Kucera H, Enzelsberger H, Eppel W, Weghaupt K
Cancer. 1987 Jul 1;60(1):1-4. doi: 10.1002/1097-0142(19870701)60:1<1::aid-cncr2820600102>3.0.co;2-s.
References in the literature to the frequent occurrence of cervix carcinoma accompanied by nicotine abuse led us to investigate the effects of cigarette smoking on the results of treatment in primary irradiation of cervix carcinoma. As not only nicotine abuse but also diabetes mellitus can lead to angiopathy, we also investigated the influence of diabetes mellitus on the results of treatment. Of 410 nonsmokers with carcinoma of the cervix in Stages I and II, 260 (63.4%) reached the 5-year limit, but only 62 of 115 smokers survived (53.9%). In Stages III and IV there were significantly less favorable rates of cure in patients with nicotine abuse. Of 626 nonsmokers with cervix carcinoma in Stages III and IV, 212 survived (33.9%); but of 153 smokers, only 31 (20.1%) could be cured (P less than 0.01). The frequency of side effects of primary irradiation was distinctly higher in smokers than in nonsmokers. Reversible complications occurred in 17.5% of the smokers and 15.5% of the nonsmokers. Severe irreversible changes occurred in 28% of the smokers versus 15.2% of the comparative group of nonsmokers (P less than 0.01). The injuries caused by smoking not only reduce the biologic effectiveness of ionizing radiation but also increase the rate of side effects due to the deficient capacity for regeneration of the tissue surrounding the tumor. With diabetes as a complication, however, no significant changes in frequency of side effects were noted. Five-year survival in diabetic patients was affected in Stage I and II, but not in the advanced stages.
文献中提及宫颈癌常伴有尼古丁滥用，这促使我们研究吸烟对宫颈癌初次放疗治疗效果的影响。由于不仅尼古丁滥用，糖尿病也可导致血管病变，我们还研究了糖尿病对治疗效果的影响。在410例I期和II期宫颈癌非吸烟患者中，260例（63.4%）存活至5年，但115例吸烟患者中只有62例（53.9%）存活。在III期和IV期，尼古丁滥用患者的治愈率明显较低。在626例III期和IV期宫颈癌非吸烟患者中，212例（33.9%）存活；但在153例吸烟患者中，只有31例（20.1%）治愈（P<0.01）。初次放疗的副作用发生率在吸烟者中明显高于非吸烟者。17.5%的吸烟者出现可逆性并发症，15.5%的非吸烟者出现可逆性并发症。28%的吸烟者出现严重不可逆变化，而对照组非吸烟者为15.2%（P<0.01）。吸烟造成的损伤不仅降低了电离辐射的生物学效应，还因肿瘤周围组织再生能力不足而增加了副作用发生率。然而，糖尿病作为一种并发症，副作用发生率未出现显著变化。糖尿病患者在I期和II期的5年生存率受到影响，但在晚期则未受影响。
