Laboratory and clinical data suggest that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, or statins, may have anticancer activity. We investigated whether the concurrent use of statins with radiation therapy for prostate cancer had any effect on clinical outcomes, such as biochemical, local, and distant control.
Materials/Methods
We retrospectively studied 871 men with clinical stage T1-3 prostate adenocarcinoma treated between January 1995 and July 2000 with radiotherapy to a median dose of 81 Gy (range: 75.6–86.4 Gy). Statin use was evaluated with known tumor-related and treatment-related predictors of clinical outcomes after radiotherapy. A total of 168 patients (19%) were on a statin at the time of diagnosis, and no patient discontinued its use during radiotherapy. PSA relapse was defined according to the nadir + 2 definition. The median follow-up time for this cohort was 85 months after radiotherapy.
Results
The 5 and 10 year PSA relapse free survival for those patients on a statin were 91% and 76%, respectively compared to 81% and 66%, respectively, for those not on a statin (p = 0.01). Additionally, there was a trend toward lower incidence of distant metastases for those men on a statin (p = 0.06). Cox-regression analysis revealed that Gleason score <7 (p < 0.001–hazard ratio (HR) 2.01), clinical stage T1-T2 (p < 0.001–HR 2.41), and statin use (p = 0.03–HR 1.58) were associated with improved PSA relapse free survival outcomes following radiotherapy.
Conclusions
Statin use was associated with a significant improvement in PSA relapse-free survival after high dose radiotherapy, and a trend towards reduced distant metastases. Prospective randomized clinical trials are warranted to determine whether statin use offers any clinical benefit to men undergoing radiation therapy for prostate cancer.
1Memorial Sloan-Kettering Cancer Center, New York, NY
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