Impact of smoking cessation on clinical outcomes in patients with head and neck squamous cell carcinoma receiving curative chemoradiotherapy: A prospective study
Journal
Head and Neck
Journal Volume
41
Journal Issue
9
Pages
3201-3210
Date Issued
2019
Author(s)
Shen C.-W.
Lin Y.-L.
Abstract
Background: We hypothesized that patients with head and neck squamous cell carcinoma (HNSCC) with smoking cessation during curative chemoradiotherapy (CRT) had fewer complications and lower tumor progression risks. Methods: Sixty-three patients with nonmetastatic HNSCC who were smokers at diagnosis (carbon monoxide [CO] breath concentrations ?3 ppm) and underwent curative CRT were prospectively enrolled. Successful smoking cessation throughout CRT was confirmed by CO breath concentrations <3 ppm at CRT completion. Results: Forty-one patients (65%) successfully discontinued smoking throughout CRT. With a median 33-month follow-up, patients with successful smoking cessation during CRT had significantly fewer, greater, and lower probabilities of grade ?3 acute toxicities (P =.01), progression-free survival (P =.03), and permanent gastrostomy or tracheostomy (P =.04), respectively, than those continuing smoking throughout CRT. In multivariate analysis, successful smoking cessation during CRT significantly reduced tumor progression risks (hazard ratio: 0.4, P =.05). Conclusion: Smoking cessation during curative CRT reduced treatment-related toxicities and tumor progression risks in patients with HNSCC. ? 2019 Wiley Periodicals, Inc.
SDGs
Other Subjects
cisplatin; taxane derivative; UFT; acute toxicity; adult; aged; Article; bone necrosis; cancer survival; chemoradiotherapy; clinical article; clinical outcome; clinical trial; cone beam computed tomography; dermatitis; distant metastasis free survival; female; fibrosis; follow up; gastrostomy; head and neck squamous cell carcinoma; human; infection; intensity modulated radiation therapy; male; mucosa inflammation; overall survival; priority journal; progression free survival; prospective study; radiation dose fractionation; radiotherapy dosage; risk reduction; smoking cessation; smoking cessation program; soft tissue disease; tracheostomy; trismus; tumor growth; adverse event; disease exacerbation; head and neck tumor; middle aged; multivariate analysis; prognosis; survival analysis; treatment outcome; Adult; Aged; Chemoradiotherapy; Disease Progression; Female; Head and Neck Neoplasms; Humans; Male; Middle Aged; Multivariate Analysis; Prognosis; Prospective Studies; Smoking Cessation; Squamous Cell Carcinoma of Head and Neck; Survival Analysis; Treatment Outcome
Publisher
John Wiley and Sons Inc.
Type
journal article