Statin Use During Concurrent Chemoradiotherapy for Advanced Nasopharyngeal Cancer

BACKGROUND: The objective of this study was to assess the impact of statin use on overall survival (OS) and nasopharyngeal cancer (NPC)-specific survival in patients with advanced NPC who underwent standard concurrent chemoradiotherapy (CCRT). PATIENTS AND METHODS: This propensity score matched cohort study used data from the Taiwan Cancer Registry Database and National Health Insurance Research Database to examine the impact of statin use during CCRT on both OS and NPC-specific survival. RESULTS: Statin use during CCRT demonstrated significant and independent prognostic value for both OS and NPC-specific survival. The adjusted hazard ratio for all-cause mortality in the statin group compared with the nonstatin group was 0.48 (95% CI, 0.34-0.68; P<.0001). Similarly, the adjusted hazard ratio for NPC-specific mortality in the statin group compared with the nonstatin group was 0.43 (95% CI, 0.29-0.65; P<.0001). Rosuvastatin, atorvastatin, and lovastatin demonstrated significant efficacy in improving NPC-specific survival outcomes. Moreover, our findings indicate a dose-response relationship, with higher cumulative defined daily doses and greater daily intensity of statin use associated with reduced mortality. CONCLUSIONS: This study suggests an association between statin use during the CCRT period for NPC and potential enhancements in both OS and NPC-specific survival. Our findings indicate a possible survival benefit of rosuvastatin, atorvastatin, and lovastatin for patients with NPC undergoing CCRT. The observed dose-response relationship underscores the potential importance of higher statin use in mitigating NPC-specific mortality, but further research is needed to establish a definitive causal relationship.