Diabetes mellitus tipo 2 y toxicidad por quimioterapia en adultos mayores con cáncer prostático

Fernando M. Runzer-Colmenares, Diego Chambergo-Michilot, Geraldine A. Espinoza-Gutierrez, Rodrigo Corcuera-Ciudad, Ana F. Patiño-Villena, Rosmery Paima-Olivari, Maria G. Luján Peche, Manuel Cabrera-Lopez, José F. Parodi

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Introducción: Siendo el cáncer prostático una neoplasia prevalente, el envejecimiento es un factor para la toxicidad quimioterapéutica, adicionalmente puede incrementarse por enfermedades crónicas, destacando la diabetes. A pesar de estos conocimientos, no hay estudios que evalúen la asociación entre la diabetes y el riesgo de toxicidad quimioterapéutica en estos pacientes. 

Objetivo: Determinar la asociación entre diabetes mellitus tipo 2 y riesgo de toxicidad por quimioterapia en adultos mayores con cáncer prostático del Servicio de Geriatría del Centro Médico Naval del Perú.

Material y métodos: Estudio analítico de cohorte retrospectiva, análisis secundario de una base de datos. Se evaluaron los efectos adversos de quimioterapia y factores asociados de 161 marinos retirados con cáncer prostático entre 2013 y 2015. Se construyó un modelo de regresión de Cox sobre la toxicidad ajustado por el antecedente de diabetes, edad, antecedentes patológicos, antecedentes de consumo de tabaco, circunferencia de pantorrilla, actividad física, dependencia para ABVD, caídas, polifarmacia, fragilidad y vulnerabilidad.

Resultados: El 23.6% presentó diabetes. La prevalencia de fragilidad fue del 39.7% y de vulnerabilidad, del 24.2% (G8) y 26.71% (VES-13). Los efectos adversos frecuentes fueron gastrointestinales (13.04%) y hematológicos (8.07%). Mediante el modelo de regresión ajustado, el antecedente de diabetes mellitus tipo 2, 3 o más antecedentes patológicos, antecedente de consumo de tabaco, circunferencia de pantorrilla, actividad física, dependencia de ABVD, caídas, polifarmacia, vulnerabilidad y fragilidad presentaron asociación significativa.

Conclusiones: El antecedente de diabetes mellitus tipo 2 es un factor predictivo para el riesgo de toxicidad por quimioterapia en adultos mayores con cáncer prostático.

Palabras clave: diabetes mellitus, toxicidad, quimioterapia, adultos mayores, cáncer, próstata, cohorte

 

 

 

 

ABSTRACT

Introduction: Prostate cancer being a frequent neoplasia, aging is a factor for antineoplastic therapy toxicity, it can also be increased by chronic diseases, highlighting diabetes. Despite this knowledge, there are no studies that evaluate the association between diabetes and the risk of antineoplastic therapy toxicity in these patients.

Objective: To determine the association between type 2 diabetes mellitus and the risk of antineoplastic therapy toxicity in aged diagnosed with prostate cancer from Centro Medico Naval del Peru Geriatrics Service.

Material and methods: Retrospective cohort, analytical study, secondary analysis of a database. The adverse effects of antineoplastic therapy and associated factors of 161 retired sailors with prostate cancer between 2013 and 2015 were evaluated. A Cox regression model was constructed on the toxicity adjusted by the history of diabetes, age, pathological history, smoking history, calf circumference, physical activity, disability, falls, polypharmacy, frailty and vulnerability.

Results: 23.6% presented diabetes. The prevalence of frailty was 39.7%, vulnerability of 24.2% (G8) and 26.71% (VES-13). Frequent adverse effects were gastrointestinal (13.04%) and hematological (8.07%). Through the adjusted regression model type 2 diabetes mellitus, 3 or more comorbidities, history of tobacco use, calf circumference, physical activity, disability, falls, polypharmacy, vulnerability and frailty were significant factors.

Conclusion: The history of diabetes mellitus type 2 is a predictive factor for the risk of antineoplastic therapy toxicity in aged patients with prostate cancer.

Key words: diabetes mellitus, toxicity, antineoplastic, aged, cancer, prostate, cohort

 

Palabras clave

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

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