1 Mayo Clinic School of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
2 Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Otolaryngol Head Neck Surg. 2019 Jun;160(6):1081-1086. doi: 10.1177/0194599819827812. Epub 2019 Feb 5.
Conflicting research exists surrounding the utility of aspirin to prevent tumor growth in the medical management of vestibular schwannoma (VS). Recent studies demonstrated no association between aspirin and VS growth using linear tumor measurements. Given the heightened sensitivity of volumetric analyses to monitor tumor growth, the current study was conceived with the chief objective of assessing the association between aspirin or other nonsteroidal anti-inflammatory drug (NSAID) use and VS growth using volumetric analyses.
Retrospective review.
Tertiary referral center.
A total of 361 patients totaling 1601 volumetrically analyzed magnetic resonance imaging studies who underwent initial observation since January 1, 2003.
In total, 123 (35%) patients took 81 mg aspirin daily, 23 (7%) took 325 mg aspirin daily, and 41 (11%) reported other NSAID use. Among those taking aspirin, 112 (72%) exhibited volumetric tumor growth during observation compared to 33 (80%) among other NSAID users and 137 (67%) among nonaspirin users. Patients taking aspirin or other NSAIDs were significantly older at time of diagnosis (median, 66 vs 56 years; P < .001). Neither aspirin use (hazard ratio [HR], 0.96; P = .73) nor other NSAID use (HR, 1.39; P = .081) was significantly associated with a reduced risk of volumetric tumor growth. These results were similar following age adjustment ( P = .81 and .087, respectively). When separating aspirin users by 81-mg or 325-mg dosing, neither group exhibited a reduced risk of growth ( P = .95 and .73, respectively).
Despite promising initial results, the preponderance of existing literature suggests that aspirin and other NSAID use does not prevent tumor growth in VS.
关于阿司匹林在前庭神经鞘瘤（VS）的医学治疗中预防肿瘤生长的效果，存在相互矛盾的研究。最近的研究表明，线性肿瘤测量与阿司匹林与 VS 生长之间没有关联。鉴于体积分析在监测肿瘤生长方面的高度敏感性，本研究的主要目的是评估阿司匹林或其他非甾体抗炎药（NSAID）使用与使用体积分析评估 VS 生长之间的关联。
回顾性研究。
三级转诊中心。
共有 361 名患者，共进行了 1601 次体积分析磁共振成像研究，他们自 2003 年 1 月 1 日开始首次观察。
共有 123 名（35%）患者每天服用 81mg 阿司匹林，23 名（7%）患者每天服用 325mg 阿司匹林，41 名（11%）报告服用其他 NSAID。在服用阿司匹林的患者中，112 名（72%）在观察期间显示出肿瘤体积增长，而其他 NSAID 使用者中为 33 名（80%），非阿司匹林使用者中为 137 名（67%）。诊断时服用阿司匹林或其他 NSAID 的患者年龄明显较大（中位数，66 岁比 56 岁；P<.001）。阿司匹林使用（风险比 [HR]，0.96；P=.73）或其他 NSAID 使用（HR，1.39；P=.081）均与肿瘤体积生长风险降低无显著相关性。在调整年龄后，这些结果仍然相似（P=.81 和.087，分别）。当按 81mg 或 325mg 剂量将阿司匹林使用者分开时，两组均未显示出生长风险降低（P=.95 和.73，分别）。
尽管有初步的有希望的结果，但现有的大量文献表明，阿司匹林和其他 NSAID 的使用并不能预防 VS 中的肿瘤生长。
