头颈部癌症患者诊断后的戒烟情况及生存结果

Postdiagnosis Smoking Cessation and Survival Outcomes of Head and Neck Cancer Patients.

作者信息

Mohebbi Elham, Guthrie Garret, Patil Siddhi, Benjamin William, Tan Ming, Giurintano Jonathan P, Witek Matthew E, Ahn Peter H, Taylor Kathryn, Wolf Gregory, Fan Ruzong, Rozek Laura S

机构信息

Department of Oncology, School of Medicine, Georgetown University, Washington, District of Columbia, USA.

Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University Medical Center, Washington, District of Columbia, USA.

出版信息

Head Neck. 2025 Oct;47(10):2725-2734. doi: 10.1002/hed.28182. Epub 2025 May 15.

DOI:10.1002/hed.28182

PMID:40370118

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12434553/

Abstract

BACKGROUND

Post-diagnosis smoking remains prevalent among head and neck squamous cell carcinoma (HNSCC) patients. Smoking cessation may improve patient outcomes.

METHODS

A prospective longitudinal cohort study (2008-2014) included 835 newly diagnosed HNSCC patients and followed up for 7 years. Participants were categorized by smoking behavior (never smokers, former smokers, quitters, continuing smokers, and intermittent smokers). The primary outcomes were overall survival (OS) and recurrence-free survival (RFS).

RESULTS

Smoking cessation after diagnosis was associated with significantly improved OS. Quitters had a 61% reduction in mortality risk compared to continuing smokers (HR: 0.39, 95% CI: 0.22, 0.69), with the greatest benefit in oral cavity cancer patients (HR: 0.28, 95% CI: 0.12, 0.65). Intermittent smokers also showed improved survival (HR: 0.50, 95% CI: 0.31, 0.79). RFS did not significantly differ based on smoking behavior.

CONCLUSIONS

Smoking cessation post-diagnosis improves OS, particularly in oral cavity cancer patients, highlighting the importance of targeted smoking cessation interventions in HNSCC care.

摘要

背景

头颈部鳞状细胞癌（HNSCC）患者确诊后吸烟仍然很普遍。戒烟可能会改善患者的预后。

方法

一项前瞻性纵向队列研究（2008 - 2014年）纳入了835例新确诊的HNSCC患者，并随访7年。参与者按吸烟行为分类（从不吸烟者、既往吸烟者、戒烟者、持续吸烟者和间歇性吸烟者）。主要结局为总生存期（OS）和无复发生存期（RFS）。

结果

确诊后戒烟与OS显著改善相关。与持续吸烟者相比，戒烟者的死亡风险降低了61%（HR：0.39，95%CI：0.22，0.69），在口腔癌患者中获益最大（HR：0.28，95%CI：0.12，0.65）。间歇性吸烟者的生存期也有所改善（HR：0.50，95%CI：0.31，0.79）。RFS在吸烟行为方面无显著差异。