Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Gynecol Oncol. 2012 Nov;127(2):375-8. doi: 10.1016/j.ygyno.2012.07.102. Epub 2012 Jul 20.
Stress may promote ovarian cancer progression through mechanisms including autonomic nervous system mediators such as norepinephrine and epinephrine. Beta blockers, used to treat hypertension, block production of these adrenergic hormones, and have been associated with prolonged survival in several malignancies. We sought to determine the association between beta blocker use and epithelial ovarian cancer (EOC) disease progression and survival.
We performed an institutional retrospective review of patients with EOC treated between 1996 and 2006. Patients underwent cytoreductive surgery followed by platinum-based chemotherapy. Women were considered beta blocker users if these medications were documented on at least two records more than 6 months apart. Statistical tests included Fisher's exact, Kaplan-Meier, and Cox regression analyses.
248 met inclusion criteria. 68 patients used antihypertensives, and 23 used beta blockers. Median progression-free survival for beta blocker users was 27 months, compared with 17 months for non-users (p=0.05). Similarly, overall disease-specific survival was longer for beta blocker users (56 months) compared with non-users (48 months, p=0.02, hazard ratio=0.56). Multivariate analysis identified beta blocker use as an independent positive prognostic factor, after controlling for age, stage, grade, and cytoreduction status (p=0.03). Overall survival remained longer for beta blocker users (56 months) when compared with hypertensive patients on other medications (34 months) and patients without hypertension (51 months) (p=0.007).
In this cohort of patients with EOC, beta blocker use was associated with a 54% reduced chance of death compared with that of non-users.
压力可通过自主神经系统介质（如去甲肾上腺素和肾上腺素）促进卵巢癌进展。β 受体阻滞剂用于治疗高血压，可阻断这些肾上腺素激素的产生，并与多种恶性肿瘤的生存延长有关。我们旨在确定β受体阻滞剂的使用与上皮性卵巢癌（EOC）疾病进展和生存之间的关联。
我们对 1996 年至 2006 年间接受治疗的 EOC 患者进行了机构回顾性研究。患者接受了减瘤手术，随后进行了铂类为基础的化疗。如果这些药物在至少两份记录中有记录，且两次记录的时间间隔超过 6 个月，则认为女性为β受体阻滞剂使用者。统计检验包括 Fisher 确切检验、Kaplan-Meier 和 Cox 回归分析。
248 名符合纳入标准。68 名患者使用了降压药，23 名患者使用了β受体阻滞剂。β受体阻滞剂使用者的无进展中位生存时间为 27 个月，而非使用者为 17 个月（p=0.05）。同样，β受体阻滞剂使用者的总疾病特异性生存时间也较长（56 个月），而非使用者为 48 个月（p=0.02，风险比=0.56）。多变量分析表明，在控制年龄、分期、分级和减瘤状态后，β受体阻滞剂的使用是一个独立的阳性预后因素（p=0.03）。与使用其他降压药物的高血压患者（34 个月）和无高血压患者（51 个月）相比，β受体阻滞剂使用者的总生存时间仍然更长（56 个月）（p=0.007）。
在本队列的 EOC 患者中，与非使用者相比，β受体阻滞剂使用者的死亡风险降低了 54%。
