Stefan Andreas and Achim Rittmeyer have equally contributed to the manuscript ; Lung Hospital Immenhausen, pneumological training hospital of Göttingen University.
Dtsch Arztebl Int. 2013 Oct;110(43):719-24. doi: 10.3238/arztebl.2013.0719. Epub 2013 Oct 25.
Lung cancer is the leading cause of death from cancer in Germany. 90% of cases are due to the inhalation of tobacco smoke. About 40% of patients with newly diagnosed lung cancer are still smokers. A structured smoking cessation program is medically reasonable in this situation but is only rarely offered.
This review is based on a selective search in the PubMed database combined with a manual search for current publications.
Many cross-sectional and longitudinal studies have shown that patients with lung cancer benefit from smoking cessation. After resection with curative intent, second tumors are 2.3 times more common, and recurrent tumors 1.9 times more common, in patients who continue to smoke than in those who stop. The overall mortality in smokers is 2.9 times higher. Smoking cessation also lowers the rate of radiation pneumonitis and infection during radiotherapy and prolongs the median survival after chemoradiotherapy for small-cell lung cancer (18.0 vs. 13.6 months). For patients with non-small-cell lung cancer, smoking cessation is associated with a better general state of health (77.5% vs. 57.6%). For the many patients with lung cancer who are treated palliatively, smoking cessation offers the advantages of improved pulmonary function, weight gain, and better overall quality of life.
Smoking cessation in patients with lung cancer is an important means of increasing the efficacy of treatment and improving their quality of life.
肺癌是德国癌症死亡的主要原因。90%的病例是由于吸入烟草烟雾。约 40%的新诊断肺癌患者仍在吸烟。在这种情况下,进行结构化的戒烟计划在医学上是合理的,但很少提供。
本综述基于在 PubMed 数据库中进行的选择性搜索,并结合对当前出版物的手动搜索。
许多横断面和纵向研究表明,肺癌患者从戒烟中获益。与继续吸烟的患者相比,接受根治性切除术的患者中,二次肿瘤的发生率增加 2.3 倍,复发性肿瘤的发生率增加 1.9 倍。吸烟者的总死亡率高 2.9 倍。戒烟还可降低放疗期间放射性肺炎和感染的发生率,并延长小细胞肺癌放化疗后的中位生存期(18.0 个月比 13.6 个月)。对于非小细胞肺癌患者,戒烟与更好的整体健康状况相关(77.5%比 57.6%)。对于许多接受姑息治疗的肺癌患者,戒烟可带来改善肺功能、体重增加和整体生活质量提高的优势。
肺癌患者戒烟是提高治疗效果和改善生活质量的重要手段。