The Incidence and Risk of Biochemical Recurrence Following Radical Radiotherapy for Prostate Cancer in Men on Angiotensin-Converting Enzyme Inhibitors (ACEIs) or Angiotensin Receptor Blockers (ARBs)

Abduelmenem Alashkham, Catherine Paterson, Phyllis Windsor, Allan Struthers, Petra Rauchhaus, Ghulam Nabi

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are anti-hypertensive medication and have been linked to prostate cancer, but their effect on biochemical recurrence (BR) remains unexplored. The aims of the study were to evaluate the incidence and risk of BR in men receiving ACEIs/ARBs after radical radiotherapy with adjuvant∖neoadjuvant hormone treatment. The administration of ACEIs/ARBs were associated with a reduced risk of BR. Background Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are linked to prostate cancer, but their effect on biochemical recurrence (BR) remains unknown. Our aims were to investigate the incidence and risk of BR in men on ACEIs/ARBs after radical radiotherapy with adjuvant∖neoadjuvant hormone treatment. Material and Methods A propensity score analysis of 558 men was conducted. Men were stratified into 3 groups: hypertensive men on ACEIs/ARBs (as a study group), non-hypertensive men not on ACEIs/ARBs, and hypertensive men not on ACEIs/ARBs (both as a control group). The multivariate analysis of variance, chi-square, Kruskal-Wallis, analysis of variance, risk ratio, confidence interval, Kaplan-Meier plots, and log-rank tests were used. Results The mean age and follow-up were 68.51 and 3.33 years, respectively. There was a statistically significant difference in the prevalence of BR among the treatment groups (P < .001). The incidence of BR was significantly lower in hypertensive men taking ACEIs/ARBs than in non-hypertensive men not taking ACEIs/ARBs (P < .001) or in hypertensive men not taking ACEIs/ARBs (P < .009). The incidence of BR was significantly lower in hypertensive men not taking ACEIs/ARBs than in non-hypertensive men not taking ACEIs/ARBs (P < .013). The risk ratio (RR) of BR in the group of hypertensive men taking ACEIs/ARBs was significantly lower than in the group of non-hypertensive men not taking ACEIs/ARBs (RR, 0.74; 95% CI, 0.64-0.86; P < .001) and in the group of hypertensive men not taking ACEIs/ARBs (RR, 0.78; 95% CI, 0.67-0.91; P < .001). The time-to-event analysis revealed that the group of hypertensive men taking ACEIs/ARBs was significantly different compared with the control groups (P < .031). Conclusion Men who were taking ACEIs/ARBs had significantly lower incidence of BR after radical radiotherapy with hormone treatment. The intake of ACEIs/ARBs was associated with reduced risk of BR.

Original languageEnglish
Pages (from-to)398-405
Number of pages8
JournalClinical Genitourinary Cancer
Volume14
Issue number5
DOIs
Publication statusPublished - 1 Oct 2016
Externally publishedYes

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Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Prostatic Neoplasms
Radiotherapy
Recurrence
Incidence
Odds Ratio
Adjuvant Radiotherapy
Neoadjuvant Therapy
Hormones
Analysis of Variance
Propensity Score
Control Groups

