Statin Use and Risk of Prostate Cancer Recurrence in Men Treated With Radiation Therapy
Statin Use and Risk of Prostate Cancer Recurrence in Men Treated With Radiation Therapy
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DOI：
10.1200/jco.2009.27.3003
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发表时间：
2010-06-01
影响因子：
45.3
通讯作者：
Liauw, Stanley L.
中科院分区：
文献类型：
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作者：
Gutt, Ruchika;Tonlaar, Nathan;Liauw, Stanley L.
目的基于他汀类药物的抗增殖、促凋亡和放射增敏作用的临床前证据，他汀类药物潜在的抗癌活性受到越来越多的关注。这项研究的主要目的是确定他汀类药物的使用是否与前列腺癌放射治疗(RT)患者的临床结果改善有关。患者和方法回顾分析1988至2006年间接受治疗性放射治疗的691名前列腺癌患者。在这些患者中，189名患者(27%)在初次咨询或随访期间使用他汀类药物。298例受试者在放疗开始前平均5个月收集脂类样本。中位随访期为50个月。结果他汀类药物的使用与避免生化衰竭(FFBF；P<；.001)、避免挽救雄激素剥夺治疗(FFADT；P=.0011)和无复发生存(RFS；P=.001)相关。在低危、中危和高危人群中，他汀类药物使用者的FFBF有所改善(分别为P=.0401，P=.0331和P=.0034)。使用他汀类药物后FFBF的改善与ADT的使用或辐射剂量无关。在多变量分析中，使用他汀类药物与改善FFBF有关(P=.001)，与治疗前前列腺特异性抗原有关
PurposeThere has been growing interest in the potential anticancer activity of statins based on preclinical evidence of their antiproliferative, proapoptotic, and radiosensitizing properties. The primary objective of this study was to determine whether statin use is associated with improved clinical outcomes in patients treated with radiotherapy (RT) for prostate cancer.Patients and MethodsIn total, 691 men with prostate adenocarcinoma treated with curative-intent RT between 1988 and 2006 were retrospectively analyzed. Of those, 189 patients (27%) were using statins, either during initial consultation or during follow-up. Lipid panels were collected (n = 298) a median of 5 months before RT start. Median follow-up was 50 months after RT.ResultsStatin use was associated with improved freedom from biochemical failure (FFBF; P < .001), freedom from salvage androgen deprivation therapy (FFADT; P = .0011), and relapse-free survival (RFS; P = .001). Improved FFBF for statin users was seen in low-, intermediate-, and high-risk groups (P = .0401, P = .0331, and P = .0034, respectively). The improvement in FFBF with statin use was independent of ADT use or radiation dose. On multivariable analysis, statin use was associated with improved FFBF (P = .001) along with pretreatment prostate-specific antigen