Tseng Chien-Hua, Chiang Chun-Ju, Tseng Jeng-Sen, Yang Tsung-Ying, Hsu Kuo-Hsuan, Chen Kun-Chieh, Wang Chih-Liang, Chen Chih-Yi, Yen Sang-Hue, Tsai Chun-Ming, Huang Ming-Shyan, Ho Chao-Chi, Yu Chong-Jen, Tsai Ying-Huang, Chen Jin-Shing, Chou Teh-Ying, Tsai Ming-Hsun, Chen Hsuan-Yu, Su Kang-Yi, Chen Jeremy J W, Chen Huei-Wen, Yu Sung-Liang, Liu Tsang-Wu, Chang Gee-Chen
Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Oncotarget. 2017 Oct 12;8(58):98384-98393. doi: 10.18632/oncotarget.21842. eCollection 2017 Nov 17.
In the current targeted therapy era, information on the effect of smoking in epidermal growth factor receptor ()-mutant lung cancer patients is scarce.
In total, 11,678 adenocarcinoma patients were enrolled. Of these, 33.3% and 91.8% of male and female patients were non-smokers, respectively. An increased amount of smoking ( < 0.001 for trend), fewer smoke-free years ( < 0.001 for trend), and younger age of smoking initiation ( = 0.034 for trend) were all associated with significantly lower mutation rates. Smokers had a shorter median overall survival (OS) among both -mutant and -wild type patients (17.8 vs. 21.1 months, and 7.9 vs. 11.4 months respectively; both < 0.001). Among patients with -mutant adenocarcinoma, younger smokers were associated with shorter OS ( = 0.047). In multivariate analysis, female gender was an independent prognostic factor for OS (hazard ratio: 0.86 [95% confidence interval {CI}: 0.80-0.93]; < 0.001 in the -mutant group and 0.88 [95% CI: 0.81-0.96]; = 0.004 in the -wild type group).
We reviewed the National Lung Cancer database (Taiwan) to assess the impact of smoking on the mutation rate and survival in advanced lung adenocarcinoma patients during 2011 and 2014 retrospectively.
Smoking was associated with lower incidence of mutation rate and reduced OS of advanced lung adenocarcinoma patients in a dose-dependent manner. In addition to mutation and smoking, gender also plays an important role in survival among these patients.
在当前的靶向治疗时代，关于吸烟对表皮生长因子受体（EGFR）突变型肺癌患者影响的信息稀缺。
总共纳入了11678例腺癌患者。其中，男性和女性患者分别有33.3%和91.8%为非吸烟者。吸烟量增加（趋势P<0.001）、无烟年限减少（趋势P<0.001）以及开始吸烟年龄较小（趋势P=0.034）均与EGFR突变率显著降低相关。在EGFR突变型和EGFR野生型患者中，吸烟者的中位总生存期均较短（分别为17.8个月对21.1个月，以及7.9个月对11.4个月；均P<0.001）。在EGFR突变型腺癌患者中，较年轻的吸烟者总生存期较短（P=0.047）。多因素分析显示，女性是总生存期的独立预后因素（风险比：0.86[95%置信区间{CI}：0.80 - 0.93]；EGFR突变型组P<0.001，EGFR野生型组为0.88[95%CI：0.81 - 0.96]；P = 0.004）。
我们回顾了台湾国家肺癌数据库，以回顾性评估2011年至2014年期间吸烟对晚期肺腺癌患者EGFR突变率和生存的影响。
吸烟与晚期肺腺癌患者EGFR突变率较低及总生存期缩短呈剂量依赖性相关。除了EGFR突变和吸烟外，性别在这些患者的生存中也起着重要作用。