Cite this

@article{d1bcd20b65f54bd1ac1f82ced5306bd0,
title = "The Incidence and Risk of Biochemical Recurrence Following Radical Radiotherapy for Prostate Cancer in Men on Angiotensin-Converting Enzyme Inhibitors (ACEIs) or Angiotensin Receptor Blockers (ARBs)",
abstract = "Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are anti-hypertensive medication and have been linked to prostate cancer, but their effect on biochemical recurrence (BR) remains unexplored. The aims of the study were to evaluate the incidence and risk of BR in men receiving ACEIs/ARBs after radical radiotherapy with adjuvant∖neoadjuvant hormone treatment. The administration of ACEIs/ARBs were associated with a reduced risk of BR. Background Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are linked to prostate cancer, but their effect on biochemical recurrence (BR) remains unknown. Our aims were to investigate the incidence and risk of BR in men on ACEIs/ARBs after radical radiotherapy with adjuvant∖neoadjuvant hormone treatment. Material and Methods A propensity score analysis of 558 men was conducted. Men were stratified into 3 groups: hypertensive men on ACEIs/ARBs (as a study group), non-hypertensive men not on ACEIs/ARBs, and hypertensive men not on ACEIs/ARBs (both as a control group). The multivariate analysis of variance, chi-square, Kruskal-Wallis, analysis of variance, risk ratio, confidence interval, Kaplan-Meier plots, and log-rank tests were used. Results The mean age and follow-up were 68.51 and 3.33 years, respectively. There was a statistically significant difference in the prevalence of BR among the treatment groups (P < .001). The incidence of BR was significantly lower in hypertensive men taking ACEIs/ARBs than in non-hypertensive men not taking ACEIs/ARBs (P < .001) or in hypertensive men not taking ACEIs/ARBs (P < .009). The incidence of BR was significantly lower in hypertensive men not taking ACEIs/ARBs than in non-hypertensive men not taking ACEIs/ARBs (P < .013). The risk ratio (RR) of BR in the group of hypertensive men taking ACEIs/ARBs was significantly lower than in the group of non-hypertensive men not taking ACEIs/ARBs (RR, 0.74; 95{\%} CI, 0.64-0.86; P < .001) and in the group of hypertensive men not taking ACEIs/ARBs (RR, 0.78; 95{\%} CI, 0.67-0.91; P < .001). The time-to-event analysis revealed that the group of hypertensive men taking ACEIs/ARBs was significantly different compared with the control groups (P < .031). Conclusion Men who were taking ACEIs/ARBs had significantly lower incidence of BR after radical radiotherapy with hormone treatment. The intake of ACEIs/ARBs was associated with reduced risk of BR.",
keywords = "Biochemical recurrence, Hormonal therapy, Prostate cancer, Radiotherapy, Renin angiotensin system, Angiotensin-Converting Enzyme Inhibitors/therapeutic use, Humans, Middle Aged, Kaplan-Meier Estimate, Neoplasm Recurrence, Local/epidemiology, Male, Treatment Outcome, Incidence, Prostate-Specific Antigen/metabolism, Propensity Score, Kallikreins/metabolism, Survival Analysis, Aged, 80 and over, Aged, Angiotensin Receptor Antagonists/therapeutic use, Antineoplastic Agents, Hormonal/therapeutic use, Prostatic Neoplasms/metabolism, Hypertension/drug therapy",
author = "Abduelmenem Alashkham and Catherine Paterson and Phyllis Windsor and Allan Struthers and Petra Rauchhaus and Ghulam Nabi",
note = "Copyright {\circledC} 2016 Elsevier Inc. All rights reserved.",
year = "2016",
month = "10",
day = "1",
doi = "10.1016/j.clgc.2016.03.009",
language = "English",
volume = "14",
pages = "398--405",
journal = "Clinical Prostate Cancer",
issn = "1558-7673",
publisher = "Elsevier",
number = "5",

}

The Incidence and Risk of Biochemical Recurrence Following Radical Radiotherapy for Prostate Cancer in Men on Angiotensin-Converting Enzyme Inhibitors (ACEIs) or Angiotensin Receptor Blockers (ARBs). / Alashkham, Abduelmenem; Paterson, Catherine; Windsor, Phyllis; Struthers, Allan; Rauchhaus, Petra; Nabi, Ghulam.

In: Clinical Genitourinary Cancer, Vol. 14, No. 5, 01.10.2016, p. 398-405.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The Incidence and Risk of Biochemical Recurrence Following Radical Radiotherapy for Prostate Cancer in Men on Angiotensin-Converting Enzyme Inhibitors (ACEIs) or Angiotensin Receptor Blockers (ARBs)

AU - Alashkham, Abduelmenem

AU - Paterson, Catherine

AU - Windsor, Phyllis

AU - Struthers, Allan

AU - Rauchhaus, Petra

AU - Nabi, Ghulam

N1 - Copyright © 2016 Elsevier Inc. All rights reserved.

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are anti-hypertensive medication and have been linked to prostate cancer, but their effect on biochemical recurrence (BR) remains unexplored. The aims of the study were to evaluate the incidence and risk of BR in men receiving ACEIs/ARBs after radical radiotherapy with adjuvant∖neoadjuvant hormone treatment. The administration of ACEIs/ARBs were associated with a reduced risk of BR. Background Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are linked to prostate cancer, but their effect on biochemical recurrence (BR) remains unknown. Our aims were to investigate the incidence and risk of BR in men on ACEIs/ARBs after radical radiotherapy with adjuvant∖neoadjuvant hormone treatment. Material and Methods A propensity score analysis of 558 men was conducted. Men were stratified into 3 groups: hypertensive men on ACEIs/ARBs (as a study group), non-hypertensive men not on ACEIs/ARBs, and hypertensive men not on ACEIs/ARBs (both as a control group). The multivariate analysis of variance, chi-square, Kruskal-Wallis, analysis of variance, risk ratio, confidence interval, Kaplan-Meier plots, and log-rank tests were used. Results The mean age and follow-up were 68.51 and 3.33 years, respectively. There was a statistically significant difference in the prevalence of BR among the treatment groups (P < .001). The incidence of BR was significantly lower in hypertensive men taking ACEIs/ARBs than in non-hypertensive men not taking ACEIs/ARBs (P < .001) or in hypertensive men not taking ACEIs/ARBs (P < .009). The incidence of BR was significantly lower in hypertensive men not taking ACEIs/ARBs than in non-hypertensive men not taking ACEIs/ARBs (P < .013). The risk ratio (RR) of BR in the group of hypertensive men taking ACEIs/ARBs was significantly lower than in the group of non-hypertensive men not taking ACEIs/ARBs (RR, 0.74; 95% CI, 0.64-0.86; P < .001) and in the group of hypertensive men not taking ACEIs/ARBs (RR, 0.78; 95% CI, 0.67-0.91; P < .001). The time-to-event analysis revealed that the group of hypertensive men taking ACEIs/ARBs was significantly different compared with the control groups (P < .031). Conclusion Men who were taking ACEIs/ARBs had significantly lower incidence of BR after radical radiotherapy with hormone treatment. The intake of ACEIs/ARBs was associated with reduced risk of BR.

