Abstract
This study examined factors influencing lung cancer in patients with type 2 diabetes mellitus (T2DM). A total of 111 patients with T2DM diagnosed with stage IIIB or IV lung cancer and treated at Jining No. 1 People's Hospital between January 2015 and December 2020 were included. Diagnoses were confirmed through bronchoscopy and/or percutaneous biopsy under computed tomography guidance. Patient age, sex, pathological type, treatment, and progression-free survival (PFS) were recorded. Survival analysis and Cox proportional hazards model multifactor analysis were performed using the Kaplan-Meier method to identify factors influencing survival. Univariate analysis revealed the following: (1) PFS was significantly longer in women than in men (12.50 vs 8.63 months, relative risk [RR] = 0.76, 95% confidence interval [CI] = 0.45-1.28, P = .042), (2) PFS differed significantly among patients with adenocarcinoma, squamous cell carcinoma, and small cell lung cancer (12.29 vs 10.02 vs 7.12 months, RR = 1.5, 95% CI = 1.07-2.0, P = .027). Compared with small cell lung cancer, PFS was significantly longer in adenocarcinoma (12.29 vs 7.12 months, P = .011), (3) PFS varied across chemotherapy, tyrosine kinase inhibitor therapy, and chemoradiotherapy (6.69 vs 14.50 vs 13.97 months, RR = 0.86, 95% CI = 0.74-0.99, P = .001). Compared with chemotherapy, PFS was significantly longer in patients receiving targeted therapy and chemoradiotherapy (14.50 vs 6.69 months, P = .001; 13.97 vs 6.69 months, P = .008), and (4) No significant difference in PFS was observed between patients who received metformin therapy and those who did not (9.96 vs 9.95 months, P = .926). In multivariate analysis, pathological type and treatment modality were identified as independent factors influencing PFS in patients with advanced lung cancer and T2DM (P < .05). In patients with advanced lung cancer and T2DM, PFS was significantly longer in women, particularly those with adenocarcinoma and those treated with epidermal growth factor receptor-tyrosine kinase inhibitors or chemoradiotherapy. Pathological type and treatment were independent factors influencing PFS in these patients.