Gamma Knife, radiation necrosis, stereotactic radiosurgery