アスピリンの使用と結腸直腸がんの診断後の生存率
Andrew T Chan1, Shuji Ogino, Charles S Fuchs
1Gastrointestinal Unit, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, GRJ 722 Boston, MA 02114, USA. achan@partners.org
JAMA
|August 13, 2009
まとめ
結腸直腸がんの診断後,アスピリンの定期的な使用は,結腸直腸がん特異的および全体的な死亡率を大幅に低下させます. この生存効果は,腫瘍がサイクロオキシゲネーゼ2 (COX-2) を過剰に発現する患者で特に顕著です.
科学分野:
- 腫瘍学 腫瘍学
- 薬理学 薬理学とは
- エピデミオロジー エピデミオロジー
背景:
- アスピリンは,大腸直腸新形成のリスクを低減し,臨床前モデルの腫瘍進行を抑制する効果を示しています.
- しかし,結腸直腸がんの診断後の生存結果に対するその影響は,ほとんど未知のままです.
研究 の 目的:
- 結腸直腸がん患者の診断後のアスピリン使用と生存率との関連を調べる.
- アスピリンの使用が結腸直腸がん特異的な死亡率と全体的な死亡率に影響を与えるかどうかを判断する.
主な方法:
- ステージI-IIIの結腸直腸がんと診断された1279人の患者を対象とした前向きなコホート研究.
- 参加者は2つの全国的な保健医療従事者のコホートから採用され,診断から2008年6月1日まで追跡されました.
- 評価されたアウトカムには,結腸直腸がん特異的および全体的な死亡率が含まれていました.
主要な成果:
- 診断後の定期的なアスピリンの使用は,大腸がん特異的な死亡率 (HR: 0.71) と全死亡率 (HR: 0.79) のリスク低下と関連していました.
- 診断後に開始されたアスピリンの使用は,大腸がん特異的な死亡率の有意な減少を示した (HR: 0.53).
- アスピリンの生存効果は,低COX-2発現の患者と比較して,サイクロオキシゲナーゼ2 (COX-2) (HR:0.39) を過剰に発現する腫瘍を有する患者において,著しく高かった.
結論:
- 診断後のアスピリンの使用は,大腸がん患者の生存率の改善と関連しています.
- この発見は,アスピリンの潜在的な治療的役割,特にCOX-2を過剰に発現する腫瘍を有する患者において顕著である.
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