Otolaryngology, Head and Neck Surgery, Hôtel-Dieu de France University Hospital, Beirut, Lebanon.
Otolaryngology, Head and Neck Surgery, Hôtel-Dieu de France University Hospital, Beirut, Lebanon.
Am J Otolaryngol. 2021 Jan-Feb;42(1):102832. doi: 10.1016/j.amjoto.2020.102832. Epub 2020 Nov 14.
To evaluate the effectiveness of a brief smoking cessation intervention in head and neck cancer patients (HNCP).
A prospective randomized controlled trial that randomly assigns participants in two groups: a usual care group (UCG), and a standardized intervention group (SIG).
Patients with a confirmed diagnosis of head and neck squamous cell carcinoma (HNSCC) and who are active smokers were prospectively approached by one of 4 trained Ear-nose-throat (ENT) residents. Participants were randomized into a UCG, and a SIG consisting of a brief perioperative smoking cessation intervention based on National Institute of Health (NIH) "5A's" model along with an informative motivational document and nicotine patch therapy (NPT) offered for 8 weeks in gradually decreasing doses.
The evaluation of abstinence at 3, 6 and 12 months after enrollment.
56 subjects were randomized into the UCG (N = 29, 52%), and the SIG (N = 27, 48%). The overall smoking cessation rates were not statistically different between the two groups; we observed at 3 months cessation rates of 57.1% vs. 57.7% (p = 0.96); at 6 months, 42.9% vs. 24% (p = 0.148); and at 12 months, 33.3% vs. 20.8% (p = 0.318), for the UCG and the SIG respectively.
This study failed to show the effectiveness of a combined brief smoking cessation approach led by and ENT resident in HNSCC patients. A multifaceted approach addressing different pharmacological treatments, factors contributing to smoking maintenance, mainly alcohol dependence and mood disturbances and dealing with relapse risks through close face-to-face or phone call follow-ups may have better outcomes and should be evaluated in upcoming trials.
评估针对头颈部癌症患者（HNCP）的简短戒烟干预的效果。
这是一项前瞻性随机对照试验，将参与者随机分为两组：常规护理组（UCG）和标准化干预组（SIG）。
通过 4 名经过培训的耳鼻喉科住院医师，前瞻性地接触确诊为头颈部鳞状细胞癌（HNSCC）且正在吸烟的患者。将参与者随机分配到 UCG 和 SIG，SIG 组接受基于美国国立卫生研究院（NIH）“5A's”模型的简短围手术期戒烟干预，以及提供 8 周的尼古丁贴片治疗（NPT），剂量逐渐减少。
评估入组后 3、6 和 12 个月的戒烟情况。
56 名患者被随机分配到 UCG（N=29，52%）和 SIG（N=27，48%）。两组的总体戒烟率没有统计学差异；我们观察到 3 个月时的戒烟率分别为 57.1%和 57.7%（p=0.96）；6 个月时分别为 42.9%和 24%（p=0.148）；12 个月时分别为 33.3%和 20.8%（p=0.318），分别为 UCG 和 SIG。
本研究未能证明由耳鼻喉科住院医师主导的综合简短戒烟方法对头颈部癌症患者有效。一种多方面的方法，涉及不同的药理学治疗，解决导致吸烟持续的因素，主要是酒精依赖和情绪障碍，并通过密切的面对面或电话随访处理复发风险，可能会有更好的结果，并应在未来的试验中进行评估。
