Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 4th Floor, Philadelphia, PA, 19104, USA.
Cancer Causes Control. 2010 Jun;21(6):811-20. doi: 10.1007/s10552-010-9507-8. Epub 2010 Jan 20.
Many cancer patients continue to smoke post diagnosis, yet there have been few smoking cessation trials for this population. Depression, which is prevalent among cancer patients, may be a barrier to cessation.
This double-blind placebo-controlled trial randomized 246 cancer patients to 9 weeks of placebo or bupropion, stratifying by pre-treatment depression symptoms. In addition, all patients received transdermal nicotine and behavioral counseling. Primary outcomes were 7-day point-prevalence abstinence, biochemically confirmed, at the end of treatment (Week 12), and at 6 months post quit day (Week 27). Additional outcomes included: withdrawal, affect, quality of life, compliance, and side effects.
There was no main effect of bupropion vs. placebo on abstinence (Odds Ratio [OR] = 1.36, 95% CI: 0.38-4.81, p = .64). Patients with depression symptoms reported significantly lower abstinence rates vs. patients without depression symptoms (OR = .14, 95% CI: 0.02-0.80, p = .03). Bupropion increased abstinence rates, vs. placebo, more for participants with depression vs. those without depression symptoms. For patients with depression symptoms, bupropion reduced withdrawal symptoms and improved quality of life vs. placebo.
For patients with depression symptoms, bupropion increases abstinence rates, lowers withdrawal, and increases quality of life. However, abstinence rates among patients with depression symptoms were low vs. patients without depression symptoms, who exhibited similar abstinence rates when treated with bupropion or transdermal nicotine and counseling alone. These results can guide future smoking cessation intervention studies with cancer patients.
许多癌症患者在确诊后仍继续吸烟，但针对这一人群的戒烟试验却很少。癌症患者中普遍存在的抑郁可能是戒烟的一个障碍。
这项双盲安慰剂对照试验将 246 名癌症患者随机分为 9 周的安慰剂或安非他酮组，根据治疗前的抑郁症状进行分层。此外，所有患者都接受了经皮尼古丁和行为咨询。主要结局是治疗结束时（第 12 周）和戒烟后 6 个月（第 27 周）的 7 天点预率戒烟，经生物化学证实。其他结局包括：戒断、情感、生活质量、依从性和副作用。
安非他酮与安慰剂相比，对戒烟没有主要影响（优势比[OR] = 1.36，95%置信区间：0.38-4.81，p =.64）。有抑郁症状的患者报告的戒烟率明显低于无抑郁症状的患者（OR =.14，95%置信区间：0.02-0.80，p =.03）。与安慰剂相比，安非他酮增加了有抑郁症状患者的戒烟率。对于有抑郁症状的患者，安非他酮降低了戒断症状，改善了生活质量。
对于有抑郁症状的患者，安非他酮增加了戒烟率，降低了戒断症状，提高了生活质量。然而，有抑郁症状的患者的戒烟率仍然很低，而无抑郁症状的患者在接受安非他酮或经皮尼古丁和咨询单独治疗时，戒烟率相似。这些结果可以指导未来针对癌症患者的戒烟干预研究。
