评估吸烟和饮酒对头颈部癌症放化疗毒性和结局的影响。

Evaluation of the Impact of Smoking and Alcohol Consumption on Toxicity and Outcomes of Chemoradiation for Head and Neck Cancer.

机构信息

Department of Radiation Oncology, University of Lübeck, Lübeck, Germany;

Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.

出版信息

Anticancer Res. 2023 Feb;43(2):823-830. doi: 10.21873/anticanres.16224.

DOI:10.21873/anticanres.16224

PMID:36697089

Abstract

BACKGROUND/AIM: Smoking and alcohol abuse may impair outcomes of chemoradiation for squamous cell head and neck cancer (SCCHN). Potential associations with toxicity, loco-regional control (LRC), and overall survival (OS) were investigated.

PATIENTS AND METHODS

Ninety-six patients were retrospectively analyzed for impacts of pre-radiotherapy (pre-RT) smoking history, smoking during radiotherapy, and pre-RT alcohol abuse on toxicity, LRC, and OS.

RESULTS

A trend was found for associations between pre-RT smoking history and grade ≥2 dermatitis. Smoking during radiotherapy was significantly associated with grade ≥3 mucositis and showed trends regarding grade ≥2 mucositis and dermatitis. On univariate analyses, smoking during radiotherapy was negatively associated with LRC and OS, pre-RT alcohol abuse with OS, and >40 pack years with LRC and OS. In multivariate analyses, smoking during radiotherapy remained significant for decreased OS, and pack years showed a trend.

CONCLUSION

Smoking during radiotherapy was an independent predictor of OS and associated with increased toxicity. Thus, it is important to stop smoking prior to the start of radiotherapy.

摘要

背景/目的：吸烟和酗酒可能会影响头颈部鳞状细胞癌（SCCHN）的放化疗效果。本研究旨在调查其与毒性、局部区域控制（LRC）和总生存（OS）之间的潜在关联。

患者和方法

对 96 例患者进行回顾性分析，以评估放化疗前（pre-RT）吸烟史、放疗期间吸烟以及 pre-RT 酗酒对毒性、LRC 和 OS 的影响。

结果

pre-RT 吸烟史与≥2 级皮炎之间存在相关性趋势。放疗期间吸烟与≥3 级黏膜炎显著相关，且与≥2 级黏膜炎和皮炎也存在相关性趋势。单因素分析显示，放疗期间吸烟与 LRC 和 OS 降低、pre-RT 酗酒与 OS 降低相关，而>40 包年与 LRC 和 OS 降低相关。多因素分析显示，放疗期间吸烟仍是 OS 降低的独立预测因子，且吸烟包年数也有一定的相关性。