OncologyNo Effect of Statins on Biochemical Outcomes After Radiotherapy for Localized Prostate Cancer
Section snippets
Patient Selection
With institutional review board approval, we retrospectively reviewed the medical records of patients with localized prostate cancer who were treated with three-dimensional conformal radiotherapy (RT) or intensity-modulated RT with curative intent at the University of Michigan Cancer Center from January 1987 to July 2006. The required data for inclusion in this study included documentation of T stage, initial prostate-specific antigen (iPSA) level, Gleason score, and medication use before the
Patient Characteristics
We identified 968 patients who met our inclusion criteria. The median patient age was 68 years; 91% were white. The median iPSA level was 7.9 ng/mL, and 57% of patients had a Gleason score of 7 or greater. ADT was used in 29% of the patients. Overall, 42% and 30% were intermediate and high-risk patients, respectively. The clinical and treatment characteristics for the cohort are listed in Table 1. Of the 968 patients, 220 (23%) were taking a statin during RT. The statins used included
Comment
In 1987 the Food and Drug Administration approved the first agent from the drug class of HMG-CoA reductase inhibitors, commonly known as statins, for use as a treatment of hypercholesteremia. These agents have since been widely adopted for use because of their benefits against vascular disease. Drugs in this class include lovastatin, simvastatin, pravastatin, pitavastatin, fluvastatin, atorvastatin, and cerivastatin. The last of these, also known as Baycol, was removed from the market during
Conclusions
In this single-institution cohort, we observed no effect of statin use on PSA failure. Excluding hydrophilic pravastatin from the analysis resulted in the same conclusion. Given the interest in improving cancer outcomes with the use of systemic radiosensitizers and the in vitro data supporting statin use, future research could focus on studies using specific classes of statin agents, larger sample sizes, more intermediate/high-risk patients, longer follow-up, and, if possible, prospectively
Acknowledgment
To Steven Kronenberg for assistance with the generation of figures.
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Linking CHHiP prostate cancer RCT with GP records: A study proposal to investigate the effect of co-morbidities and medications on long-term symptoms and radiotherapy-related toxicity
2017, Technical Innovations and Patient Support in Radiation OncologyStatin use not associated with improved outcomes in patients treated with brachytherapy for prostate cancer
2015, BrachytherapyCitation Excerpt :Associations between statin use and a decreased risk of advanced prostate cancer (3) have been described. Although some series have shown a decreased risk of biochemical failure after radical prostatectomy (4) and radiation therapy (RT) (5–7) with statin use, others have shown no significant benefit (8, 9). To further investigate the effect of statin therapy on brachytherapy for prostate cancer, we examined the association between statin use and biochemical and clinical outcomes in intermediate- and high-risk patients treated with brachytherapy-based regimens for prostate cancer.
Statin therapy is not associated with prostate cancer recurrence among patients who underwent radiation therapy
2013, Cancer LettersCitation Excerpt :Given the anti-inflammatory and other anti-cancer properties of statins, we hypothesized that use of statins may reduce the rate of prostate cancer recurrence in patients treated with radiation therapy. To date, several studies have examined the associations between statin use and risk of recurrence and/or survival after radiation therapy or brachytherapy [18–22]. However, these studies report conflicting results.
How can i help myself? A critical review of modifiable behaviors, medications, and complementary alternative medicine for men receiving radiotherapy for prostate cancer
2013, Seminars in Radiation OncologyCitation Excerpt :Among 691 men treated definitively with external radiotherapy, brachytherapy, or both at the University of Chicago, men who used statins at the time of consultation or during follow-up had improved freedom from biochemical failure (HR: 0.43; 95% CI: 0.25-0.73; P = 0.002), regardless of their initial risk group, statin dose (<40 mg, ≥40 mg simvastatin equivalents), or timing of statin use (before radiotherapy vs after radiotherapy).24 Given that statin users tend to present with more favorable disease characteristics,24-26 it is unclear whether reduced biochemical recurrence reflects an imbalanced distribution of adverse prognostic factors versus a true therapeutic benefit of statins on prostate cancer progression. However, in studies from both Memorial Sloan-Kettering Cancer Center and University of Chicago, statin use remained an independent predictor after adjusting for pathologic characteristics.24,25
Effect of bisphosphonates and statins on the in vitro radiosensitivity of breast cancer cell lines
2024, Pharmacological Reports