Department Radiation and Cellular Oncology, University of Chicago, Pritzker School of Medicine, Chicago, Illinois, USA.
Cancer. 2010 Apr 1;116(7):1820-6. doi: 10.1002/cncr.24890.
: Substantial experimental evidence suggests that anticoagulants (ACs) may inhibit cancer growth and metastasis, although the limited data from clinical trials have been inconsistent. The potential antineoplastic effect of ACs was investigated in patients who received radiotherapy for localized prostate cancer.
: The study cohort consisted of 662 patients with adenocarcinoma of the prostate who received radiotherapy (RT) with curative intent. Among those 622 men, 243 (37%) were receiving ACs (warfarin, clopidogrel, and/or aspirin). All patients received external-beam RT, permanent seed implantation, or a combination of both. Prostate-specific antigen (PSA) values were monitored for biochemical control of disease.
: At a median follow-up of 49 months, the biochemical control rate at 4-years was significantly better in patients who received ACs at 91% compared with 78% in patients who did not receive ACs (P = .0002). The distant metastasis rate at 4 years also was reduced in the AC group compared with the non-AC group (1% vs 5%; P = .0248). In subgroup analysis, the improvement in biochemical control was significant only for patients with high-risk disease. Along with Gleason score, T classification, and initial PSA, the use of AC therapy was associated independently with improved biochemical control in multivariate analysis.
: AC therapy was associated with an improvement in biochemical control in patients with prostate cancer who received RT with curative intent. The effect was most prominent in patients who had high-risk disease. Cancer 2010. (c) 2010 American Cancer Society.
大量实验证据表明，抗凝剂（ACs）可能抑制癌症的生长和转移，尽管临床试验的有限数据一直存在不一致。本研究旨在调查接受局部前列腺癌放射治疗的患者中 AC 对肿瘤的潜在抗肿瘤作用。
研究队列包括 662 例接受根治性放疗的前列腺腺癌患者。在这 622 例患者中，有 243 例（37%）接受 AC 治疗（华法林、氯吡格雷和/或阿司匹林）。所有患者均接受外照射放疗、永久性种子植入或两者联合治疗。监测前列腺特异抗原（PSA）值以评估疾病的生化控制情况。
中位随访 49 个月时，接受 AC 治疗的患者在 4 年内生化控制率显著更好（91% vs. 78%，P=0.0002），远处转移率也显著更低（1% vs. 5%，P=0.0248）。亚组分析显示，仅高危疾病患者的生化控制改善有统计学意义。在多因素分析中，除了 Gleason 评分、T 分期和初始 PSA 外，AC 治疗的使用与生化控制的改善独立相关。
AC 治疗与接受根治性放疗的前列腺癌患者的生化控制改善相关，在高危疾病患者中效果最为显著。癌症 2010。（c）2010 年美国癌症协会。
