诊断后多维生素补充剂使用和结直肠癌存活率:一项前性队列研究
Ming-Ming He1,2, Kai Wang2, Chun-Han Lo2,3,4
1Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Cancer
|February 6, 2024
概括
在结直肠癌诊断后适度使用复合维生素可能会改善存活率. 然而,高剂量与死亡率的增加有关,这表明对结直肠癌的结果有剂量依赖的影响.
科学领域:
- 在瘤学瘤学.
- 营养流行病学 营养流行病学
- 预防医学 预防医学
背景情况:
- 多种维生素补充剂的使用与减少结直肠癌 (CRC) 发病率有关.
- 复合维生素对CRC存活率的影响仍在调查中.
研究的目的:
- 调查诊断后多维生素补充剂使用与I-III期结直肠癌患者的死亡率之间的关联.
- 为了确定多维生素使用和生存结果之间的剂量反应关系.
主要方法:
- 从护士健康研究和卫生专业人员随访研究中分析了2424名患有I-III期CRC的患者.
- 基于诊断后的多种维生素使用和剂量,计算了所有原因和CRC特定死亡率的多变量危险比率 (HRs).
- 随访时间中位数为11年,共有1512例死亡记录,其中包括343例CRC特异性死亡.
主要成果:
- 诊断后使用多种维生素 (每周3-5片) 与CRC特异性死亡率减少45%有关 (HR,0.55;95% CI,0.36-0.83).
- 适度多维生素使用 (每周3-9片) 与较低的全因死亡率相关 (HR,0.81-0.79).
- 观察到剂量反应关系,最大益处为每周3-5片;较高剂量 (每周≥10片) 和停止使用与死亡风险增加有关.
结论:
- 中度的诊断后多维生素使用 (每周3-5片) 与非转移性结直肠癌患者的生存率改善有关.
- 在CRC诊断后使用高剂量的多种维生素 (≥10片/周) 可能会增加死亡风险.
- 对结直肠癌患者的最佳多维生素剂量似乎是适度的,较高剂量没有额外的生存益处.
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