Statin Use During Concurrent Chemoradiotherapy with Improved Survival Outcomes in Esophageal Squamous Cell Carcinoma: A Propensity Score Matched Nationwide Cohort Study
Menée à Taïwan à partir de données 2012-2018 de l'Assurance maladie et du registre des cancers portant sur 981 patients atteints d'un carcinome épidermoïde de l'oesophage, cette étude analyse l'effet, sur la survie, d'une utilisation de statines pendant la chimioradiothérapie
Résumé en anglais
Objective: To determine the effect of statin use during concurrent chemoradiotherapy (CCRT) on overall survival and esophageal squamous cell carcinoma (ESCC)-specific survival in patients with ESCC receiving standard CCRT.
Methods: In this propensity score matching cohort study, we used data from the Taiwan Cancer Registry Database and National Health Insurance Research Database to investigate the effects of statin use during the period of CCRT on overall survival and ESCC-specific survival.
Results: Statin use during the period of CCRT was found to be a significant and independent prognostic factor for overall survival and ESCC-specific survival. The adjusted hazard ratio for all-cause mortality in the statin group compared to the non-statin group was 0.65 (95% CI, 0.51-0.84; P = 0.0009). The adjusted hazard ratio for ESCC-specific mortality in the statin group compared to the non-statin group was 0.63 (95% CI, 0.47-0.84; P = 0.0016). The use of hydrophilic statins such as rosuvastatin and pravastatin were associated with the greatest survival benefits. A dose-response relationship was also found, with higher cumulative defined daily doses and higher daily intensity of statin use associated with lower mortality.
Conclusions: This study is the first to show that statin use during the period of CCRT for ESCC is associated with improvement in overall survival and ESCC-specific survival. Additionally, we found that use of rosuvastatin, pravastatin, and simvastatin was associated with better survival outcomes for ESCC patients receiving CCRT. Furthermore, we found a dose-response relationship of statin use associated with lower ESCC-specific mortality.
