Gaist David, Hallas Jesper, Friis Søren, Hansen Steinbjørn, Sørensen Henrik Toft
Department of Neurology, Odense University Hospital & Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
Clinical Pharmacology, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
Cancer Epidemiol. 2014 Dec;38(6):722-7. doi: 10.1016/j.canep.2014.09.010. Epub 2014 Oct 23.
While some studies indicate a potential chemopreventive effect of statin use on the risk of glioma, the effect of statins on the prognosis of brain tumours has not yet been examined. We thus conducted a cohort study evaluating the influence of statin use on survival in patients with glioblastoma multiforme (GBM).
We identified 1562 patients diagnosed with GBM during 2000-2009 from the Danish Cancer Registry and linked this cohort to Danish nationwide demographic and health registries. Within the GBM cohort, each patient recorded as using statins prior to diagnosis (defined as ≥ 2 redeemed prescriptions) was matched to two statin non-users (<2 redeemed prescriptions) by propensity scores based on age, gender, year of diagnosis, comorbidity, and use of selected drugs. Cox proportional hazard models were used to compute hazard ratios (HRs) and 95% confidence intervals (CI) for all-cause death associated with prediagnostic statin use.
A total of 339 GBM patients were included in the analyses. Of these, 325 died during median follow-up of 6.9 months (interquartile range: 3.8-13.4 months). Prediagnostic statin use was associated with a reduced HR of death (0.79; 95% CI: 0.63-1.00). The HRs decreased with increasing duration or intensity of prediagnostic statin use [long-term (≥ 5 years) statin use: HR 0.75 (95% CI: 0.47-1.20); high-intensity statin use: HR 0.66 (95% CI: 0.44-0.98)]. Additional adjustment for oncotherapeutic modalities yielded similar results (overall HR 0.80, 95% CI: 0.63-1.01).
Long-term prediagnostic statin use may improve survival following GBM.
虽然一些研究表明使用他汀类药物对胶质瘤风险具有潜在的化学预防作用，但他汀类药物对脑肿瘤预后的影响尚未得到研究。因此，我们开展了一项队列研究，评估使用他汀类药物对多形性胶质母细胞瘤（GBM）患者生存的影响。
我们从丹麦癌症登记处确定了2000年至2009年期间诊断为GBM的1562例患者，并将该队列与丹麦全国人口和健康登记处相联系。在GBM队列中，根据年龄、性别、诊断年份、合并症和所选药物的使用情况，通过倾向评分将每位在诊断前记录为使用他汀类药物（定义为≥2张已兑换处方）的患者与两名未使用他汀类药物的患者（<2张已兑换处方）进行匹配。采用Cox比例风险模型计算与诊断前使用他汀类药物相关的全因死亡风险比（HR）和95%置信区间（CI）。
共有339例GBM患者纳入分析。其中，325例在中位随访6.9个月（四分位间距：3.8 - 13.4个月）期间死亡。诊断前使用他汀类药物与死亡HR降低相关（0.79；95%CI：0.63 - 1.00）。HR随着诊断前使用他汀类药物的持续时间或强度增加而降低[长期（≥5年）使用他汀类药物：HR 0.75（95%CI：0.47 - 1.20）；高强度使用他汀类药物：HR 0.66（95%CI：0.44 - 0.98）]。对肿瘤治疗方式进行额外调整产生了类似结果（总体HR 0.80，
