INTRODUCTION: 3-Hydroxy-methylglutaryl coenzyme-a reductase inhibitors (statins) improve survival following pelvic irradiation for cancer. Large studies suggest that patients with hypertension may have reduced gastrointestinal (GI) toxicity. Animal data suggest that statins and ACE inhibitors (ACEi) may protect against normal tissue injury. Their efficacy in humans has not been reported. AIMS/ METHODS: To evaluate the impact of statins and ACEi on normal tissue toxicity during radical pelvic radiotherapy. GI symptomatology was recorded prospectively before radiotherapy, weekly during treatment and 1 year later using the inflammatory bowel disease questionnaire-bowel (IBDQ-B) subset. Cumulative acute toxicity (IBDQ-B AUC) and worst score were determined. Dose, brand and duration of statin and/or ACEi usage were obtained from General Practitioners. RESULTS: Of 308 patients recruited, 237 had evaluable acute drug and toxicity data and 164 had data at 1year. Acutely, 38 patients (16%) were taking statins, 39 patients (16.5%) were taking ACEi and 18 patients (7.6%) were taking statin+ACEi. Mean changes in acute scores were 7.3 points (non-statin users), 7.3 (non-ACEi users) and 7.0 (non-statin+ACEi users) compared to 4.8 points (statin users), 5.0 points (ACEi users) and 4.9 points (statin+ACEi users). Statin use (p=0.04) and combined statin+ACEi use (p=0.008) were associated with reduced acute IBDQ-B AUC after controlling for baseline scores (ANOVA). At 1 year, users maintained higher IBDQ-B scores than non-users in all user subgroups. CONCLUSION: Use of statin or statin+ACEi medication during radical pelvic radiotherapy significantly reduces acute gastrointestinal symptoms scores and also appears to provide longer-term sustained protection.
INTRODUCTION: 3-Hydroxy-methylglutaryl coenzyme-a reductase inhibitors (statins) improve survival following pelvic irradiation for cancer. Large studies suggest that patients with hypertension may have reduced gastrointestinal (GI) toxicity. Animal data suggest that statins and ACE inhibitors (ACEi) may protect against normal tissue injury. Their efficacy in humans has not been reported. AIMS/ METHODS: To evaluate the impact of statins and ACEi on normal tissue toxicity during radical pelvic radiotherapy. GI symptomatology was recorded prospectively before radiotherapy, weekly during treatment and 1 year later using the inflammatory bowel disease questionnaire-bowel (IBDQ-B) subset. Cumulative acute toxicity (IBDQ-B AUC) and worst score were determined. Dose, brand and duration of statin and/or ACEi usage were obtained from General Practitioners. RESULTS: Of 308 patients recruited, 237 had evaluable acute drug and toxicity data and 164 had data at 1year. Acutely, 38 patients (16%) were taking statins, 39 patients (16.5%) were taking ACEi and 18 patients (7.6%) were taking statin+ACEi. Mean changes in acute scores were 7.3 points (non-statin users), 7.3 (non-ACEi users) and 7.0 (non-statin+ACEi users) compared to 4.8 points (statin users), 5.0 points (ACEi users) and 4.9 points (statin+ACEi users). Statin use (p=0.04) and combined statin+ACEi use (p=0.008) were associated with reduced acute IBDQ-B AUC after controlling for baseline scores (ANOVA). At 1 year, users maintained higher IBDQ-B scores than non-users in all user subgroups. CONCLUSION: Use of statin or statin+ACEi medication during radical pelvic radiotherapy significantly reduces acute gastrointestinal symptoms scores and also appears to provide longer-term sustained protection.
Authors: Mitchell S Anscher; Michael G Chang; Drew Moghanaki; Mihaela Rosu; Ross B Mikkelsen; Diane Holdford; Vicki Skinner; Baruch M Grob; Arun Sanyal; Aiping Wang; Nitai D Mukhopadhyay Journal: Am J Clin Oncol Date: 2018-06 Impact factor: 2.339
Authors: Elena V Efimova; Natalia Ricco; Edwardine Labay; Helena J Mauceri; Amy C Flor; Aishwarya Ramamurthy; Harold G Sutton; Ralph R Weichselbaum; Stephen J Kron Journal: Mol Cancer Ther Date: 2017-10-13 Impact factor: 6.261
Authors: Sarah L Kerns; Ashley Amidon Morlang; Sharon M Lee; Derick R Peterson; Brian Marples; Hong Zhang; Kevin Bylund; Doug Rosenzweig; William Hall; Kim De Ruyck; Barry S Rosenstein; Richard G Stock; Antonio Gómez-Caamaño; Ana Vega; Paloma Sosa-Fajardo; Begoña Taboada-Valladares; Miguel E Aguado-Barrera; Chris Parker; Liv Veldeman; Valérie Fonteyne; Renée Bultijnck; Christopher J Talbot; R Paul Symonds; Kerstie Johnson; Tim Rattay; Adam Webb; Maarten Lambrecht; Dirk de Ruysscher; Ben Vanneste; Ananya Choudhury; Rebecca M Elliott; Elena Sperk; Carsten Herskind; Marlon R Veldwijk; Tiziana Rancati; Barbara Avuzzi; Riccardo Valdagni; David Azria; Marie-Pierre Farcy Jacquet; Jenny Chang-Claude; Petra Seibold; Catharine West; Michelle Janelsins; Yuhchyau Chen; Edward Messing; Gary Morrow Journal: Radiother Oncol Date: 2022-01-22 Impact factor: 6.280
Authors: Hongmei Wang; Zhongxing Liao; Yan Zhuang; Ting Xu; Quynh-Nhu Nguyen; Lawrence B Levy; Michael O'Reilly; Kathryn A Gold; Daniel R Gomez Journal: Int J Radiat Oncol Biol Phys Date: 2013-10-22 Impact factor: 7.038