Division of Otolaryngology-Head and Neck Surgery, McMaster University, Ontario, Canada.
Otolaryngol Head Neck Surg. 2013 Aug;149(2):200-11. doi: 10.1177/0194599813490886. Epub 2013 May 28.
To evaluate tobacco smoking cessation interventions and cessation rates in the oncology population through a systematic review and meta-analysis.
The literature was searched using PubMed, Google Scholar, Medline, EMBASE, and the Cochrane Library (inception to October 2012) by 3 independent review authors.
Studies were included if they were randomized controlled trials (RCTs) or prospective cohort (PCs) studies evaluating tobacco smoking cessation interventions with patients assigned to a usual care or an intervention group. The primary outcome measure was smoking cessation rates. Two authors extracted data independently for each study. When applicable, disagreements were resolved by consensus.
The systematic review identified 10 RCTs and 3 PCs. Statistical analysis was conducted using StatsDirect software (Cheshire, UK). Pooled odds ratios (ORs) for smoking cessation interventions were calculated in 2 groups based on follow-up duration. The therapeutic interventions included counseling, nicotine replacement therapy, buproprion, and varenicline. Smoking cessation interventions had a pooled odds ratio of 1.54 (95% confidence interval [CI], 0.909-2.64) for patients in the shorter follow-up group and 1.31 (95% CI, 0.931-1.84) in the longer follow-up group. Smoking cessation interventions in the perioperative period had a pooled odds ratio of 2.31 (95% CI, 1.32-4.07).
Our systematic review and meta-analysis demonstrate that tobacco cessation interventions in the oncology population, in both the short-term and long-term follow-up groups, do not significantly affect cessation rates. The perioperative period, though, may represent an important teachable moment with regard to smoking cessation.
通过系统评价和荟萃分析评估肿瘤患者的戒烟干预措施和戒烟率。
通过 3 位独立的综述作者，使用 PubMed、Google Scholar、Medline、EMBASE 和 Cochrane Library（从创建到 2012 年 10 月）搜索文献。
如果研究是评估针对患者的吸烟干预措施的随机对照试验（RCT）或前瞻性队列（PC）研究，并且将患者分配到常规护理组或干预组，则纳入研究。主要结局测量指标为戒烟率。两位作者分别独立地从每个研究中提取数据。如果适用，通过协商解决分歧。
系统评价共确定了 10 项 RCT 和 3 项 PC。使用 StatsDirect 软件（英国柴郡）进行统计分析。根据随访时间长短将吸烟干预措施分为两组，计算其合并优势比（OR）。治疗干预措施包括咨询、尼古丁替代疗法、安非他酮和伐尼克兰。短期随访组的吸烟干预措施合并 OR 为 1.54（95%置信区间[CI]，0.909-2.64），长期随访组为 1.31（95% CI，0.931-1.84）。围手术期的吸烟干预措施合并 OR 为 2.31（95% CI，1.32-4.07）。
我们的系统评价和荟萃分析表明，肿瘤患者的戒烟干预措施，无论是在短期还是长期随访组，都不能显著影响戒烟率。然而，围手术期可能是一个重要的可教授的戒烟时刻。
