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首页> 外文期刊>Kaohsiung Journal of Medical Sciences >Role of cyclooxygenase-2 inhibitors in the survival outcome of colorectal cancer patients: A?population-based cohort study
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Role of cyclooxygenase-2 inhibitors in the survival outcome of colorectal cancer patients: A?population-based cohort study

机译：环氧合酶-2抑制剂在大肠癌患者生存结局中的作用：一项基于人群的队列研究

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The aim of this study is to investigate whether use of cyclooxygenase-2 (COX-2) inhibitors as auxiliary drug in colorectal cancer (CRC) patients will lead to better survival outcome. This population-based retrospective cohort study was conducted using the Taiwan National Health Insurance Research Database. The cohort consisted of newly diagnosed CRC adult patients during 2003–2010 with at least one prescription of nonsteroidal anti-inflammation drugs. Analysis groups were defined as users or nonusers of COX-2 inhibitors based on their usage prior to or 1 year after diagnosis of CRC. The outcome measurement was overall survival. The application of propensity scores through the inverse probability of treatment weighting (IPTW) was applied to the study groups. Subgroup analyses included stratification of different cancer site, treatment modalities, and first chemotherapy regimens. Kaplan–Meier estimates and Cox regressions were used to compare survival outcome. We identified 14,688 patients with newly diagnosed CRC. The adjusted hazard ratio (HR) with IPTW was 0.91 [95% confidence interval (CI), 0.86–0.96] in patients using COX-2 inhibitors in before and after diagnosis groups, and statistical significance was not reached for usages at only prior to or only after diagnosis. In subgroup analyses, patients with rectal cancer (adjusted HR with IPTW = 0.86; 95% CI, 0.79–0.94) who received surgery followed by chemoradiation (adjusted HR with IPTW = 0.57; 95% CI, 0.47–0.77) and with adjuvant chemotherapy of FOLFOX regimen (adjusted HR with IPTW = 0.81; 95% CI, 0.67–0.99) had survival benefits in using COX-2 inhibitors both prior to and after diagnosis. Use of COX-2 inhibitors was found to be associated with reduction in mortality for CRC patients when taken both prior to and after cancer diagnosis.
机译：这项研究的目的是调查在大肠癌（CRC）患者中使用环氧合酶2（COX-2）抑制剂作为辅助药物是否会导致更好的生存结果。这项基于人群的回顾性队列研究是使用台湾国家健康保险研究数据库进行的。该队列由2003-2010年期间新诊断的CRC成年患者组成，他们至少具有一种非甾体类抗炎药处方。根据诊断CRC之前或之后使用COX-2抑制剂，将分析组定义为使用或不使用COX-2抑制剂。结果测量是总体生存率。通过治疗加权权重的倒数概率（IPTW）的倾向得分的应用应用于研究组。亚组分析包括不同癌症部位的分层，治疗方式和首次化疗方案。 Kaplan–Meier估计和Cox回归用于比较生存结果。我们确定了14,688例新诊断为CRC的患者。在诊断前和诊断后使用COX-2抑制剂的患者，IPTW调整后的危险比（HR）为0.91 [95％置信区间（CI），0.86-0.96]，并且仅在使用前，未达到统计学显着性或仅在诊断后。在亚组分析中，接受直肠癌手术（经校正后的HR，IPTW = 0.86; 95％CI，0.79–0.94），并接受了化学放射治疗（经校正后的HR，IPTW = 0.57; 95％CI，0.47–0.77）和辅助化疗的患者FOLFOX方案（校正后的HR，IPTW = 0.81; 95％CI，0.67–0.99）在诊断前后使用COX-2抑制剂具有生存获益。发现在癌症诊断之前和之后服用COX-2抑制剂可降低CRC患者的死亡率。

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