Analysis of the correlation among hypertension, the intake of β-blockers, and overall survival outcome in patients undergoing chemoradiotherapy with inoperable stage III non-small cell lung cancer

It is known that hypertension could increase the plasma levels of VEGF and that ß-blockers propranolol could counteract the effect. Our aim was to explore the possibility of improving survival outcomes for patients with and patients without hypertension. In addition, we also compared the efficacy of the usage of β-blockers in inoperable non-small cell lung cancer (NSCLC) patients. We retrospectively reviewed 1753 NSCLC patients who underwent concurrence/sequential chemoradiotherapy in our hospital from 1994 to 2005. A total of 606 inoperable patients with stage III were enrolled in this study. Fifty-five patients survived until the follow-up date of May 2011. From the 606 patients, 123 of them had hypertension. We identified 11 of them who took β-blockers orally. Kaplan-Meier methods and Cox proportional hazard model were utilized to analyze the overall survival (OS) outcome among patients with hypertension and patients without hypertension. After that, we compared the patients who took β-blockers with patients who did not take β-blockers in the whole stage III cohort using the same approaches. The Kaplan-Meier analysis revealed that there were no significant survival outcomes between hypertension and non-hypertention groups (P>0.05). No significant difference was found between using β-blockers and not using them in the hypertention group (P>0.05). We also found no statistical significance between using β-blockers and not using them in the whole cohort of 606 NSCLC patients (P>0.05). The results from both univariate or multivariate analysis using the Cox proportional hazards regression model indicated that there was no statistical difference between hypertension and non-hypertension group. There was also no difference between using β-blockers and not using them in the whole stage III cohort (P>0.05). For the patients with hypertension, the usage of β-blockers did not influence the overall survival in stage III inoperable NSCLC. Further randomized clinical trials will be warranted to validate this finding.