Choi Chel Hun, Song Taejong, Kim Tae Hyun, Choi Jun Kuk, Park Jin-Young, Yoon Aera, Lee Yoo-Young, Kim Tae-Joong, Bae Duk-Soo, Lee Jeong-Won, Kim Byoung-Gie
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul, 135-710, Korea.
J Cancer Res Clin Oncol. 2014 Jul;140(7):1179-88. doi: 10.1007/s00432-014-1658-7. Epub 2014 Mar 27.
This study was to elucidate the potential benefit of beta blockers on cancer survival.
We comprehensively searched PubMed, Embase, and the Cochrane Library from their inception to April 2013. Two authors independently screened and reviewed the eligibility of each study and coded the participants, treatment, and outcome characteristics. The primary outcomes were overall survival (OS) and disease-free survival (DFS).
Twelve studies published between 1993 and 2013 were included in the final analysis. Four papers reported results from 10 independent groups, resulting in a total of 18 comparisons based on data obtained from 20,898 subjects. Effect sizes (hazard ratios, HR) were heterogeneous, and random-effects models were used in the analyses. The meta-analysis demonstrated that beta blocker use is associated with improved OS (HR 0.79; 95 % CI 0.67-0.93; p = 0.004) and DFS (HR 0.69; 95 % CI 0.53-0.91; p = 0.009). Although statistically not significant, the effect size was greater in patients with low-stage cancer or cancer treated primarily with surgery than in patients with high-stage cancer or cancer treated primarily without surgery (HR 0.60 vs. 0.78, and 0.60 vs. 0.80, respectively). Although only two study codes were analyzed, the studies using nonselective beta blockers showed that there was no overall effect on OS (HR 0.52, 95 % CI 0.09-3.04).
This meta-analysis provides evidence that beta blocker use can be associated with the prolonged survival of cancer patients, especially patients with early-stage cancer treated primarily with surgery.
本研究旨在阐明β受体阻滞剂对癌症患者生存的潜在益处。
我们全面检索了PubMed、Embase和Cochrane图书馆，检索时间从建库至2013年4月。两位作者独立筛选并评估每项研究的合格性，并对参与者、治疗方法和结果特征进行编码。主要结局指标为总生存期（OS）和无病生存期（DFS）。
最终分析纳入了1993年至2013年间发表的12项研究。4篇论文报告了10个独立组的结果，基于从20898名受试者获得的数据，共进行了18项比较。效应量（风险比，HR）存在异质性，分析中采用随机效应模型。荟萃分析表明，使用β受体阻滞剂与改善OS（HR 0.79；95%CI 0.67 - 0.93；p = 0.004）和DFS（HR 0.69；95%CI 0.53 - 0.91；p = 0.009）相关。尽管在统计学上不显著，但低分期癌症患者或主要接受手术治疗的癌症患者的效应量大于高分期癌症患者或主要未接受手术治疗的癌症患者（HR分别为0.60对0.78和0.60对0.80）。尽管仅分析了两个研究编码，但使用非选择性β受体阻滞剂的研究表明，对OS没有总体影响（HR 0.52，95%CI 0.09 - 3.04）。
这项荟萃分析提供了证据，表明使用β受体阻滞剂可能与癌症患者生存期延长相关，尤其是主要接受手术治疗的早期癌症患者。
