Home 
Bratislava Medical Journal 2022 Bratislava Medical Journal Vol.123, No.2, p.100–109, 2022
Bratislava Medical Journal 2022 Bratislava Medical Journal Vol.123, No.2, p.100–109, 2022
Journal info
|
||||
Select Journal
Journals
Bratislava Medical Journal 2024 Ahead of print 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 Endocrine Regulations General Physiology and Biophysics Neoplasma Acta Virologica Studia Psychologica Cardiology Letters Psychológia a patopsych. dieťaťa Kovove Materialy-Metallic Materials Slovenská hudbaWebshop Cart
Your Cart is currently empty.
Info: Your browser does not accept cookies. To put products into your cart and purchase them you need to enable cookies.
Bratislava Medical Journal Vol.123, No.2, p.100–109, 2022 |
||
| Title: Radiotherapy and high bilirubin may be metformin like effect on lung cancer via possible AMPK pathway modulation | ||
| Author: O. Atasoy, N. Cini, M. A. Erdogan, G. Yaprak, O. Erbas | ||
| Abstract: PURPOSE: Life expectancy of cancer patients determine the regimen of treatment. There is no feasible marker that determines the survival other than the stage of the disease or other patients related factors. Bilirubin can be a revealing marker for these. The effect of bilirubin may be due to the fact that the genetic and biochemical processes of bilirubin also modulate the tumour microenvironment. Radiotherapy and bilirubin can produce an effect similar to metformin via AMPK pathway. MATERIALS AND METHODS: This analysis was performed retrospectively in a cohort of 80 patients with a diagnosis of locoregional lung cancer with bilirubin levels in the accepted range. Receiver operating characteristic curve (ROC) analysis was performed to determine the optimal cut-off points. Pre-treatment serum total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL) levels and tumour volumes in the prognosis of the patients were investigated. RESULTS: The cut-off points for serum TBIL, DBIL and IBIL were 0.565 mg/dL, 0.105 mg/dL and 0.415 mg/dL, respectively. High TBIL 47.5 %, high DBIL and high IBIL were observed in 45 % of the entire patient population. The overall survival was three times longer in the high TBIL group than in the low TBIL group (OS; Hazard Ratio (HR), 0.33; 95% CI 0.16–0.70; p <0.001), locoregional free survival (LRFS; HR, 0.44; 95% CI 0.27–0.71; p <0.001) and distant metastasis-free survival (DMFS; HR, 0.44; 95% 0.25–0.80; p < 0.001). Similarly, high DBIL and high IBIL levels have been associated with longer OS, LRFS, and DMFS with significant differences. In addition, in the survival analysis of the cohort stratified with gross tumour volume (GTV) 128.5cc and TBIL 0.565 cut-off values; In the comparison of high TBIL and low TBIL groups, a significantly longer OS was observed in the high TBIL group in the patients with a GTV volume greater than128.5cc (p <0.001). CONCLUSION: Plasma bilirubin level at the time of diagnosis affects the survival of the patients independent of cancer stage and tumour volume. Possible additive interactions of radiotherapy and bilirubin are discussed with their pathophysiological mechanisms (Tab. 2, Fig. 7, Ref. 26). |
||
| Keywords: bilirubin, radiotherapy, AMPK, GTVcc, lung cancer | ||
| Published online: 23-Jan-2022 | ||
| Year: 2022, Volume: 123, Issue: 2 | Page From: 100, Page To: 109 | |
| doi:10.4149/BLL_2022_016 |
||
|
|
 download file |
|