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β受体阻滞剂在绝经后三阴性乳腺癌患者中的治疗效果。

Therapeutic effect of β-blockers in triple-negative breast cancer postmenopausal women.

机构信息

Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.

出版信息

Breast Cancer Res Treat. 2013 Aug;140(3):567-75. doi: 10.1007/s10549-013-2654-3. Epub 2013 Aug 3.

DOI:10.1007/s10549-013-2654-3
PMID:23912960
Abstract

Beta-blockers (BB) drugs have been used for decades worldwide, mainly to treat hypertension. However, in recent epidemiological studies, BBs were suggested to improve cancer prognosis. In the wake of this evidence, we evaluated the possible therapeutic effect of BBs in triple-negative breast cancer (TNBC) patients. We identified 800 postmenopausal women operated between 1997 and 2008 for early primary TNBC. The effect of BB intake on the risk of breast cancer (BC) recurrence and death was evaluated through competing risk and Cox regression survival models. At cancer diagnosis, 74 (9.3 %) women out of 800 were BBs users. Median age was 62 years in BB users and 59 years in non-users (P = 0.02). BB users and non-users were similarly distributed by all tumor characteristics. The 5-year cumulative incidence of BC-related events was 13.6 % in BB users and 27.9 % in non-users (P = 0.02). The beneficial impact of BBs remained statistically significant at multivariable analysis (HR, 0.52; 95 % CI 0.28-0.97), after the adjustment for age, tumor stage, and treatment, peritumoral vascular invasion and use of other antihypertensive drugs, antithrombotics, and statins. Adjusted HRs for metastases and for BC deaths were 0.32 (95 % CI 0.12-0.90) and 0.42 (95 % CI 0.18-0.97), respectively, in favor of BBs. Hypertension, other antihypertensive drugs, antithrombotics, and statins did not impact prognosis. In this series of postmenopausal TNBC patients, BB intake was associated with a significantly decreased risk of BC-related recurrence, metastasis, and BC death. Innovative therapeutic strategies including BBs should be urgently explored in cancer patients.

摘要

β受体阻滞剂(BB)药物已在全球范围内使用了数十年,主要用于治疗高血压。然而,在最近的流行病学研究中,BB 被认为可以改善癌症的预后。鉴于这一证据,我们评估了 BB 在三阴性乳腺癌(TNBC)患者中的可能治疗效果。我们确定了 800 名 1997 年至 2008 年间因早期原发性 TNBC 而接受手术的绝经后女性。通过竞争风险和 Cox 回归生存模型评估 BB 摄入对乳腺癌(BC)复发和死亡风险的影响。在癌症诊断时,800 名女性中有 74 名(9.3%)为 BB 使用者。BB 使用者的中位年龄为 62 岁,非使用者为 59 岁(P=0.02)。BB 使用者和非使用者在所有肿瘤特征方面的分布相似。BB 使用者的 5 年累积 BC 相关事件发生率为 13.6%,而非使用者为 27.9%(P=0.02)。在多变量分析中,BB 的有益影响仍然具有统计学意义(HR,0.52;95%CI,0.28-0.97),调整了年龄、肿瘤分期和治疗、肿瘤周围血管侵犯以及其他降压药、抗血栓药和他汀类药物的使用后。调整后的转移和 BC 死亡风险比分别为 0.32(95%CI,0.12-0.90)和 0.42(95%CI,0.18-0.97),有利于 BB。高血压、其他降压药、抗血栓药和他汀类药物对预后没有影响。在这一系列绝经后 TNBC 患者中,BB 摄入与 BC 相关复发、转移和 BC 死亡风险显著降低相关。应紧急探索包括 BB 在内的创新治疗策略。

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