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接受雄激素剥夺治疗的前列腺癌患者使用他汀类药物与死亡率结局的关联:一项系统评价和荟萃分析。

Association of statins use and mortality outcomes in prostate cancer patients who received androgen deprivation therapy: a systematic review and meta-analysis.

作者信息

Aydh Abdulmajeed, Motlagh Reza Sari, Alshyarba Mishari, Mori Keiichiro, Katayama Satoshi, Grossmann Nico, Rajwa Pawel, Mostafai Hadi, Laukhtina Ekaterina, Pradere Benjamin, Quhal Fahad, König Frederik, Nyirady Peter, Karakiewicz Pierre I, Haydter Martin, Shariat Shahrokh F

机构信息

Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.

Department of Urology, King Faisal Medical City, Abha, Saudi Arabia.

出版信息

Cent European J Urol. 2021;74(4):484-490. doi: 10.5173/ceju.2021.0260. Epub 2021 Dec 6.

Abstract

INTRODUCTION

While several recent studies investigated the influence of statins on survival outcomes in prostate cancer (PCa) patients on androgen deprivation therapy (ADT), definitive conclusions are still missing. The present systematic review and meta-analysis aimed to develop an overarching framework for the association of statins use and survival outcomes in PCa patients who receive ADT.

MATERIAL AND METHODS

We conducted a systematic review and meta-analysis of the literature assessing the survival outcomes for statin compared to non-statin users in PCa patients who received ADT. We searched PubMed and Web of Science for studies published before March 1, 2021. We used the random effect model in the presence of heterogeneity and the fixed-effects model in the absence of heterogeneity per the statistic. We did two meta-analyses; the primary meta-analysis was accomplished for articles reporting cancer-specific survival (CSS) as an outcome. A secondary meta-analysis was completed for articles reporting overall survival (OS) as an outcome.

RESULTS

Ten studies were eligible for inclusion. Nine studies included in the first meta-analysis comprising 136,285 patients showed no statistically significant difference in CSS (HR 0.77; 95% CI 0.49-1.21) between statin users and non-users in PCa patients who received ADT. In four studies included in the second meta-analysis comprising 95,032 patients, statin users had a significantly better OS compared to non-users (HR 0.67; 95% CI 0.62-0.73).

CONCLUSIONS

Although the combination of statins and ADT in PCa patients significantly improves OS, it seems not to be through an effect on cancer-specific factors.

摘要

引言

虽然最近有几项研究调查了他汀类药物对接受雄激素剥夺治疗(ADT)的前列腺癌(PCa)患者生存结局的影响,但仍未得出明确结论。本系统评价和荟萃分析旨在构建一个总体框架,以探讨接受ADT的PCa患者使用他汀类药物与生存结局之间的关联。

材料与方法

我们对评估接受ADT的PCa患者中他汀类药物使用者与非使用者生存结局的文献进行了系统评价和荟萃分析。我们在PubMed和Web of Science上检索了2021年3月1日前发表的研究。根据统计结果,在存在异质性时我们使用随机效应模型,不存在异质性时使用固定效应模型。我们进行了两项荟萃分析;主要荟萃分析针对报告癌症特异性生存(CSS)作为结局的文章。第二项荟萃分析针对报告总生存(OS)作为结局的文章。

结果

有10项研究符合纳入标准。第一项荟萃分析纳入的9项研究共136,285例患者显示,接受ADT的PCa患者中,他汀类药物使用者与非使用者的CSS无统计学显著差异(HR 0.77;95% CI 0.49 - 1.21)。第二项荟萃分析纳入的4项研究共95,032例患者显示,与非使用者相比,他汀类药物使用者的OS显著更好(HR 0.67;95% CI 0.62 - 0.73)。

结论

虽然他汀类药物与ADT联合应用可显著改善PCa患者的OS,但似乎并非通过对癌症特异性因素产生作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43d7/8771132/70855c4bb62b/CEJU-74-0260-g001.jpg

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