他汀类药物，尤其是阿托伐他汀，可能会对临床局限性前列腺癌近距离放疗后的临床表现和无生化进展生存期产生有利影响。

Statins, especially atorvastatin, may favorably influence clinical presentation and biochemical progression-free survival after brachytherapy for clinically localized prostate cancer.

作者信息

Moyad Mark A, Merrick Gregory S, Butler Wayne M, Wallner Kent E, Galbreath Robert W, Kurko Brian, Adamovich Edward

机构信息

Department of Complementary/Alternative Medicine, University of Michigan Medical Center, Ann Arbor, Michigan, USA.

出版信息

Urology. 2005 Dec;66(6):1150-4. doi: 10.1016/j.urology.2005.08.053.

DOI:10.1016/j.urology.2005.08.053

PMID:16360430

Abstract

OBJECTIVES

To conduct a preliminary investigation on statin use and its impact on clinical presentation and biochemical progression-free survival after brachytherapy.

METHODS

A total of 512 consecutive patients were treated with permanent brachytherapy for clinical Stage T1c-T3aNxM0 prostate cancer at least 3 years before analysis. Biochemical progression-free survival was defined by a prostate-specific antigen (PSA) level of 0.4 ng/mL or less after nadir. The median follow-up was 5.3 years. The clinical, treatment, and dosimetric parameters evaluated included use of any and specific statins, age, body mass index, PSA level, Gleason score, percentage of positive biopsies, perineural invasion, prostate volume, planning volume, dosimetric quality, supplemental external beam radiotherapy, tobacco use, hypertension, and diabetes.

RESULTS

The actuarial 8-year biochemical progression-free survival rate for the entire group was 94.6%. On forward conditional Cox regression analysis, the pretreatment PSA level and percentage of positive biopsies were statistically significant predictors of biochemical outcome. However, a significantly lower pretreatment PSA level, percentage of positive biopsy cores, and PSA density and earlier clinical stage were found in the statin group. Almost every clinical presentation parameter comparison at least favored statin users. When stratified by any or specific statin use, 97.0% of patients taking statins compared with 94.3% not taking statins and 97.8% of patients taking atorvastatin compared with 94.7% taking other statins were free of biochemical progression.

CONCLUSIONS

The results of this brachytherapy investigation with the longest reported follow-up period to date suggest that statins, especially atorvastatin, may improve most clinical presentations with a nonsignificant improvement in 8-year biochemical progression-free survival.

摘要

目的

对近距离放射治疗后他汀类药物的使用及其对临床表现和无生化进展生存期的影响进行初步调查。

方法

在分析前至少3年，共有512例连续患者接受了临床T1c - T3aNxM0期前列腺癌的永久性近距离放射治疗。无生化进展生存期定义为最低点后前列腺特异性抗原（PSA）水平≤0.4 ng/mL。中位随访时间为5.3年。评估的临床、治疗和剂量学参数包括是否使用及使用特定他汀类药物、年龄、体重指数、PSA水平、Gleason评分、活检阳性百分比、神经周围侵犯、前列腺体积、计划体积、剂量学质量、补充外照射放疗、吸烟、高血压和糖尿病。

结果

整个队列的8年精算无生化进展生存率为94.6%。在向前条件Cox回归分析中，治疗前PSA水平和活检阳性百分比是生化结果的统计学显著预测因素。然而，他汀类药物组的治疗前PSA水平、活检阳性核心百分比和PSA密度显著更低，且临床分期更早。几乎每一项临床表现参数比较至少都有利于他汀类药物使用者。按是否使用或使用特定他汀类药物分层时，服用他汀类药物的患者中97.0%无生化进展，未服用他汀类药物的患者为94.3%；服用阿托伐他汀的患者中97.8%无生化进展，服用其他他汀类药物的患者为94.7%。