主动吸烟对人乳头瘤病毒阳性口咽癌预后的影响。
Impact of active smoking on outcomes in HPV+ oropharyngeal cancer.
作者信息
Xiao Roy, Pham Yvonne, Ward Matthew C, Houston Narcissa, Reddy Chandana A, Joshi Nikhil P, Greskovich John F, Woody Neil M, Chute Deborah J, Lamarre Eric D, Prendes Brandon L, Lorenz Robert R, Scharpf Joseph, Burkey Brian B, Geiger Jessica L, Adelstein David J, Koyfman Shlomo A
机构信息
Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts.
Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts.
出版信息
Head Neck. 2020 Feb;42(2):269-280. doi: 10.1002/hed.26001. Epub 2019 Nov 26.
BACKGROUND
The role of smoking among patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) is unclear.
METHODS
A retrospective cohort study of patients with HPV(+) OPSCC from 2001 to 2015 at a tertiary-care institution was conducted. The primary outcome was overall survival (OS).
RESULTS
Among 484 included patients, 94 (19.4%) were active smokers, 226 (46.7%) were former smokers, and 164 (33.9%) never smoked. Among active smokers, 82 patients (87.2%) had a ≥10 pack-year and 69 (73.4%) had a ≥20 pack-year smoking history. After adjusting for covariates, active smoking was a significant predictor of inferior OS (HR 2.28, P < .001) and PFS (HR 2.26, P < .001). When including pack-years as the covariate, ≥20 pack-years predicted a decreased effect-size for inferior OS and PFS.
CONCLUSIONS
For patients with HPV(+) OPSCC, active smoking at diagnosis is the most powerful covariate capturing smoking history to predict OS and PFS.
背景
吸烟在人乳头瘤病毒（HPV）阳性口咽鳞状细胞癌（OPSCC）患者中的作用尚不清楚。
方法
对2001年至2015年在一家三级医疗机构就诊的HPV（+）OPSCC患者进行了一项回顾性队列研究。主要结局是总生存期（OS）。
结果
在纳入的484例患者中，94例（19.4%）为现吸烟者，226例（46.7%）为既往吸烟者，164例（33.9%）从不吸烟。在现吸烟者中，82例（87.2%）有≥10包年的吸烟史，69例（73.4%）有≥20包年的吸烟史。在对协变量进行调整后，现吸烟是OS较差（风险比2.28，P<0.001）和无进展生存期（PFS）较差（风险比2.26，P<0.001）的显著预测因素。当将吸烟包年数作为协变量纳入时，≥20包年预测较差的OS和PFS的效应量降低。
结论
对于HPV（+）OPSCC患者，诊断时现吸烟是反映吸烟史以预测OS和PFS的最有力协变量。
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