Li Xingbao, Toll Benjamin A, Carpenter Matthew J, Nietert Paul J, Dancy Morgan, George Mark S
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
J Smok Cessat. 2022 Jul 11;2022:2617146. doi: 10.1155/2022/2617146. eCollection 2022.
Smoking cessation represents a significant opportunity to improve cancer survival rates, reduces the risk of cancer treatment complications, and improves quality of life. However, about half of cancer patients who smoke continue to smoke despite the availability of several treatments. Previous studies demonstrate that repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) decreases cue craving, reduces cigarette consumption, and increases the quit rate in tobacco use disorder. We investigated whether 5 sessions of rTMS can be safely and efficaciously used for smoking cessation in cancer patients.
We enrolled 11 treatment-seeking smokers with cancer (>5 cigarettes per day) in a randomized, double-blind, sham-controlled proof-of-concept study. Participants received 5 daily sessions of active 10 Hz rTMS of the left DLPFC (3000 pulses per session) or sham rTMS and were followed up for 1 month via phone assessments. Main outcomes included reductions in the number of smoked-cigarettes per day (primary) and craving (secondary). Adverse effects were reported daily by participants.
Seven of 11 participants completed 5 sessions of rTMS over one week. Compared to sham treatment ( = 4), the active rTMS ( = 3) exhibited modest effects overtime on smoking (Cohen's effect size of 0.16) and large effects on cue craving (Cohen's = 0.40). No serious side effects related to rTMS were reported in the treatment.
Five sessions of daily rTMS over the left DLPFC might benefit cancer patients who smoke cigarettes. However, further evidence is needed to determine with more certainty its therapeutic effect and adverse effects for cancer patients who smoke cigarettes.
戒烟是提高癌症生存率、降低癌症治疗并发症风险以及改善生活质量的重要契机。然而，约一半吸烟的癌症患者尽管有多种治疗方法可供选择，仍继续吸烟。既往研究表明，对左侧背外侧前额叶皮质（DLPFC）进行重复经颅磁刺激（rTMS）可减少线索诱发的渴望、降低香烟消费量并提高烟草使用障碍患者的戒烟率。我们调查了5次rTMS治疗能否安全有效地用于癌症患者戒烟。
我们纳入了11名寻求治疗的吸烟癌症患者（每日吸烟>5支），进行一项随机、双盲、假刺激对照的概念验证研究。参与者每天接受5次对左侧DLPFC的10Hz主动rTMS治疗（每次3000个脉冲）或假rTMS治疗，并通过电话评估随访1个月。主要结局包括每日吸烟量减少（主要结局）和渴望程度降低（次要结局）。参与者每天报告不良反应。
11名参与者中有7名在一周内完成了5次rTMS治疗。与假刺激治疗组（n = 4）相比，主动rTMS治疗组（n = 3）随着时间推移对吸烟有适度影响（科恩d效应量为0.16），对线索诱发的渴望有较大影响（科恩d = 0.40）。治疗中未报告与rTMS相关的严重副作用。
对左侧DLPFC进行每日5次的rTMS治疗可能对吸烟的癌症患者有益。然而，需要更多证据来更确切地确定其对吸烟癌症患者的治疗效果和不良反应。
