医学
他汀类
普伐他汀
鼻咽癌
内科学
阿托伐他汀
危险系数
冲程(发动机)
比例危险模型
四分位数
肿瘤科
队列
放射治疗
置信区间
胆固醇
工程类
机械工程
作者
Chuan-Yi Lin,Chia‐Lun Chang,Kuan‐Chou Lin,Wan‐Ming Chen,Ben‐Chang Shia,Po‐Hsiu Kuo,Szu‐Yuan Wu
标识
DOI:10.1016/j.radonc.2023.110067
摘要
Abstract
Objective
This cohort study aimed to evaluate the impact of statin use on ischemic stroke risk in patients with advanced nasopharyngeal carcinoma (NPC) undergoing standard concurrent chemoradiotherapy (CCRT). Methods
Using data from the Taiwan Cancer Registry Database, we conducted an inverse probability of treatment-weighted Cox regression analysis to examine the association between statin use during CCRT and ischemic stroke risk. Results
The adjusted hazard ratio (aHR) for ischemic stroke in the statin group compared to the non-statin group was 0.70 (95 % CI: 0.54–0.92; P < 0.0107). This protective effect was observed across different statin classes, with hydrophilic statins such as pravastatin showing an aHR of 0.37 (95 % CI: 0.17–0.85) and lipophilic statins including atorvastatin displaying an aHR of 0.32 (95 % CI: 0.21–0.50) compared to non-statin use. Analysis of cumulative defined daily doses (cDDD) revealed a dose–response relationship, with lower stroke risk observed in higher quartiles of cDDD. Additionally, patients with a daily defined dose (DDD) > 1 had a reduced risk of stroke with an aHR of 0.49 (95 % CI: 0.31–0.63), while those with DDD ≤ 1 showed an aHR of 0.59 (95 % CI: 0.40–0.84). Conclusions
Our study provides evidence supporting the beneficial effects of statin use during the CCRT period in reducing radiation-induced stroke risk among patients with advanced NPC undergoing definitive CCRT. Notably, pravastatin and atorvastatin demonstrated significant reductions in stroke occurrence. Furthermore, the findings suggest a dose–response relationship, where higher cumulative doses and greater daily dose intensity of statin use were associated with a lower risk of stroke.
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