title: Statin use is associated with decreased prostate cancer recurrence in men treated with brachytherapy.
abstract: OBJECTIVE
  Recent in vitro and in vivo evidence has suggested that statin medications may have anticancer activity. We sought to determine whether statin use was associated with improved clinical outcome in men treated with brachytherapy for prostate cancer.
  
  
  METHODS
  A database of men with prostate cancer treated with permanent Iodine-125 brachytherapy between January 1999 and February 2009 was retrospectively analyzed. Standard guidelines (i.e., American Brachytherapy Society selection criteria) were used for selecting patients for brachytherapy. Biochemical failure was defined using the Phoenix definition.
  
  
  RESULTS
  From a total of 247 men with prostate adenocarcinoma treated with brachytherapy, 174 patients (70 %) were identified as using statin medications, either during initial visit or during follow-up. Median PSA follow-up was 51 months after date of implant (range 9.4-140.35). Overall biochemical failure rate was 7.3 % (18 patients). On univariate analysis, statin use was associated with significantly improved freedom from biochemical failure [hazard ratio (HR) 0.28; 95 % CI 0.10-0.72; p < 0.01 by log-rank test]. In multivariate Cox analysis performed with the variables statin use, pretreatment PSA, clinical T stage, Gleason score, and D90 or V100, statin use remained significantly associated with improved freedom from biochemical failure (HR 0.288; 95 % CI 0.086-0.886; p = 0.0299).
  
  
  CONCLUSIONS
  Statin use was associated with a significant improvement in freedom from biochemical failure in this cohort of men treated with brachytherapy for prostate cancer. Further investigation into the favorable effect of statin use on brachytherapy and radiation therapy in general is warranted, including prospective trials.
authors.affiliation: Durham VA Medical Center, Duke University, Durham, NC, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Oh
authors.forename: Bridget
authors.initials: B
authors.lastname: Koontz
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Freedland
authors.forename: Leah
authors.initials: L
authors.lastname: Gerber
authors.forename: Pretesh
authors.initials: P
authors.lastname: Patel
authors.forename: Stephen
authors.initials: S
authors.lastname: Lewis
authors.forename: David S
authors.initials: DS
authors.lastname: Yoo
authors.forename: James
authors.initials: J
authors.lastname: Oleson
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Salama
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017430:Prostate-Specific Antigen