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. Patients and 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). Conclusion: The use of metformin in patients with hepatocellular carcinoma receiving radiotherapy was associated with higher overall survival.