SCI 18 May 2023

Statin Use During Concurrent Chemoradiotherapy with Improved Survival Outcomes in Esophageal Squamous Cell Carcinoma: A Propensity Score Matched Nationwide Cohort Study

(Journal of Thoracic Oncology, IF: 20.121)

Wan-Ming Chen, Ying-Hui Yu, Mingchih Chen, Ben-Chang Shia, Szu-Yuan Wu

CORRESPONDENCE TO: szuyuanwu5399@gmail.com 

Objective 目的

To determine the effect of statin use during concurrent chemoradiotherapy (CCRT) on overall survival and esophageal squamous cell carcinoma (ESCC)-specific survival in patients with ESCC receiving standard CCRT.

明确同步放化疗（CCRT）中他汀类药物的使用对接受标准CCRT治疗的食管鳞状细胞癌患者的总生存率和食管鳞状细胞瘤（ESCC）特异性生存率的影响。

Methods 方法 

In this propensity score matching cohort study, we used data from the Taiwan Cancer Registry Database and National Health Insurance Research Database to investigate the effects of statin use during the period of CCRT on overall survival and ESCC-specific survival.

在这项倾向评分匹配队列研究中，我们使用来自中国台湾癌症登记数据库和国家健康保险研究数据库的数据，调查CCRT治疗期间使用他汀类药物对总生存率和ESCC特异性生存率的影响。

Results 结果 

Statin use during the period of CCRT was found to be a significant and independent prognostic factor for overall survival and ESCC-specific survival. The adjusted hazard ratio for all-cause mortality in the statin group compared to the nonstatin group was 0.65 (95% CI, 0.51-0.84; P = 0.0009). The adjusted hazard ratio for ESCC-specific mortality in the statin group compared to the non-statin group was 0.63 (95% CI, 0.47-0.84; P = 0.0016). The use of hydrophilic statins such as rosuvastatin and pravastatin were associated with the greatest survival benefits. A dose-response relationship was also found, with higher cumulative defined daily doses and higher daily intensity of statin use associated with lower mortality.

CCRT治疗期间他汀类药物的使用被发现是影响总生存率和ESCC特异性生存率的一个重要且独立的预后因素。他汀组与非他汀组相比，全因死亡率调整后的危险比为0.65（95%CI，0.51-0.84；P=0.0009）。他汀组与非他汀组相比，ESCC特异性死亡率调整后的危险比为0.63（95%CI，0.47-0.84；P=0.0016）。亲水性他汀类药物如瑞舒伐他汀和普伐他汀的使用与最大的生存益处相关。我们还发现了剂量-反应关系，即较高的累积限定日剂量和较高的他汀类药物每日使用强度与较低的死亡率相关。

Conclusion 结论 

This study is the first to show that statin use during the period of CCRT for ESCC is associated with improvement in overall survival and ESCC-specific survival. Additionally, we found that use of rosuvastatin, pravastatin, and simvastatin was associated with better survival outcomes for ESCC patients receiving CCRT. Furthermore, we found a dose-response relationship of statin use associated with lower ESCC-specific mortality.

这是首次有研究表明，在CCRT治疗ESCC期间使用他汀类药物与总生存率和ESCC特异性生存率的提高有关。此外，我们发现ESCC患者在接受CCRT治疗期间使用瑞舒伐他汀、普伐他汀和辛伐他汀具有更好生存结果。此外，我们发现他汀类药物的使用与较低的ESCC特异性死亡率有关。

Keywords 关键词 

esophageal squamous cell carcinoma; statin; concurrent chemoradiotherapy; survival; dose-response relationship.

食管鳞状细胞癌；他汀类药物；同步放化疗；生存；剂量-反应关系。

来源 | 健康界

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