The Incidence and Risk of Biochemical Recurrence Following Radical Radiotherapy for Prostate Cancer in Men on Angiotensin-Converting Enzyme Inhibitors (ACEIs) or Angiotensin Receptor Blockers (ARBs)
The Incidence and Risk of Biochemical Recurrence Following Radical Radiotherapy for Prostate Cancer in Men on Angiotensin-Converting Enzyme Inhibitors (ACEIs) or Angiotensin Receptor Blockers (ARBs)
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DOI：
10.1016/j.clgc.2016.03.009
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发表时间：
2016-10-01
影响因子：
3.2
通讯作者：
Nabi, Ghulam
中科院分区：
文献类型：
--
作者：
Alashkham, Abduelmenem;Paterson, Catherine;Nabi, Ghulam
血管紧张素转换酶抑制剂（ACEIs）和血管紧张素受体阻滞剂（ARBs）是降压药物，与前列腺癌有关，但其对生化复发（BR）的影响尚不清楚。该研究的目的是评估接受acei /ARBs的男性在接受辅助/新辅助激素治疗的根治性放疗后BR的发生率和风险。服用acei / arb与BR风险降低相关。背景：血管紧张素转换酶抑制剂（ACEIs）和血管紧张素受体阻滞剂（ARBs）与前列腺癌有关，但它们对生化复发（BR）的影响尚不清楚。我们的目的是调查接受acei /ARBs的男性在根治性放疗加辅助/新辅助激素治疗后BR的发生率和风险。材料与方法：对558名男性进行倾向评分分析。男性被分为3组：服用acei / arb的高血压男性（作为研究组），未服用acei / arb的非高血压男性，以及未服用acei / arb的高血压男性（均为对照组）。采用多变量方差分析、卡方分析、Kruskal-Wallis分析、方差分析、风险比、置信区间、Kaplan-Meier图和log-rank检验。结果：患者平均年龄68.51岁，随访3.33岁。治疗组间BR患病率比较，差异有统计学意义（P < 0.001）。服用acei /ARBs的高血压患者BR发生率显著低于未服用acei /ARBs的非高血压患者（P < 0.001）或未服用acei /ARBs的高血压患者（P < 0.009）。未服用acei /ARBs的高血压患者BR发生率显著低于未服用acei /ARBs的非高血压患者（P < 0.013）。高血压男性服用acei /ARBs组BR的危险比（RR）显著低于未服用acei /ARBs的非高血压男性组（RR, 0.74, 95% CI, 0.64-0.86, P < 0.001）和未服用acei /ARBs的高血压男性组（RR, 0.78, 95% CI, 0.67-0.91, P < 0.001）。时间-事件分析显示，高血压男性服用。acei /ARBs与对照组比较差异有统计学意义（P < 0.031）。结论：接受acei /ARBs治疗的男性根治性放疗合并激素治疗后BR发生率明显降低。acei / arb的摄入与BR风险降低相关。
Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are antihypertensive medication and have been linked to prostate cancer, but their effect on biochemical recurrence (BR) remains unexplored. The aims of the study were to evaluate the incidence and risk of BR in men receiving ACEIs/ARBs after radical radiotherapy with adjuvant\neoadjuvant hormone treatment. The administration of ACEIs/ARBs were associated with a reduced risk of BR.Background: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are linked to prostate cancer, but their effect on biochemical recurrence (BR) remains unknown. Our aims were to investigate the incidence and risk of BR in men on ACEIs/ARBs after radical radiotherapy with adjuvant \ neoadjuvant hormone treatment. Material and Methods: A propensity score analysis of 558 men was conducted. Men were stratified into 3 groups: hypertensive men on ACEIs/ARBs (as a study group), non-hypertensive men not on ACEIs/ARBs, and hypertensive men not on ACEIs/ARBs (both as a control group). The multivariate analysis of variance, chi-square, Kruskal-Wallis, analysis of variance, risk ratio, confidence interval, Kaplan-Meier plots, and log-rank tests were used. Results: The mean age and follow-up were 68.51 and 3.33 yealt, respectively. There was a statistically significant difference in the prevalence of BR among the treatment groups (P < .001). The incidence of BR was significantly lower in hypertensive men taking ACEIs/ARBs than in non-hypertensive men not taking ACEIs/ARBs (P < .001) or in hypertensive men not taking ACEIs/ARBs (P < .009). The incidence of BR was significantly lower in hypertensive men not taking ACEIs/ARBs than in non-hypertensive men not taking ACEIs/ARBs (P < .013). The risk ratio (RR) of BR in the group of hypertensive men taking ACEIs/ARBs was significantly lower than in the group of non-hypertensive men not taking ACEIs/ARBs (RR, 0.74; 95% CI, 0.64-0.86; P < .001) and in the group of hypertensive men not taking ACEIs/ARBs (RR, 0.78; 95% CI, 0.67-0.91; P < .001). The time-to-event analysis revealed that the group of hypertensive men taking. ACEIs/ARBs was significantly different compared with the control groups (P < .031). Conclusion: Men who were taking ACEIs/ARBs had significantly lower incidence of BR after radical radiotherapy with hormone treatment. The intake of ACEIs/ARBs was associated with reduced risk of BR.