Clin Cancer Res:根治性切除术后长期复发阿托伐他汀可降低前列腺癌的复发风险?

2021-10-01 Nebula MedSci原创

高危病理型前列腺癌患者在根治性前列腺切除术后辅助使用阿托伐他汀一年并不能降低疾病复发风险

前列腺癌是男性最常见的非皮肤性癌症之一。根治性前列腺切除术是治疗局限性前列腺癌的主要方法。但约40%的患者会在根治性前列腺癌切除术后10年内生化复发。因此,有效的术后治疗是减少复发的重要措施。

他汀类药物是常用的降脂药,通过抑制 3-羟基-3-甲基戊二酰辅酶 A 还原酶来降低血清胆固醇水平。据报道,他汀类药物的使用与前列腺癌的风险、治疗后的结果和前列腺癌特异性死亡率有关。本研究旨在确定在根治性前列腺切除术后采用阿托伐他汀辅助治疗对前列腺癌复发的预防作用。

这是一项随机、双盲的临床试验,根治性前列腺癌切除术后的病理性高危前列腺癌患者随机接受低剂量阿托伐他汀(20 mg/日,n=183)或安慰剂(n=181)。主要终点是一年时的生化复发率。次要终点是 5 年生化复发率以及脂质、睾酮和性激素结合球蛋白水平的变化。

两组的无复发存活率

从2012年10月至2019年1月,共364位患者随机接受了研究干预。共发生了59例主要终点事件,阿托伐他汀组和安慰剂组分别发生了30例(16.4%)和29例(16.0%)。阿托伐他汀并未明显降低一年生化复发的主要终点(HR 0.96, 95% CI 0.58-1.60)。在中位随访24个月内,共131位患者发生了生化复发,阿托伐他汀组和安慰剂组分别有68位(24.0%)和63位(25.4%;HR 1.00, 95% CI 0.71-1.41)。此外,两组间的睾酮和性激素结合球蛋白水平没有明显差异。

总而言之,该研究表明,高危病理型前列腺癌患者在根治性前列腺切除术后辅助使用阿托伐他汀一年并不能降低疾病复发风险

原始出处:

In Gab Jeong, et al. Adjuvant Low-dose Statin Use after Radical Prostatectomy: The PRO-STAT Randomized Clinical Trial. Clin Cancer Res September 15 2021 27 (18) 5004-5011; DOI:10.1158/1078-0432.CCR-21-0480

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