2083 - Beta-Adrenergic Receptor Blockers and Survival in Patients with Advanced Non-Small Cell Lung Cancer Combined with Hypertension Undergoing Radiotherapy

X. Liang^1,2, Y. Mo³, and D. Chen⁴; ¹Shandong Second Medical University, Weifang, Shandong, China, ²Shandong Cancer Hospital and Institute, Jinan, Shandong, China, ³Department of Radiation Oncology and Shandong Provincial Key Laboratory of Radiation Oncology, Shandong First Medical University and Shandong Academy of Medical Sciences,, Jinan, Shandong, China, ⁴Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China

Purpose/Objective(s): Epidemiological investigations indicate a progressive rise in the incidence of lung cancer patients concurrently afflicted with hypertension (HTN). This subset of patients frequently necessitates prolonged administration of antihypertensive pharmacotherapy. Simultaneously, ß-adrenergic blockers, being a category of antihypertensive medications, have been demonstrated in studies to mitigate the recurrence and metastasis of tumors. Hence, within this investigation, we delved deeper into the impact of ß-adrenergic blockers on the survival outcomes of individuals diagnosed with non-small cell lung cancer (NSCLC) undergoing radiotherapy (RT) for HTN conditions. Materials/

Methods: This retrospective study analyzed individuals diagnosed with advanced NSCLC and HTN who underwent RT within a single-center cohort in China. The study documented the fundamental characteristics of the patients and employed Chi-square tests to discern variances between the two groups. Survival analysis, alongside univariate and multivariate Cox regression risk models, was utilized to examine the association between the utilization of ß-adrenergic blockers and both overall survival (OS) and progression-free survival (PFS). Additionally, the NHANES database was employed to scrutinize the impact of ß-adrenergic receptor blockers on the OS within the tumor population.
Results: In a single-center study of 750 patients in China, ß-adrenergic blockers were associated with improved OS (ß-adrenergic blockers: median overall survival (mOS) 17.64 months, no ß-adrenergic blockers: mOS 13.16 months; p<0.0001) and PFS (ß-adrenergic blockers: median progression-free survival (mPFS) 7.50 months, no ß-adrenergic blockers: mPFS 4.91 months; p<0.0001).Cox regression analysis, the hazard ratio (HR) for OS (ß-adrenergic blockers vs no ß-adrenergic blockers) was 0.71, with a 95% confidence interval [CI] of 0.33-0.91 and a significance level of p=0.01. The HR for PFS (ß-blocker versus no ß-blocker) was 0.64, with a 95% confidence interval [CI] of 0.39-0.96 and a significance level of p=0.03. Simultaneously, a total of 568 patients were encompassed in the NHANES database. The utilization of ß-adrenergic receptor blockers exhibited no discernible impact on OS within the entire tumor population, as evidenced by the Kaplan-Meier curve, which revealed no statistically significant difference between the two groups (p=0.254). In multifactorial Cox regression risk models, the use of ß-blockers did not emerge as an independent risk factor for the overall tumor population (p=0.78).
Conclusion: ß-adrenergic receptor blockers have been recognized as agents that enhance both OS and PFS in individuals with HTN and NSCLC undergoing RT. Nevertheless, it is essential to underscore that these blockers did not exhibit a notable impact on the overall population of tumor patients. These findings further underscore the significance of beta blockers within the context of RT.