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 - Publisher Copyright:
© 2016 Elsevier Inc.
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
C2 - 27053500
AN - SCOPUS:84961879934
SN - 1558-7673
VL - 14
SP - 398
EP - 405
JO - Clinical Genitourinary Cancer
JF - Clinical Genitourinary Cancer
IS - 5
ER -