Background: Limited research has compared external beam radiotherapy (RT) to non-RT in patients with nonsurgical locally advanced pancreatic cancer (LAPC). Therefore, this study investigates the impact of RT on overall survival (OS) in patients with nonsurgical LAPC in a real-world context. Methods: The authors conducted an analysis of patients with nonsurgical LAPC using data from the Surveillance, Epidemiology, and End Results (SEER) database. This analysis involved the utilization of Kaplan–Meier survival curves and multivariable Cox regression analyses. Results: A total of 5413 individuals with nonsurgical LAPC were included in this analysis. Among them, 2320 (42.9%) received RT, while 3093 (57.1%) underwent non-RT treatment. The median OS was 12.0 months for the RT group and 9.0 months for the non-RT group, with a statistically significant difference ( P <0.001). Multivariate analysis revealed that RT had a statistically significant impact on OS (HR, 0.86; 95% CI: 0.81–0.91; P <0.001). Propensity score matching analysis confirmed a statistically significant association of RT with improved OS (HR, 0.84, 95% CI: 0.79–0.90; P <0.001). These results remained consistent after conducting sensitivity analyses, subgroup analyses, and propensity score matching. Conclusion: The study findings suggest that RT could be advantageous for patients with nonsurgical LAPC. Further investigations are warranted to explore the relationship between RT and OS.

Background: Some anti-diabetic drugs have been proved to be a tumor suppressor or activator. The associations of three relatively new classes of anti-diabetic medications–glucagon-like peptide-1 receptor agonists (GLP-1RA), dipeptidyl peptidase 4 inhibitors (DPP-4I), and sodium-glucose cotransporter 2 inhibitors (SGLT-2I) with lung cancer prognosis remain unclear.Methods: The electronic medical data from the National Healthcare Big Data (East) Center was retrospectively analyzed. We included 11,357 newly diagnosed lung cancer patient with type 2 diabetes (T2D) between January 1st, 2020 and July 1^st, 2023. Patients were categorized into eight groups according to the mono-or-combination therapy of GLP-1RA, DPP-4I and SGLT-2I. Disease progression and mortality risk were evaluated by cox proportional hazards analysis. Progression-free survival (PFS) and overall survival (OS) were assessed by the Kaplan-Meier (log-rank) method.Results: Lung cancer patients with T2D who were treated with SGLT-2I & GLP-1RA exhibited the lowest progression (hazard ratio [HR]: 0.37; 95% confidence interval [CI]: 0.18, 0.78) and mortality risks (HR: 0.34; 95% CI: 0.14, 0.82) as well as prolonged median PFS (1.55 years) and OS (1.62 years) among all groups. In contrast, DPP-4I monotherapy did not show benefit for progression (HR: 1.09; 95% CI: 0.98, 1.22. Median PFS: 1.41 years) and mortality risks (HR: 0.96, 95%CI: 0.84, 1.09. Median OS: 1.48 years). However, when DPP-4I was used in combination with SGLT-2I or GLP-1RA, it caused reductions in both progression and mortality risks.Conclusion: SGLT-2I & GLP-1RA dual therapy is associated with improved prognosis for lung cancer patients with concurrent T2D. DPP-4I transits from a tumor activator to suppressor when combined with other anti-diabetic drugs. Future studies are needed to examine the underlying biological mechanisms.

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An abstract is unavailable. This article is available as a PDF only.