Department of Radiation Oncology, L'Hôtel-Dieu de Québec, Canada.
Radiother Oncol. 2010 Jul;96(1):89-93. doi: 10.1016/j.radonc.2010.05.008. Epub 2010 Jun 10.
The role of post-operative radiotherapy in patients with resected non-small-cell lung cancer (NSCLC) is unclear. Modifiable factors, like smoking, may help guide therapy. We retrospectively evaluated the impact of smoking on control in patients undergoing post-operative radiation therapy (PORT) for NSCLC.
Between 1995 and 2007, 152 patients who underwent surgery for NSCLC were analyzed (median follow-up 26 months). Non-smokers were defined as patients who never smoked or who had stopped smoking at the time of initial consultation. Sixty seven percent were non-smokers; 5% never smoked, 40% of the non-smokers had ceased smoking for a year or less, while 55% had stopped for more than a year.
On univariate analysis, smokers had worse 5-year local control than non-smokers (70% versus 90%, p=0.001) and locoregional control (52% versus 77%, p=0.002). The 5-year survival rate was 21% for smokers and 31% for non-smokers (p=0.2). On multivariate analysis, smokers maintained a detrimental effect on locoregional control (HR 3.6, p=0.0006).
Smokers at initial consultation have poorer local and locoregional control after PORT than non-smokers. In patients being considered for PORT for NSCLC, quitting smoking before treatment confers additional treatment advantage.
术后放疗在可切除非小细胞肺癌（NSCLC）患者中的作用尚不明确。可改变的因素，如吸烟，可能有助于指导治疗。我们回顾性评估了吸烟对接受术后放疗（PORT）的 NSCLC 患者控制的影响。
1995 年至 2007 年间，我们分析了 152 例接受 NSCLC 手术治疗的患者（中位随访 26 个月）。从不吸烟者定义为初始就诊时从未吸烟或已戒烟的患者。67%为从不吸烟者；5%从不吸烟，40%的从不吸烟者戒烟时间不到 1 年，而 55%的从不吸烟者戒烟时间超过 1 年。
单因素分析显示，吸烟者 5 年局部控制率低于从不吸烟者（70%比 90%，p=0.001）和局部区域控制率（52%比 77%，p=0.002）。吸烟者的 5 年生存率为 21%，从不吸烟者为 31%（p=0.2）。多因素分析显示，吸烟者对局部区域控制仍有不良影响（HR 3.6，p=0.0006）。
初始就诊时吸烟的患者在 PORT 后局部和局部区域控制率低于从不吸烟者。在考虑对 NSCLC 患者进行 PORT 治疗时，治疗前戒烟可带来额外的治疗优势。
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