Statin use reduces radiation-induced stroke risk in advanced nasopharyngeal carcinoma patients

Chuan Yi Lin, Chia Lun Chang, Kuan Chou Lin, Wan Ming Chen, Ben Chang Shia, Po Hsiu Kuo, Szu Yuan Wu

研究成果: 雜誌貢獻文章同行評審


Objective: This cohort study aimed to evaluate the impact of statin use on ischemic stroke risk in patients with advanced nasopharyngeal carcinoma (NPC) undergoing standard concurrent chemoradiotherapy (CCRT). Methods: Using data from the Taiwan Cancer Registry Database, we conducted an inverse probability of treatment-weighted Cox regression analysis to examine the association between statin use during CCRT and ischemic stroke risk. Results: The adjusted hazard ratio (aHR) for ischemic stroke in the statin group compared to the non-statin group was 0.70 (95 % CI: 0.54–0.92; P < 0.0107). This protective effect was observed across different statin classes, with hydrophilic statins such as pravastatin showing an aHR of 0.37 (95 % CI: 0.17–0.85) and lipophilic statins including atorvastatin displaying an aHR of 0.32 (95 % CI: 0.21–0.50) compared to non-statin use. Analysis of cumulative defined daily doses (cDDD) revealed a dose–response relationship, with lower stroke risk observed in higher quartiles of cDDD. Additionally, patients with a daily defined dose (DDD) > 1 had a reduced risk of stroke with an aHR of 0.49 (95 % CI: 0.31–0.63), while those with DDD ≤ 1 showed an aHR of 0.59 (95 % CI: 0.40–0.84). Conclusions: Our study provides evidence supporting the beneficial effects of statin use during the CCRT period in reducing radiation-induced stroke risk among patients with advanced NPC undergoing definitive CCRT. Notably, pravastatin and atorvastatin demonstrated significant reductions in stroke occurrence. Furthermore, the findings suggest a dose–response relationship, where higher cumulative doses and greater daily dose intensity of statin use were associated with a lower risk of stroke.
期刊Radiotherapy and Oncology
出版狀態已發佈 - 2月 2024

ASJC Scopus subject areas

  • 血液學
  • 腫瘤科
  • 放射學、核子醫學和影像學


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