我们旨在评估抗生素（ABX）和质子泵抑制剂（PPI）对于接受辅助铂类化疗（PC）治疗的子宫内膜癌（EC）患者的无进展生存期（PFS）和总生存期（OS）的影响。本研究回顾性分析了从2014年到2020年在一家单机构进行外科分期后接受≥四个疗程辅助PC治疗的EC患者的队列资料。通过χ2检验和Fisher精确检验比较了人口统计学特征和临床病理特征，包括ABX和PPI使用情况。进行了单因素和多因素分析，并使用log-rank检验比较了生存结果。在325名患者中，95名（29%）接受了ABX治疗，80名（24.6%）接受了PPI治疗。与无ABX组相比，ABX组的3年PFS明显降低（49.9% vs. 66%; p = 0.0237），但3年OS差异不显著（68.9% vs. 79.9%; p = 0.0649）。与未使用ABX组和其他ABX组相比，针对革兰阳性细菌的ABX与3年PFS（21.2% vs. 66.0% vs. 55.4%; p = 0.0038）和3年OS（36.5% vs. 79.9% vs. 75.6%; p = 0.0014）均显著降低。与未使用PPI组相比，PPI组的3年PFS明显降低（46.9% vs. 66.0%; p = 0.0001），3年OS也明显降低（60.7% vs. 81.9%; p = 0.0041）。在多因素回归分析中，调节混杂因素包括分期、组织学类型、分级、放疗和合并症后，PPI使用与PFS（HR 1.96, 95% CI 1.25-3.08; p = 0.0041）和OS（HR 2.06, 95% CI 1.01-4.18, p = 0.04）明显相关。在这个回顾性队列研究中，我们证明了PPI的使用与接受PC治疗的EC患者的较差PFS和OS有独立关联。ABX的使用仅在单因素分析中与较差PFS有关。有必要了解PPI、ABX，以及潜在的微生物组如何影响EC患者的化疗效果。 © 2023 Elsevier Inc. 保留所有权利。

We sought to assess the impact of antibiotic (ABX) and proton-pump inhibitor (PPI) use on progression-free (PFS) and overall survival (OS) in patients treated with adjuvant platinum-based chemotherapy (PC) for endometrial cancer (EC).A retrospective, single-institution cohort study of EC patients treated with ≥four cycles of adjuvant PC following surgical staging from 2014 to 2020. Demographics and clinicopathologic features, including ABX and PPI use, were compared using χ2 and Fisher's exact tests. Univariate and multivariable analyses were performed, and survival outcomes were compared using the log-rank test.Of 325 patients, 95 (29%) received ABX, and 80 (24.6%) received PPI. ABX were associated with decreased 3-year PFS (49.9% vs. 66%; p = 0.0237) but not 3-year OS (68.9% vs. 79.9%; p = 0.0649). ABX targeting gram-positive bacteria were associated with decreased 3-year PFS (21.2% vs. 66.0% vs. 55.4%; p = 0.0038) and 3-year OS (36.5% vs. 79.9% vs. 75.6%; p = 0.0014) compared to no ABX and other ABX, respectively. PPI use was associated with decreased 3-year PFS (46.9% vs. 66.0%; p = 0.0001) and 3-year OS (60.7% vs. 81.9%; p = 0.0041) compared to no PPI. On multivariable regression analysis controlling for confounders including stage, histology, grade, radiation, and co-morbidities, PPI use was independently associated with worse PFS (HR 1.96, 95% CI 1.25-3.08; p = 0.0041) and OS (HR 2.06, 95% CI 1.01-4.18, p = 0.04).In this retrospective cohort study, we demonstrate that PPI use is independently associated with worse PFS and OS in patients with EC treated with PC. ABX use was associated with worse PFS on univariate analysis only. There is an unmet need to understand how PPI, ABX, and, potentially, the microbiome impact the effectiveness of chemotherapy in EC patients.Copyright © 2023 Elsevier Inc. All rights reserved.