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头颈部癌症患者诊断后他汀类药物的使用与生存情况:一项在全民医疗保健系统中的队列研究

Post-diagnosis statin use and survival among head and neck cancer patients: a cohort study in a universal health care system.

作者信息

Lin Jie, Orestes Michael I, Shriver Craig D, Zhu Kangmin

机构信息

Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

出版信息

Br J Cancer. 2025 Feb;132(3):259-265. doi: 10.1038/s41416-024-02925-y. Epub 2024 Dec 7.

Abstract

BACKGROUND

Little research has been conducted on the relationship between statin use and the survival of head and neck cancer patients. This study assessed whether statin use after head and neck cancer diagnosis is associated with overall survival among patients in the U.S. military health system (MHS) that provides universal health care to its beneficiaries.

METHODS

The study included 1842 patients with head and neck squamous cell carcinoma (HNSCC) from MHS. Statin use was extracted from the pharmacy database of the Military Health System Data Repository (MDR). Time-dependent multivariate Cox proportional hazards models were used to assess the relationship between post-diagnosis statin use and overall survival with the adjustment for potential confounders.

RESULTS

Compared to non-users, increased post-diagnosis cumulative use of statins (per one-year of use) conferred a significant improved survival with adjusted hazard ratio (HR) of 0.70 (95% Confidence Interval, CI = 0.55 to 0.90). When analysis was stratified by status of statin use prior to HNSCC diagnosis, the HRs were 0.31 (95% CI = 0.15-0.65) and 0.81 (95% CI = 0.59-1.11) for post-diagnosis users who also used it before HNSCC diagnosis and those who only used it after the diagnosis, respectively.

CONCLUSION

Prolonged statin use was associated with improved survival among HNSCC patients in MHS.

摘要

背景

关于他汀类药物使用与头颈癌患者生存率之间的关系,相关研究较少。本研究评估了在美国军事卫生系统(MHS)中,头颈癌诊断后使用他汀类药物是否与患者的总生存率相关,该系统为其受益者提供全民医疗保健服务。

方法

该研究纳入了1842例来自MHS的头颈鳞状细胞癌(HNSCC)患者。他汀类药物的使用情况从军事卫生系统数据仓库(MDR)的药房数据库中提取。使用时间依赖性多变量Cox比例风险模型,在对潜在混杂因素进行调整的情况下,评估诊断后他汀类药物使用与总生存率之间的关系。

结果

与未使用者相比,诊断后他汀类药物的累积使用量增加(每使用一年)可显著提高生存率,调整后的风险比(HR)为0.70(95%置信区间,CI = 0.55至0.90)。当按HNSCC诊断前他汀类药物的使用状况进行分层分析时,对于在HNSCC诊断前也使用过他汀类药物的诊断后使用者和仅在诊断后使用过他汀类药物的使用者,HR分别为0.31(95% CI = 0.15 - 0.65)和0.81(95% CI = 0.59 - 1.11)。

结论

在MHS中,长期使用他汀类药物与HNSCC患者生存率的提高相关。

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本文引用的文献

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