Postdiagnostic use of β-blockers and other antihypertensive drugs and the risk of recurrence and mortality in head and neck cancer patients: an observational study of 10,414 person-years of follow-up
Postdiagnostic use of β-blockers and other antihypertensive drugs and the risk of recurrence and mortality in head and neck cancer patients: an observational study of 10,414 person-years of follow-up
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DOI：
10.1007/s12094-016-1608-8
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发表时间：
2017-07-01
影响因子：
3.4
通讯作者：
Kim, S. Y.
中科院分区：
文献类型：
--
作者：
Kim, S. -A.;Moon, H.;Kim, S. Y.
简介越来越多的证据表明，去甲肾上腺素促进癌症生长和转移，而β-受体阻滞剂则降低这些风险。本研究旨在研究β-受体阻滞剂和其他高血压药物对头颈部鳞状细胞癌(HNSCC)患者疾病复发和生存率的临床影响。材料与方法分析2001年1月至2012年12月在我们的第三转诊中心接受明确治疗的1274名连续接受HNSCC治疗的患者。如果患者从HNSCC诊断到治疗开始后至少一年内一直服用药物，则认为使用抗高血压药物是积极的。结果高血压本身并不是复发和生存的显著变量，抗高血压药物的使用不影响第二原发癌的发生(均P>；0.1)。在控制了临床因素后，钙通道阻滞剂的使用仍然是癌症复发指数的独立变量，而β-阻滞剂的使用与较差的癌症特异性死亡率、竞争性死亡率和全因死亡率显著相关(均P<；0.05)。在血压正常的患者中，β-受体阻滞剂的使用显著影响竞争性死亡率和全因死亡率，而在血压正常的患者中，钙通道阻滞剂的使用影响癌症复发指数(均P
Introduction Growing evidence indicates that norepinephrine promotes cancer growth and metastasis whereas beta-blockers decrease these risks. This study aimed to examine the clinical impact of beta-blockers and other hypertensive drugs on disease recurrence and survival in patients with head and neck squamous cell carcinoma (HNSCC).Materials and methods This study analyzed a cohort of 1274 consecutive patients who received definitive treatments for previously untreated HNSCC at our tertiary referral center between January 2001 and December 2012. Antihypertensive use was considered positive if patients were on medication from HNSCC diagnosis to at least 1 year after treatment initiation. Cox proportional hazard models were utilized to determine associations between antihypertensive drugs and recurrence, survival, and second primary cancer (SPC) occurrence.Results Hypertension itself was not a significant variable of recurrence and survival and no antihypertensive drug use affected SPC occurrence (all P > 0.1). After controlling for clinical factors, calcium-channel blocker use remained an independent variable for index cancer recurrence, and beta-blocker use was significantly associated with poor cancer-specific mortality, competing mortality, and all-cause mortality (all P < 0.05). beta-blocker use significantly affected competing and all-cause mortalities in normotensive patients, and calcium-channel blocker use affected index cancer recurrence in normotensive patients (all P