Statin and metformin therapy in prostate cancer patients with hyperlipidemia who underwent radiotherapy: a population-based cohort study
Statin and metformin therapy in prostate cancer patients with hyperlipidemia who underwent radiotherapy: a population-based cohort study
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他汀类药物和二甲双胍治疗接受放射治疗的前列腺癌伴高脂血症患者：一项基于人群的队列研究
DOI：
10.2147/cmar.s166638
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发表时间：
2019-01-01
影响因子：
3.3
通讯作者：
Wang, Dejuan
中科院分区：
文献类型：
--
作者：
Li, Ke;Jie Si-Tu;Wang, Dejuan
目的评估台湾地区前列腺癌患者使用他汀类药物和/或二甲双胍与患者生存率之间的关系。对象和方法从2000-2010年国民健康保险研究数据库中确定患有高脂血症并接受放射治疗的新诊断前列腺癌患者。采用Kaplan-Meier法估计生存率。单变量和多变量考克斯回归分析进行检查死亡率的关联。进行敏感性分析以评估糖尿病患者的死亡风险。结果共纳入567例患者。前列腺癌诊断后使用他汀类药物或二甲双胍的患者与癌症诊断前持续使用或使用药物的患者相比，平均生存时间更长（分别为9.3年和8.1年; P=0.001）。多变量考克斯回归分析发现，与研究期间未使用他汀类药物的患者相比，癌症诊断后接受他汀类药物治疗的患者死亡风险显著降低（aHR =0.24，95% CI =0.09-0.66）。与研究期间未使用二甲双胍的患者相比，癌症诊断后接受二甲双胍治疗的患者与死亡风险增加的相关性更高（aHR =6.78，95% CI =2.45-18.77）。敏感性分析显示，不同用药组糖尿病患者的平均生存时间相似。结论前列腺癌诊断后使用他汀类药物和二甲双胍可能会增加高脂血症和放疗患者的生存率。
Purpose To evaluate the association between the use of statins and/or metformin and patient survival in prostate cancer patients in Taiwan. Subjects and methods Newly diagnosed prostate cancer patients who had hyperlipidemia and received radiotherapy were identified from the National Health Insurance Research Database 2000–2010. The survival rate was estimated by the Kaplan–Meier method. Univariate and multivariate Cox regression analyses were performed to examine the association of mortality. Sensitivity analysis was performed to assess the risk of mortality in patients with diabetes. Results The study included 567 patients. Patients who used statins or metformin after prostate cancer diagnosis had longer average survival times (9.3 years and 8.1 years, respectively; P=0.001) compared with patients who persistently used or used the medicines prior to cancer diagnosis. Multivariate Cox regression analysis found that patients treated with statins after cancer diagnosis were significantly associated with a lower risk of mortality (aHR =0.24, 95% CI =0.09–0.66) compared to patients who did not use statins during the study period. Patients treated with metformin after cancer diagnosis were significantly associated more with an increased risk of mortality (aHR =6.78, 95% CI =2.45–18.77) compared to patients who did not use metformin during the study period. Sensitivity analysis revealed that the average survival time was similar among different medicine use groups in patients with diabetes. Conclusion The finding suggests that statins and metformin use after prostate cancer diagnosis may increase survival in patients with hyperlipidemia and radiotherapy.