Department of General Surgery, Peking University Third Hospital, Beijing, China; Peking University Third Hospital Cancer Center, Beijing, China.
Department of General Surgery, Peking University Third Hospital, Beijing, China; Peking University Third Hospital Cancer Center, Beijing, China.
Eur J Pharmacol. 2022 Aug 15;929:175135. doi: 10.1016/j.ejphar.2022.175135. Epub 2022 Jul 4.
Preclinical and in vitro studies have shown that beta blockade affect colorectal cancer growth and metastasis through the sympathetic nervous system. There is no consensus on the effect of beta blockade on clinical outcomes in patients with colorectal cancer. We conducted a systematic review and meta-analysis to assess the impact of beta blockade on clinical outcomes in patients with colorectal cancer.
A systematic review and meta-analysis was conducted through a comprehensive search of the PubMed, EMBASE and the Cochrane Central Library databases for all studies to compare clinical outcomes in colorectal cancer patients based on the use of beta blockade. Pooled data of survival was analyzed.
Fourteen studies involving 85993 patients were included in our meta-analysis. The use of beta blockade was associated with improvements in cancer-specific mortality (N = 59621; HR 0.87; 95%CI, 0.76-0.99; P = 0.04)and overall 1-year mortality (N = 37442; HR 0.54; 95%CI, 0.43-0.67; P < 0.00001),while there was no significant difference in overall survival (N = 37975; HR 0.95; 95%CI, 0.85-1.05; P = 0.28). In patients with stage IV colorectal cancer,the use of beta blockade was significantly associated with improvement in progression-free survival (N = 749; HR 0.76; 95%CI, 0.62-0.92; P = 0.005).
In this meta-analysis, beta blockade use was associated with a reduction in cancer-specific mortality. The correlation was particularly significant for PFS improvement in patients with stage IV colorectal cancer. beta blockade may be an option for patients with advanced colorectal cancer.
临床前和体外研究表明，β阻断通过交感神经系统影响结直肠癌的生长和转移。β阻断对结直肠癌患者临床结局的影响尚无共识。我们进行了系统评价和荟萃分析，以评估β阻断对结直肠癌患者临床结局的影响。
通过全面检索 PubMed、EMBASE 和 Cochrane 中央图书馆数据库，对所有比较结直肠癌患者使用β阻断与临床结局的研究进行系统评价和荟萃分析。对生存数据进行汇总分析。
荟萃分析纳入了 14 项涉及 85993 例患者的研究。β阻断的使用与癌症特异性死亡率的改善相关（N=59621；HR 0.87；95%CI，0.76-0.99；P=0.04）和 1 年总死亡率（N=37442；HR 0.54；95%CI，0.43-0.67；P<0.00001），而总生存率无显著差异（N=37975；HR 0.95；95%CI，0.85-1.05；P=0.28）。在 IV 期结直肠癌患者中，β阻断的使用与无进展生存期的改善显著相关（N=749；HR 0.76；95%CI，0.62-0.92；P=0.005）。
在这项荟萃分析中，β阻断的使用与癌症特异性死亡率的降低相关。对于 IV 期结直肠癌患者，PFS 的改善相关性尤为显著。β阻断可能是晚期结直肠癌患者的一种选择。
