好色先生

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Abstract Details

The Prevalence, Timing, and Prognostic Significance of Glycemic Control as Assessed By Serial Hemoglobin A1c Measurements in Patients with Newly Diagnosed Glioma
Neuro-oncology
S14 - Translational and Clinical Advances in Neuro-oncology (1:55 PM-2:06 PM)
006
Prior retrospective studies suggest that elevated blood glucose is associated with shorter survival in malignant gliomas. However, the prevalence, scope, timing, and optimal measures of glycemia have not been defined.
To quantify the prevalence of at-risk (>5.7%) and diabetic-range hemoglobin A1c (HbA1c>6.5%) in glioma patients, explore associated factors, and impact on survival.
To address this, two studies were conducted: (1) cross-sectional study to determine prevalence of elevated HbA1c at any point following diagnosis; and (2) prospective observational study to explore the trajectory and survival impact. Patients with WHO Grade II-IV gliomas were enrolled. In the cross-sectional study, a single HbA1c was collected at any point after diagnosis. In the prospective study, patients receiving standard chemoradiotherapy underwent random blood glucose, HbA1c, and clinical outcome assessment including corticosteroid dose and anti-diabetic treatment at 4 clinically actionable times: pre-radiation, post-radiation, post-chemotherapy, and 1-year from diagnosis. T-test and Fisher’s exact test assessed predictors of elevated HbA1c; Cox regression explored associations with survival.
85 glioma patients were enrolled (cross-sectional: n=38, prospective: n=47). Diagnoses included grade II (8%), III (28%), and IV gliomas (64%). In the 38-patient cross-section, elevated HbA1c was prevalent in 42% (21% diabetic-range). Of newly diagnosed patients (n=47), elevated HbA1c was observed in 64% pre-radiation (24% diabetic-range), 44% post-radiation (9%), 45% post-chemotherapy (15%), and 36% at 1-year (14%). Anti-diabetic treatment was generally <10%. Larger non-enhancing tumor volume at diagnosis was associated with pre-radiation HbA1c>6.5% (p=0.03). When controlling for tumor size and age, pre-radiation HbA1c>5.7% was associated with worse survival (HR=4.17, 1.08-16, p=0.039), which remained when also controlling for corticosteroids (HR=4.33, 1.11-16.9, p=0.035).

Impaired glycemic control was seen in >40% of glioma patients which was most pronounced at presentation and associated with worse survival. These results suggest that further study of systematic hyperglycemia control in patients with glioma is warranted.
Authors/Disclosures
Logan Williams
PRESENTER 		No disclosure on file
Juan Carlos Martinez-Gutierrez, MD (Massachusetts General Hospital, Brigham, Harvard) No disclosure on file
Fang-Chi Hsu No disclosure on file
Christina Cramer No disclosure on file
Michael Chan No disclosure on file
Adrian Laxton No disclosure on file
Stephen B. Tatter, MD (Wake Forest Univ School of Medicine) The institution of Dr. Tatter has received research support from Monteris Medical, Inc. The institution of Dr. Tatter has received research support from Arbor Pharmaceuticals. Dr. Tatter has received intellectual property interests from a discovery or technology relating to health care.
Glenn Lesser No disclosure on file
Roy E. Strowd III, MD, FAAN (Wake Forest School Of Medicine) Dr. Strowd has received personal compensation for serving as an employee of Kaplan. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Monteris Medical, Inc. Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novocure. The institution of Dr. Strowd has received personal compensation in the range of $500-$4,999 for serving as a Consultant for SpringWorks . Dr. Strowd has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for 好色先生. The institution of Dr. Strowd has received research support from Southeastern Brain Tumor Foundation. The institution of Dr. Strowd has received research support from Jazz Pharmaceuticals. The institution of Dr. Strowd has received research support from National Institutes of Health. The institution of Dr. Strowd has received research support from Alpha Omega Alpha. The institution of Dr. Strowd has received research support from American Board of Psychiatry and Neurology. Dr. Strowd has received publishing royalties from a publication relating to health care. Dr. Strowd has received publishing royalties from a publication relating to health care.