Martinez Elisa, Tatum Kristina L, Weber Dorothy M, Kuzla Natalie, Pendley Anna, Campbell Kirsten, Ridge John A, Langer Corey, Miyamoto Curtis, Schnoll Robert A
Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA 19111, USA.
Cancer Causes Control. 2009 Feb;20(1):97-104. doi: 10.1007/s10552-008-9222-x. Epub 2008 Aug 29.
Given high rates of smoking among cancer patients, smoking cessation treatment is crucial; yet limited data exist to guide integration of such trials into the oncologic context. In order to determine the feasibility of conducting smoking cessation clinical trials with cancer patients, screening and baseline data from a large randomized placebo-controlled pharmacotherapy trial were analyzed. Descriptive statistics and regression analyses were used to compare enrollees to decliners, describe program enrollees, and assess correlates of confidence in quitting smoking. Out of 14,514 screened patients, 263 (<2%) were eligible; 43 (16%) refused enrollment. Among the eligible patients, 220 (84%) enrolled. Enrollment barriers included smoking rate, medical history/contraindicated medication, lack of interest, and language. Compared to enrollees, decliners were more likely to have advanced cancer. The trial enrolled a sample of 67 (>30%) African Americans; participants had extensive smoking histories; many were highly nicotine dependent; and participants consumed about seven alcoholic beverages/week on average. Head and neck and breast cancer were the most common tumors. About 52 (25%) reported depressive symptoms. A higher level of confidence to quit smoking was related to lower depression and lower tumor stage. Integrating a smoking cessation clinical trial into the oncologic setting is challenging, yet feasible. Recruitment strategies are needed for patients with advanced disease and specific cancers. Once enrolled, addressing participant's depressive symptoms is critical for promoting cessation.
鉴于癌症患者中吸烟率较高，戒烟治疗至关重要；然而，将此类试验纳入肿瘤学背景的指导数据有限。为了确定对癌症患者进行戒烟临床试验的可行性，对一项大型随机安慰剂对照药物治疗试验的筛查和基线数据进行了分析。使用描述性统计和回归分析来比较登记者和拒绝者，描述项目登记者，并评估戒烟信心的相关因素。在14514名接受筛查的患者中，263名（<2%）符合条件；43名（16%）拒绝入组。在符合条件的患者中，220名（84%）入组。入组障碍包括吸烟率、病史/禁忌药物、缺乏兴趣和语言。与登记者相比，拒绝者更有可能患有晚期癌症。该试验招募了67名（>30%）非裔美国人作为样本；参与者有广泛的吸烟史；许多人对尼古丁高度依赖；参与者平均每周饮用约七杯酒精饮料。头颈癌和乳腺癌是最常见的肿瘤。约52名（25%）报告有抑郁症状。更高的戒烟信心水平与更低的抑郁程度和更低的肿瘤分期相关。将戒烟临床试验纳入肿瘤学环境具有挑战性，但可行。对于晚期疾病和特定癌症的患者，需要招募策略。一旦入组，解决参与者的抑郁症状对于促进戒烟至关重要。
