The Incidence and Risk of Biochemical Recurrence Following Radical Radiotherapy for Prostate Cancer in Men on Angiotensin-Converting Enzyme Inhibitors (ACEIs) or Angiotensin Receptor Blockers (ARBs)

Abduelmenem Alashkham, Catherine Paterson, Phyllis Windsor, Allan Struthers, Petra Rauchhaus, Ghulam Nabi

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Background

Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are linked to prostate cancer, but their effect on biochemical recurrence (BR) remains unknown. Our aims were to investigate the incidence and risk of BR in men on ACEIs/ARBs after radical radiotherapy with
adjuvant∖neoadjuvant hormone treatment.

Material and Methods

A propensity score analysis of 558 men was conducted. Men were stratified
into 3 groups: hypertensive men on ACEIs/ARBs (as a study group),
non-hypertensive men not on ACEIs/ARBs, and hypertensive men not on
ACEIs/ARBs (both as a control group). The multivariate analysis of variance,
chi-square, Kruskal-Wallis, analysis of variance, risk ratio, confidence interval, Kaplan-Meier plots, and log-rank tests were used.

Results

The mean age and follow-up were 68.51 and 3.33 years, respectively. There
was a statistically significant difference in the prevalence of BR among
the treatment groups (P < .001). The incidence of BR was
significantly lower in hypertensive men taking ACEIs/ARBs than in
non-hypertensive men not taking ACEIs/ARBs (P < .001) or in hypertensive men not taking ACEIs/ARBs (P < .009). The incidence of BR was significantly lower in hypertensive men not taking ACEIs/ARBs than in non-hypertensive men not taking ACEIs/ARBs (P < .013). The risk ratio (RR) of BR in the group of
hypertensive men taking ACEIs/ARBs was significantly lower than in the
group of non-hypertensive men not taking ACEIs/ARBs (RR, 0.74; 95% CI,
0.64-0.86; P < .001) and in the group of hypertensive men not taking ACEIs/ARBs (RR, 0.78; 95% CI, 0.67-0.91; P < .001). The time-to-event analysis revealed that the group of hypertensive men taking ACEIs/ARBs was significantly different compared with the control groups (P < .031).

Conclusion

Men who were taking ACEIs/ARBs had significantly lower incidence of BR
after radical radiotherapy with hormone treatment. The intake of ACEIs/ARBs was associated with reduced risk of BR.
Original languageEnglish
Pages (from-to)398-405
Number of pages8
JournalClinical Genitourinary Cancer
Volume14
Issue number5
DOIs
Publication statusPublished - Oct 2016
Externally publishedYes

Keywords

  • Biochemical recurrence
  • Hormonal therapy
  • Prostate cancer
  • Radiotherapy
  • Renin angiotensin system

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