Yu Chih-Hsien, Lin Kuan-Chou, Chang Chia-Lun, Chen Wan-Ming, Shia Ben-Chang, Wu Szu-Yuan
Department of Cardiology, St. Paul's Hospital Taoyuan, Taiwan.
Division of Oral and Maxillofacial Surgery, Department of Dentistry, Wan Fang Hospital, Taipei Medical University Taipei, Taiwan.
Am J Cancer Res. 2024 Jun 15;14(6):2957-2970. doi: 10.62347/NZHY5175. eCollection 2024.
To evaluate the impact of statin use on overall survival and lung cancer-specific survival in patients with unresectable stage III lung squamous cell carcinoma (LSCC) undergoing standard concurrent chemoradiotherapy (CCRT). Using data from the Taiwan Cancer Registry Database and National Health Insurance Research Database, this propensity score matching cohort study analyzed the influence of statin use during CCRT on overall survival and lung cancer-specific survival. Statin use during CCRT was independently associated with significant improvements in overall survival and lung cancer-specific survival. The adjusted hazard ratio (95% CI) for all-cause mortality in the statin group versus the non-statin group was 0.60 (0.53-0.68, P < 0.0001). Similarly, the adjusted hazard ratio for lung cancer-specific mortality in the statin group versus the non-statin group was 0.61 (95% CI, 0.54-0.70, P < 0.0001). Pravastatin and fluvastatin exhibited the greatest potential in reducing lung cancer-specific mortality among statins, with rosuvastatin following closely behind. Atorvastatin demonstrated comparable effectiveness, while simvastatin and lovastatin displayed lower efficacy in this regard. Furthermore, a dose-response relationship was observed, with higher cumulative defined daily doses and greater daily intensity of statin use associated with reduced mortality. Our study provides evidence that statin use during CCRT for unresectable stage III LSCC is associated with significant improvements in overall survival and lung cancer-specific survival. Pravastatin showed the highest potential for reducing lung cancer-specific mortality among statins, followed by rosuvastatin. Atorvastatin and fluvastatin exhibited similar effectiveness, while simvastatin and lovastatin demonstrated lower efficacy. The dose-response relationship showed higher statin utilization in reducing lung cancer-specific mortality.
评估他汀类药物的使用对接受标准同步放化疗（CCRT）的不可切除Ⅲ期肺鳞状细胞癌（LSCC）患者总生存期和肺癌特异性生存期的影响。利用台湾癌症登记数据库和国民健康保险研究数据库的数据，这项倾向评分匹配队列研究分析了CCRT期间使用他汀类药物对总生存期和肺癌特异性生存期的影响。CCRT期间使用他汀类药物与总生存期和肺癌特异性生存期的显著改善独立相关。他汀类药物组与非他汀类药物组全因死亡率的调整后风险比（95%CI）为0.60（0.53 - 0.68，P < 0.0001）。同样，他汀类药物组与非他汀类药物组肺癌特异性死亡率的调整后风险比为0.61（95%CI，0.54 - 0.70，P < 0.0001）。普伐他汀和氟伐他汀在他汀类药物中降低肺癌特异性死亡率的潜力最大，瑞舒伐他汀紧随其后。阿托伐他汀显示出相当的疗效，而辛伐他汀和洛伐他汀在这方面疗效较低。此外，观察到剂量反应关系，他汀类药物累积限定日剂量越高、每日使用强度越大，死亡率越低。我们的研究提供了证据，表明CCRT期间使用他汀类药物治疗不可切除Ⅲ期LSCC与总生存期和肺癌特异性生存期的显著改善相关。普伐他汀在他汀类药物中降低肺癌特异性死亡率的潜力最高，其次是瑞舒伐他汀。阿托伐他汀和氟伐他汀显示出相似的疗效，而辛伐他汀和洛伐他汀疗效较低。剂量反应关系表明，更高的他汀类药物使用率可降低肺癌特异性死亡率。
