吸烟是接受放疗的男性鼻咽癌患者预后不良的一个因素。

Smoking is a poor prognostic factor for male nasopharyngeal carcinoma treated with radiotherapy.

作者信息

Chen Chen, Shen Lu-Jun, Li Bo-Fei, Gao Jin, Xia Yun-Fei

机构信息

Department of Radiation Oncology, Sun Yat-Sen University, Guangzhou, People's Republic of China; Zhongshan School of Medcine, Sun Yat-Sen University, Guangzhou, People's Republic of China.

Department of Radiation Oncology, Sun Yat-Sen University, Guangzhou, People's Republic of China; State Key Laboratory of Oncology in Southern China, Cancer Center, , Sun Yat-Sen University, Guangzhou, People's Republic of China.

出版信息

Radiother Oncol. 2014 Mar;110(3):409-15. doi: 10.1016/j.radonc.2013.08.003. Epub 2013 Sep 7.

DOI:10.1016/j.radonc.2013.08.003

PMID:24021341

Abstract

BACKGROUND AND PURPOSE

To evaluate the effect of smoking on prognosis of male nasopharyngeal carcinoma by comparing the treatment outcomes between smokers and non-smokers.

MATERIALS AND METHODS

A total of 2450 nasopharyngeal carcinoma patients were enrolled, including 1865 male patients. Matching was performed between smokers and non-smokers in male patients according to age, UICC clinical stage, T stage, N stage and treatment. Survival outcomes were compared using Kaplan-Meier analysis and Cox regression. Smoking index was calculated by multiplying cigarette packs per day and smoked time (year).

RESULTS

In male patients, smokers had significantly lower 5-year overall survival (70.1% vs. 77.5%, P<0.001) and locoregional recurrent free survival (76.8% vs.82.4%, P = 0.002) compared with non-smokers. Matched-pair analysis showed that smokers kept a high risk of death compared with non-smokers (HR = 2.316, P<0.001). High degree of smoking index (>15 pack-years) had a poor effect on overall survival (HR = 1.225, P = 0.016). When smoking index was more than 45 and 60 pack-years, the risk for death increased to 1.498 and 1.899 fold compared with non-smokers (P = 0.040, 0.001), respectively.

CONCLUSIONS

Smoking was a poor prognostic factor for male nasopharyngeal carcinoma. The heavier the patients smoked, the poorer prognosis they suffered.

摘要

背景与目的

通过比较吸烟者与非吸烟者的治疗结果，评估吸烟对男性鼻咽癌预后的影响。

材料与方法

共纳入2450例鼻咽癌患者，其中男性患者1865例。根据年龄、国际抗癌联盟（UICC）临床分期、T分期、N分期和治疗情况，对男性患者中的吸烟者与非吸烟者进行匹配。采用Kaplan-Meier分析和Cox回归比较生存结果。吸烟指数通过每日吸烟包数乘以吸烟时间（年）计算得出。

结果

在男性患者中，吸烟者的5年总生存率（70.1%对77.5%，P<0.001）和无局部区域复发生存率（76.8%对82.4%，P = 0.002）显著低于非吸烟者。配对分析显示，与非吸烟者相比，吸烟者的死亡风险较高（风险比[HR]=2.316，P<0.001）。高吸烟指数（>15包年）对总生存率有不良影响（HR = 1.225，P = 0.016）。当吸烟指数超过45和60包年时，与非吸烟者相比，死亡风险分别增加至1.498倍和1.899倍（P = 0.040，0.001）。