AB - Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are anti-hypertensive medication and have been linked to prostate cancer, but their effect on biochemical recurrence (BR) remains unexplored. The aims of the study were to evaluate the incidence and risk of BR in men receiving ACEIs/ARBs after radical radiotherapy with adjuvant∖neoadjuvant hormone treatment. The administration of ACEIs/ARBs were associated with a reduced risk of BR. Background Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are linked to prostate cancer, but their effect on biochemical recurrence (BR) remains unknown. Our aims were to investigate the incidence and risk of BR in men on ACEIs/ARBs after radical radiotherapy with adjuvant∖neoadjuvant hormone treatment. Material and Methods A propensity score analysis of 558 men was conducted. Men were stratified into 3 groups: hypertensive men on ACEIs/ARBs (as a study group), non-hypertensive men not on ACEIs/ARBs, and hypertensive men not on ACEIs/ARBs (both as a control group). The multivariate analysis of variance, chi-square, Kruskal-Wallis, analysis of variance, risk ratio, confidence interval, Kaplan-Meier plots, and log-rank tests were used. Results The mean age and follow-up were 68.51 and 3.33 years, respectively. There was a statistically significant difference in the prevalence of BR among the treatment groups (P < .001). The incidence of BR was significantly lower in hypertensive men taking ACEIs/ARBs than in non-hypertensive men not taking ACEIs/ARBs (P < .001) or in hypertensive men not taking ACEIs/ARBs (P < .009). The incidence of BR was significantly lower in hypertensive men not taking ACEIs/ARBs than in non-hypertensive men not taking ACEIs/ARBs (P < .013). The risk ratio (RR) of BR in the group of hypertensive men taking ACEIs/ARBs was significantly lower than in the group of non-hypertensive men not taking ACEIs/ARBs (RR, 0.74; 95% CI, 0.64-0.86; P < .001) and in the group of hypertensive men not taking ACEIs/ARBs (RR, 0.78; 95% CI, 0.67-0.91; P < .001). The time-to-event analysis revealed that the group of hypertensive men taking ACEIs/ARBs was significantly different compared with the control groups (P < .031). Conclusion Men who were taking ACEIs/ARBs had significantly lower incidence of BR after radical radiotherapy with hormone treatment. The intake of ACEIs/ARBs was associated with reduced risk of BR.

KW - Biochemical recurrence

KW - Hormonal therapy

KW - Prostate cancer

KW - Radiotherapy

KW - Renin angiotensin system

KW - Angiotensin-Converting Enzyme Inhibitors/therapeutic use

KW - Humans

KW - Middle Aged

KW - Kaplan-Meier Estimate

KW - Neoplasm Recurrence, Local/epidemiology

KW - Male

KW - Treatment Outcome

KW - Incidence

KW - Prostate-Specific Antigen/metabolism

KW - Propensity Score

KW - Kallikreins/metabolism

KW - Survival Analysis

KW - Aged, 80 and over

KW - Aged

KW - Angiotensin Receptor Antagonists/therapeutic use

KW - Antineoplastic Agents, Hormonal/therapeutic use

KW - Prostatic Neoplasms/metabolism

KW - Hypertension/drug therapy

UR - http://www.scopus.com/inward/record.url?scp=84961879934&partnerID=8YFLogxK

UR - http://www.mendeley.com/research/incidence-risk-biochemical-recurrence-following-radical-radiotherapy-prostate-cancer-men-angiotensin

U2 - 10.1016/j.clgc.2016.03.009

DO - 10.1016/j.clgc.2016.03.009

M3 - Article

VL - 14

SP - 398

EP - 405

JO - Clinical Prostate Cancer

JF - Clinical Prostate Cancer

SN - 1558-7673

IS - 5

ER -