ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2014
Strong adverse prognostic impact of hyperglycemic episodes during adjuvant chemoradiotherapy of glioblastoma multiforme.
Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 3 of them syntheses that pooled it.
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Who cites it
43 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Blood-Based Biomarkers for Glioma in the Context of Gliomagenesis: A Systematic Review.Frontiers in oncology · 2021Pooled it
- Clinical Risk and Overall Survival in Patients with Diabetes Mellitus, Hyperglycemia and Glioblastoma Multiforme. A Review of the Current Literature.International journal of environmental research and public health · 2020Pooled it
- Prognostic Significance of Hyperglycemia in Patients with Brain Tumors: a Meta-Analysis.Molecular neurobiology · 2016Pooled it
- Short-term fasting in glioma patients: analysis of diet diaries and metabolic parameters of the ERGO2 trial.European journal of nutrition · 2022Trial
- Targeting Metabolic Vulnerabilities in Glioblastoma: a Framework for Multi-node Combination Therapy.Current oncology reports · 2026Review
- Hyperglycemia is associated with poor survival in patients with brain metastases treated with radiotherapy.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2025Article
- Clinical research framework proposal for ketogenic metabolic therapy in glioblastoma.BMC medicine · 2024Review
- Advances in Anti-Cancer Drug Development: Metformin as Anti-Angiogenic Supplemental Treatment for Glioblastoma.International journal of molecular sciences · 2024Review
- The need for paradigm shift: prognostic significance and implications of standard therapy-related systemic immunosuppression in glioblastoma for immunotherapy and oncolytic virotherapy.Frontiers in immunology · 2024Review
- Insulin feedback is a targetable resistance mechanism of PI3K inhibition in glioblastoma.Neuro-oncology · 2023Article
- Could Metformin and Resveratrol Support Glioblastoma Treatment? A Mechanistic View at the Cellular Level.Cancers · 2023Review
- Steroid utility, immunotherapy, and brain tumor management: an update on conflicting therapies.Exploration of targeted anti-tumor therapy · 2022Review
- Metabolic management of microenvironment acidity in glioblastoma.Frontiers in oncology · 2022Review
- Medical and Neurological Management of Brain Tumor Complications.Current neurology and neuroscience reports · 2021Review
- Activation of nuclear factor-κB in the angiogenesis of glioma: Insights into the associated molecular mechanisms and targeted therapies.Cell proliferation · 2021Review
- Ketogenic Metabolic Therapy, Without Chemo or Radiation, for the Long-Term Management ofFrontiers in nutrition · 2021Article
- The Diagnostic and Therapeutic Role of Leptin and Its Receptor ObR in Glioblastoma Multiforme.Cancers · 2020Review
- Optimal Management of Corticosteroids in Patients with Intracranial Malignancies.Current treatment options in oncology · 2020Review
- Type 2 diabetes induced microbiome dysbiosis is associated with therapy resistance in pancreatic adenocarcinoma.Microbial cell factories · 2020Article
- Metformin as Potential Therapy for High-Grade Glioma.Cancers · 2020Article
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6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn comparison to normal brain tissue, glioblastomas exhibit significantly increased glucose uptake. Brain edema is a common complication during adjuvant chemoradiotherapy, leading to a requirement for glucocorticoid treatment. Glucocorticoid treatment frequently causes considerable deregulation of blood glucose levels. Therefore, episodes of hyperglycemia may contribute to radio- and/or chemoresistance. PATIENTS AND
methodsThis study comprises a retrospective analysis of the influence of hyperglycemic episodes (HEs) during adjuvant therapy on the overall survival of 106 glioblastoma multiforme patients.
resultsThe occurrence of one or more deregulated blood glucose value(s) > 10 mM is associated with a reduction in median overall survival from 16.7 to 8.8 months. A significantly poorer overall survival of patients with hyperglycemia could also be detected in subgroup analyses of patients with complete tumor resection and complete treatment according to the EORTC 22891/26891 trial protocol, as well as in a multivariate Cox proportional hazards analysis. A history of diabetes mellitus had no influence on prognosis. DISCUSSION: Our data suggest that the observed negative impact of elevated blood glucose levels on overall survival may not solely be explained by the patients' poorer general condition; the elevated blood glucose concentration itself may play a pathogenetic role. This could be due to increased activity of antioxidant systems, elevated expression of DNA damage response proteins and protection of hypoxic tumor cells against apoptosis combined with hypoxia-mediated radioresistance.
conclusionA possible prognostic impact of elevated blood glucose levels during the period of adjuvant (chemo-) radiotherapy of glioblastoma should be evaluated in a prospective clinical trial.
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