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N-Acetylcysteine Therapy on Cancer Survival
45 Pages Posted: 21 Aug 2024
More...Abstract
Purpose: Cancer survival rates are influenced by various factors, including type, stage at diagnosis, and healthcare access. N-Acetylcysteine (NAC) has shown promise in preclinical studies for its antioxidant properties and potential anti-cancer effects, but its clinical utility remains uncertain due to limited large-scale studies.
Patients and Methods: We conducted a retrospective cohort study using the Taiwan Cancer Registry database to evaluate the effects of long-term NAC therapy on cancer survival outcomes. Patients diagnosed with cancer between 2008 and 2018 who received curative treatments were included. Propensity score matching adjusted for confounding variables, and time-varying Cox regression models assessed the association between NAC use and mortality.
Results: Of the 41,411 cancer patients included, 7,707 used NAC long-term post-diagnosis. After propensity score matching, 15,414 patients were analyzed. NAC use was associated with reduced all-cause mortality (adjusted hazard ratio [aHR]: 0.82, 95% confidence interval [CI]: 0.79-0.86) and cancer-specific mortality (aHR: 0.78, 95% CI: 0.74-0.81). This reduction was dose-dependent across various cancer types and stages, including hepatocellular carcinoma (aHR: 0.58, 95% CI: 0.51-0.66), esophageal cancer (aHR: 0.82, 95% CI: 0.68-0.99), gastric cancer (aHR: 0.67, 95% CI: 0.54-0.83), and lung cancer (aHR: 0.70, 95% CI: 0.65-0.76). Kaplan-Meier analysis showed higher overall survival rates among NAC users compared to non-users.
Conclusion: Our study provides evidence supporting the potential benefits of NAC therapy in improving cancer survival outcomes.
Funding: Lo-Hsu Medical Foundation, LotungPoh-Ai Hospital, supports SzuYuan Wu’s work (Funding Number: 11303, 11304)
Declaration of Interest: The authors have no potential conflicts of interest to declare. The data sets supporting the study conclusions are included in the manuscript.
Ethical Approval: The study protocols were reviewed and approved by the Institutional Review Board of Tzu-Chi Medical Foundation (IRB109-015-B).
Keywords: N-Acetylcysteine, Cancer Survival, Propensity Score Matching, Taiwan Cancer Registry, Dose Dependent
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