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维生素 D 状态与卵巢癌患者治疗期间及治疗后的生存状况

Vitamin D status during and after treatment and ovarian cancer survival.

机构信息

Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia.

School of Public Health, The University of Queensland, Brisbane, Australia.

出版信息

Cancer Causes Control. 2024 Jan;35(1):1-8. doi: 10.1007/s10552-023-01757-0. Epub 2023 Aug 1.

Abstract

PURPOSE

Five-year relative survival for ovarian cancer remains below 50%. Strategies to improve outcomes are needed. Higher serum 25-hydroxyvitamin D [25(OH)D] concentrations [measure of vitamin D status] at and before diagnosis have been associated with longer survival in cancer patients; however, data for ovarian cancer are limited. We aimed to determine if 25(OH)D concentrations during and after primary treatment were associated with ovarian cancer-specific survival.

METHODS

We used data from a nationwide prospective cohort study of women with ovarian cancer. Among 886 participants treated with chemotherapy, 700 (79%) had a blood sample collected during (n = 591) and/or after (n = 458) primary treatment. These were tested for 25(OH)D. Clinical and survival data were abstracted from medical records. We used multivariable Cox proportional hazards regression to estimate hazard ratios (HR) and 95% confidence intervals (CI) for associations between 25(OH)D and ovarian cancer-specific survival.

RESULTS

Mean 25(OH)D concentrations were lower during than after primary treatment (82 and 91 nmol/L, respectively); only 14% and 8% had concentrations below 50 nmol/L during and after primary treatment, respectively. There was no association between 25(OH)D and ovarian cancer-specific survival during five years of follow-up [HR 1.10 (95% CI: 0.76, 1.61) and 0.95 (0.54, 1.68) for the highest vs. lowest quintile during and after treatment, respectively].

CONCLUSIONS

We did not observe any association between serum 25(OH)D concentration and ovarian cancer-specific survival. Our results suggest that, in the absence of vitamin D deficiency, vitamin D supplementation to improve ovarian cancer survival is not warranted.

摘要

目的

卵巢癌的 5 年相对生存率仍低于 50%。需要采取策略来改善治疗效果。癌症患者在诊断时和诊断前血清 25-羟维生素 D [25(OH)D]浓度[维生素 D 状态的衡量指标]较高与生存时间延长有关;然而,关于卵巢癌的数据有限。我们旨在确定原发性治疗期间和之后的 25(OH)D 浓度是否与卵巢癌特异性生存相关。

方法

我们使用了一项全国性前瞻性卵巢癌患者队列研究的数据。在 886 名接受化疗的患者中,有 700 名(79%)在原发性治疗期间(n=591)和/或之后(n=458)采集了血液样本进行 25(OH)D 检测。从病历中提取临床和生存数据。我们使用多变量 Cox 比例风险回归来估计 25(OH)D 与卵巢癌特异性生存之间的风险比(HR)和 95%置信区间(CI)。

结果

原发性治疗期间的平均 25(OH)D 浓度低于治疗后(分别为 82 和 91 nmol/L);仅 14%和 8%在原发性治疗期间和之后的浓度低于 50 nmol/L。在五年的随访期间,25(OH)D 与卵巢癌特异性生存之间没有关联[治疗期间和治疗后最高五分位数与最低五分位数的 HR 分别为 1.10(95%CI:0.76,1.61)和 0.95(0.54,1.68)]。

结论

我们没有观察到血清 25(OH)D 浓度与卵巢癌特异性生存之间存在任何关联。我们的结果表明,在不存在维生素 D 缺乏的情况下,维生素 D 补充剂并不能改善卵巢癌的生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c911/10764528/228c872330ec/10552_2023_1757_Fig1_HTML.jpg

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