一项烟草治疗计划对有头颈部鳞状细胞癌的当前吸烟者的戒烟率和生存率的影响。
Impact of a tobacco treatment program on abstinence and survival rates among current smokers with head and neck squamous cell carcinoma.
机构信息
Department of Otolaryngology-Head and Neck Surgery, UT Southwestern Medical Center, Dallas, Texas, USA.
Population Science & Cancer Control, UT Southwestern Simmons Comprehensive Cancer Center, Dallas, Texas, USA.
出版信息
Head Neck. 2020 Sep;42(9):2440-2452. doi: 10.1002/hed.26268. Epub 2020 Jun 1.
BACKGROUND
Approximately one quarter of head and neck cancer (HNC) patients smoke cigarettes at the time of diagnosis. Despite HNC guideline recommendations to treat tobacco dependence, the effectiveness of treatment in this population is poorly described.
METHODS
This retrospective cohort review evaluated 117 current smokers with p16-negative mucosal head and neck squamous cell carcinoma prospectively enrolled in a tobacco treatment program. Seven-day point prevalence tobacco abstinence rates at 9 months and survival outcomes were compared among abstinent and nonabstinent groups.
RESULTS
Median follow-up among survivors was 62.4 months. Forty percent of patients were abstinent at 9 months according to intention-to-treat analysis. After adjustment for age, comorbidity and site, abstinent stage I to II patients had a decreased risk of death compared to smoking stage I to II patients (HR 0.15, 95% CI 0.03-0.82).
CONCLUSIONS
High cohort abstinence rates and favorable survival among abstinent patients with early-stage HNC confirm the importance of tobacco dependence treatment in this population.
背景
大约四分之一的头颈部癌症（HNC）患者在诊断时吸烟。尽管 HNC 指南建议治疗烟草依赖，但该人群的治疗效果描述不佳。
方法
本回顾性队列研究前瞻性评估了 117 例 p16 阴性黏膜头颈部鳞状细胞癌的当前吸烟者，他们均参加了一项烟草治疗计划。比较了 9 个月时的 7 天点患病率烟草戒断率和生存结果在戒烟组和非戒烟组之间。
结果
幸存者的中位随访时间为 62.4 个月。根据意向治疗分析，40%的患者在 9 个月时戒烟。在调整年龄、合并症和部位后，与吸烟 I 期至 II 期的患者相比，戒烟 I 期至 II 期的患者死亡风险降低（HR 0.15，95%CI 0.03-0.82）。
结论
高队列戒烟率和戒烟的早期 HNC 患者的良好生存证实了在该人群中治疗烟草依赖的重要性。
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