Xie Yonglin, Lu Qin, Lenahan Cameron, Yang Shuxu, Zhou Daoyang, Qi Xuchen
Department of Emergency.
Department of Neurosurgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Medicine (Baltimore). 2020 Feb;99(9):e18997. doi: 10.1097/MD.0000000000018997.
Glioblastomas are malignant brain tumors associated with high mortality and poor prognosis. Evidence from preclinical studies suggests that statins have an antitumor role, but their effects on the survival of patients with glioblastoma remain controversial. This meta-analysis attempts to assess the association between statins and glioblastoma.
We searched 4 databases (PubMed, Web of Science, Embase, and Cochrane Library) for articles that evaluate the effect of statins on the survival of patients with glioblastoma. Two reviewers were asked to assess the quality of the studies and extract the data regarding progression-free survival (PFS) and overall survival (OS).
A total of 5 studies met the inclusion criteria with 430 statin users and 2089 nonstatin users. All 5 studies were retrospectively analyzed. The pooled hazard ratio (HR) and 95% confidence intervals (CIs) were calculated. There was no benefit of statins found pertaining to the survival of glioblastoma patients in both PFS (HR, 0.97; CI, 0.84-1.13) and OS (HR, 0.98; CI, 0.87-1.11). In a subgroup defined by the patterns of statin use, it was determined that usage before glioblastoma diagnosis favored the OS of patients (HR, 0.85). The result, however, failed to demonstrate a statistically significant difference.
Use of statins was not associated with prolonged survival of patients with glioblastoma. Further well-designed randomized controlled trials are needed to confirm.
胶质母细胞瘤是一种恶性脑肿瘤，死亡率高且预后差。临床前研究的证据表明他汀类药物具有抗肿瘤作用，但其对胶质母细胞瘤患者生存的影响仍存在争议。本荟萃分析旨在评估他汀类药物与胶质母细胞瘤之间的关联。
我们在4个数据库（PubMed、Web of Science、Embase和Cochrane图书馆）中搜索评估他汀类药物对胶质母细胞瘤患者生存影响的文章。两名审阅者被要求评估研究质量并提取无进展生存期（PFS）和总生存期（OS）的数据。
共有5项研究符合纳入标准，其中他汀类药物使用者430例，非他汀类药物使用者2089例。所有5项研究均为回顾性分析。计算合并风险比（HR）和95%置信区间（CI）。在PFS（HR，0.97；CI，0.84 - 1.13）和OS（HR，0.98；CI，0.87 - 1.11）方面，均未发现他汀类药物对胶质母细胞瘤患者的生存有益。在根据他汀类药物使用模式定义的亚组中，确定在胶质母细胞瘤诊断前使用有利于患者的OS（HR，0.85）。然而，该结果未能显示出统计学上的显著差异。
使用他汀类药物与胶质母细胞瘤患者的生存期延长无关。需要进一步设计良好的随机对照试验来证实。
