title: Survival Advantage Associated with Metformin Usage in Hepatocellular Carcinoma Patients Receiving Radiotherapy: A Propensity Score Matching Analysis.
abstract: BACKGROUND
  The present study aimed to evaluate the effects of metformin on the clinical outcomes of patients receiving radiotherapy for inoperable hepatocellular carcinoma.
  
  
  METHODS
  The medical records of 217 patients treated with stereotactic body or hypofractionated radiotherapy for inoperable hepatocellular carcinoma were reviewed. Patients were divided into the metformin group (n=19) and the non-metformin group (n=198), including those with diabetes (n=29), and those without (n=169). We performed a propensity score-matching analysis comparing the two groups.
  
  
  RESULTS
  In the propensity score-matched cohort (n=76), the overall survival rate of the metformin group was higher than that of the non-metformin group (2-year, 76% vs. 37%, p=0.022). The adjusted Cox proportional hazards model revealed that metformin usage was a significant factor for mortality (adjusted hazard ratio=0.361; 95% confidence interval=0.139-0.935).
  
  
  CONCLUSIONS
  The use of metformin in patients with hepatocellular carcinoma receiving radiotherapy was associated with higher overall survival.
authors.affiliation: Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea.
authors.forename: Won Il
authors.initials: WI
authors.lastname: Jang
authors.affiliation: Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea Cyberknife Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea mskim@kirams.re.kr.
authors.forename: Mi-Sook
authors.initials: MS
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea.
authors.forename: Jung Sub
authors.initials: JS
authors.lastname: Lim
authors.affiliation: Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea Cyberknife Center, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea.
authors.forename: Hyung Jun
authors.initials: HJ
authors.lastname: Yoo
authors.affiliation: Department of Radiation Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea.
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Seo
authors.affiliation: Department of Internal Medicine, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea.
authors.forename: Chul Ju
authors.initials: CJ
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea.
authors.forename: Su Cheol
authors.initials: SC
authors.lastname: Park
authors.affiliation: Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Chul Seung
authors.initials: CS
authors.lastname: Kay
authors.affiliation: Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Myungsoo
authors.initials: M
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Hong Seok
authors.initials: HS
authors.lastname: Jang
authors.affiliation: Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Soonchunhyang University Hospital, Seoul, Republic of Korea.
authors.forename: Ah Ram
authors.initials: AR
authors.lastname: Chang
authors.affiliation: Department of Radiation Oncology, Hanyang University Hospital, Seoul, Republic of Korea.
authors.forename: Hae Jin
authors.initials: HJ
authors.lastname: Park
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000532:radiotherapy*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D057216:Propensity Score; D016896:Treatment Outcome
chemical_list: D008687:Metformin
keywords: Hepatocellular carcinoma; metformin; radiotherapy; survival