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[癌症吸烟者戒烟的方法与结果]

[Methods and results of smoking cessation in cancer smoker's].

作者信息

Dautzenberg Bertrand

机构信息

Groupe hospitalo-universitaire Pitié-Salpêtrière - Charles-Foix, service de pneumologie et réanimation, Paris cedex, France.

出版信息

Bull Cancer. 2012 Nov;99(11):1007-15. doi: 10.1684/bdc.2012.1656.

Abstract

Tobacco prevention is the most effective prevention of cancer. Daily smoking promotes tumor progression, increases the risk of second cancer and decreases survival. The diagnosis of smoking and support for cessation and preventing recurrence is an integral part of cancer treatment. Smoking increases side effects of chemotherapy and surgery and reduces the effectiveness of radiotherapy and chemotherapy. Smokers with cancer do not smoke by life-style choice but because they are highly addicted and are suffering from a chronic relapsing disease: tobacco dependence, which justifies intensive medical management. The oncologist himself may perform this support or coordinate with other physicians in charge of the patient or with a tobacco cessation clinic, but patients are often unable to stop alone, as evidenced by the continued to use tobacco despite a cancer diagnosis. Treatment will always include a therapeutic education, compartmental behavioral therapy and medication. The patches and oral nicotine replacement or varenicline are the two most effective treatments that can be prescribed to smokers suffering of cancer, without including those with any motivation to quit. Smoking reducing occurred in a few days or weeks on treatment will allow them to reconsider the judgment. The full stop is always the goal for the doctor, even if it is not the patient initial goal. After stopping, the patient is not cured but still a patient with tobacco dependence who does not smoke. The risk of relapse in the year being 50%. The cancer patient management will use every visit to the point tobacco dependence and prevent relapse, alone or with assistance of a specialist. There is a lack of data on smoking cessation in cancer patients, but no item calls for a three-month quit rate of 50% as observed in the general population after an optimal management of tobacco cessation.

摘要

烟草预防是最有效的癌症预防措施。每日吸烟会促进肿瘤进展,增加患第二种癌症的风险并降低生存率。对吸烟情况的诊断以及对戒烟和预防复发的支持是癌症治疗的一个组成部分。吸烟会增加化疗和手术的副作用,并降低放疗和化疗的效果。患癌症的吸烟者并非出于生活方式的选择而吸烟,而是因为他们高度成瘾且患有一种慢性复发性疾病:烟草依赖,这证明了强化医疗管理的合理性。肿瘤学家本人可以提供这种支持,或者与负责该患者的其他医生或戒烟诊所进行协调,但患者往往无法独自戒烟,尽管已被诊断患有癌症仍继续吸烟就证明了这一点。治疗通常会包括治疗性教育、分段行为疗法和药物治疗。贴片、口服尼古丁替代疗法或伐尼克兰是可以开给患癌症吸烟者的两种最有效的治疗方法,不包括那些没有任何戒烟动机的人。治疗几天后或几周内吸烟量减少将使他们重新考虑戒烟的决定。完全戒烟始终是医生的目标,即使这不是患者最初的目标。戒烟后,患者并未治愈,仍然是一名患有烟草依赖但不吸烟的患者。一年内复发的风险为50%。癌症患者管理将利用每次就诊时机关注烟草依赖并预防复发,可单独进行或在专家协助下进行。关于癌症患者戒烟的数据不足,但没有任何一项要求达到在对烟草戒断进行最佳管理后普通人群中所观察到的三个月戒烟率50%的情况。

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