Department of Radiology, National Taiwan University College of Medicine, Taipei, Taiwan.
Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
Head Neck. 2019 Sep;41(9):3201-3210. doi: 10.1002/hed.25814. Epub 2019 May 22.
We hypothesized that patients with head and neck squamous cell carcinoma (HNSCC) with smoking cessation during curative chemoradiotherapy (CRT) had fewer complications and lower tumor progression risks.
Sixty-three patients with nonmetastatic HNSCC who were smokers at diagnosis (carbon monoxide [CO] breath concentrations ≥3 ppm) and underwent curative CRT were prospectively enrolled. Successful smoking cessation throughout CRT was confirmed by CO breath concentrations <3 ppm at CRT completion.
Forty-one patients (65%) successfully discontinued smoking throughout CRT. With a median 33-month follow-up, patients with successful smoking cessation during CRT had significantly fewer, greater, and lower probabilities of grade ≥3 acute toxicities (P = .01), progression-free survival (P = .03), and permanent gastrostomy or tracheostomy (P = .04), respectively, than those continuing smoking throughout CRT. In multivariate analysis, successful smoking cessation during CRT significantly reduced tumor progression risks (hazard ratio: 0.4, P = .05).
Smoking cessation during curative CRT reduced treatment-related toxicities and tumor progression risks in patients with HNSCC.
我们假设在根治性放化疗（CRT）期间戒烟的头颈部鳞状细胞癌（HNSCC）患者发生并发症和肿瘤进展的风险较低。
前瞻性纳入 63 例诊断为吸烟（一氧化碳[CO]呼气浓度≥3ppm）且接受根治性 CRT 的非转移性 HNSCC 患者。在 CRT 完成时通过 CO 呼气浓度<3ppm 来确认整个 CRT 期间成功戒烟。
41 例患者（65%）在整个 CRT 期间成功戒烟。中位随访 33 个月后，与整个 CRT 期间持续吸烟的患者相比，成功戒烟的患者发生≥3 级急性毒性的概率（P=.01）、无进展生存率（P=.03）和永久性胃造口术或气管造口术（P=.04）的概率显著降低。在多变量分析中，CRT 期间成功戒烟显著降低了肿瘤进展的风险（风险比：0.4，P=.05）。
在根治性 CRT 期间戒烟可降低 HNSCC 患者的治疗相关毒性和肿瘤进展风险。
