他汀类药物对鼻咽癌长期生存者死亡率的影响：一项在流行区开展的基于人群的研究
Effect of statins on the mortality of long-term survivors of nasopharyngeal carcinoma: a population-based study in endemic area.
文献信息
| PMID | 42861289 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ru-Yu Xu |
| 作者单位 | Department of Clinical Oncology, University of Hong Kong, Hong Kong Special Administrative Region, China. |
| 期刊 | The Lancet regional health. Western Pacific |
| SCI 分区 | Q1 |
| IF | 8.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻咽癌 |
中文摘要
背景： 鼻咽癌（NPC）长期生存者面临超额死亡风险。本项全地区队列研究旨在探讨他汀类药物使用与NPC 5年生存者死亡率之间的关系。
方法： 这是一项利用全地区登记数据库数据开展的回顾性队列研究。纳入1997年1月1日至2015年12月30日期间在香港被诊断为非转移性NPC后存活五年的患者。患者被分为他汀类药物使用者和非使用者。我们采用逆倾向治疗加权（IPTW）方法以平衡混杂因素。比较两组的主要结局总生存期（OS），并按死因、他汀类药物类型和他汀类药物使用时长进行分层分析。
结果： 最终分析纳入7872名受试者（2439名他汀类药物使用者与5433名非使用者）。他汀类药物使用者与非使用者的10年、15年和20年生存概率分别为89.1%对71.8%、77.2%对55.1%、59.2%对42.4%（HR 0.46，p < 0.001）。在调整永生时间偏倚后，总生存期的风险比为0.71（p < 0.001）。他汀类药物使用与继发性恶性肿瘤（HR 0.51；p = 0.002）、心血管疾病（HR 0.64；p = 0.002）和肺部疾病（HR 0.64；p = 0.011）所致死亡风险降低相关。长期使用他汀类药物超过6年的患者死亡率显著更低（HR 0.31；p < 0.001）。在探索性分析中，接受第二代或第三代他汀类药物的患者死亡风险更低（分别为HR 0.66和HR 0.41），尽管这一发现尚需进一步验证。
结论： 我们的研究提示，他汀类药物使用与NPC长期生存者死亡率降低相关。有必要开展进一步的前瞻性研究。
资助： 本研究未获得公共、商业或非营利部门任何资助机构的专项资助。
英文摘要
BACKGROUND: Long-term survivors of nasopharyngeal cancer (NPC) are at risk of excessive mortality. This territory-wide cohort study aims to investigate the relationship between statin use and mortality among 5-year survivors of NPC.
METHODS: This is a retrospective cohort study conducted with data from a territory-wide registry. Patients who survived five years after being diagnosed with non-metastatic NPC in Hong Kong between 1 January 1997 and 30 December 2015 were included. Patients were divided into statin users and statin non-users. We performed the inverse propensity of treatment weighting (IPTW) method to balance confounding factors. The primary outcome of overall survival (OS) was compared between the two groups and stratified by the cause of death, statin types and duration of statin usage.
FINDINGS: 7872 subjects (2439 statin users and 5433 statin non-users) were included in the final analysis. The 10-year, 15-year, and 20-year survival probabilities of statin users compared to non-users were 89.1 vs. 71.8%, 77.2 vs. 55.1%, and 59.2 vs. 42.4% respectively (HR 0.46, p < 0.001). After adjusting for immortal time bias, the hazard ratio for overall survival was 0.71 (p < 0.001). Statin use was associated with reduced risk of death due to secondary malignancy (HR 0.51; p = 0.002), cardiovascular disease (HR 0.64; p = 0.002), and pulmonary disease (HR 0.64; p = 0.011). Mortality was significantly lower in long-term statin usage of >6 years (HR 0.31; p < 0.001). In exploratory analyses, patients who received second- or third-generation statins were associated with a lower risk of mortality (HR 0.66 and HR 0.41, respectively), although this finding requires further validation.
INTERPRETATION: Our study suggests that statin usage is associated with reduced mortality in long-term NPC survivors. Further prospective study is warranted.
FUNDING: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.