Statin Use and Survival from Lung Cancer: A Population-Based Cohort Study
Statin Use and Survival from Lung Cancer: A Population-Based Cohort Study
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DOI：
10.1158/1055-9965.epi-15-0052
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发表时间：
2015-05-01
影响因子：
3.8
通讯作者：
Murray, Liam J.
中科院分区：
文献类型：
--
作者：
Cardwell, Chris R.;Mc Menamin, Una;Murray, Liam J.
背景：来自肺癌细胞系和动物模型的临床前证据表明他汀类药物可能具有抗癌特性。我们调查了他汀类药物使用者是否降低了基于人群的肺癌患者队列中癌症特异性死亡率的风险。方法：从 1998 年至 2009 年新诊断的肺癌患者中，从英国癌症登记数据中识别出来，并链接到英国临床实践研究数据链（提供处方记录）和国家统计局截至 2012 年的死亡率数据。Cox 回归模型用于计算癌症特异性死亡率的 HR 以及他汀类药物使用前后的 95% 置信区间 (CI)。结果：在 3,638 名肺癌患者中，有一些证据表明诊断后使用他汀类药物与降低肺癌特异性死亡率相关（调整后的 HR，0.89；95% CI，0.78-1.02；P = 0.09）。在 12 次处方后（调整后的 HR，0.81；95%CI，0.67-0.98；P = 0.03）以及在研究亲脂性他汀类药物时（调整后的 HR，0.81；95%CI，0.70-0.94；P=0.01），相关性更加明显，但在一些敏感性分析中减弱。此外，在 11,051 名肺癌患者中，诊断前使用他汀类药物与降低肺癌特异性死亡率相关（调整后 HR，0.88；95% CI，0.83-0.93；P < 0.001）。 结论：有一些证据表明，使用他汀类药物，特别是辛伐他汀的肺癌患者，降低了癌症特异性死亡率。影响：这些发现应首先在观察性研究中得到证实，但为开展辛伐他汀作为肺癌患者辅助癌症治疗的随机对照试验提供一些支持。 (C) 2015 年 AACR。
Background: Preclinical evidence from lung cancer cell lines and animal models suggest that statins could have anticancer properties. We investigated whether statin users had reduced risk of cancer-specific mortality in a population-based cohort of lung cancer patients.Methods: Newly diagnosed lung cancer patients, from 1998 to 2009, were identified from English cancer registry data and linked to the UK Clinical Practice Research Datalink, providing prescription records, and to Office of National Statistics mortality data up to 2012. Cox regression models were used to calculate HRs for cancer-specific mortality and 95% confidence intervals (CI) by statin use before and after diagnosis, and to adjust these HRs for potential confounders.Results: In 3,638 lung cancer patients, there was some evidence that statin use after diagnosis was associated with reduced lung cancer-specific mortality (adjusted HR, 0.89; 95% CI, 0.78-1.02; P = 0.09). Associations were more marked after 12 prescriptions (adjusted HR, 0.81; 95% CI, 0.67-0.98; P = 0.03) and when lipophilic statins were investigated (adjusted HR, 0.81; 95% CI, 0.70-0.94; P = 0.01), but were attenuated in some sensitivity analyses. Furthermore, in 11,051 lung cancer patients, statin use before diagnosis was associated with reduced lung cancer-specific mortality (adjusted HR, 0.88; 95% CI, 0.83-0.93; P < 0.001).Conclusions: There was some evidence that lung cancer patients who used statins, and particularly simvastatin, had reduced rates of cancer-specific mortality.Impact: These findings should first be confirmed in observational studies, but provide some support for conducting randomized controlled trials of simvastatin as adjuvant cancer therapy in lung cancer patients. (C) 2015 AACR.