Patients who smoke during therapy for head and neck cancer have poorer outcomes

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Patients with head and neck cancer who smoke during radiation therapy have unfavorable outcomes, according to a study published in the International Journal of Radiation Oncology, Biology and Physics (2010 Apr 14 [Epub ahead of print]).

The study, led by Allen Chen, an assistant professor in the Department of Radiation Oncology at the UC Davis Cancer Center, involved reviewing medical records of 101 patients with recently diagnosed squamous cell carcinoma of the head and neck who continued to smoke during radiation therapy. These patients were matched to others who had quit smoking prior to starting radiation therapy for their head and neck cancers.

Results revealed that head- and neck-cancer patients who continue to smoke during radiation therapy have poorer 5-year overall survival and higher rates of disease recurrence than those who quit smoking before starting treatment. Specifically, 55% of patients who had quit smoking prior to treatment were still alive 5 years later, compared to 23% of those who continued to smoke.

Researchers also reported that 53 of the patients who still smoked experienced disease recurrence, compared to 40 patient in the control group. In addition, active smokers experienced more complications of radiation therapy than patients who quit smoking prior to starting therapy.

“A diagnosis of cancer is emotionally devastating, and a lot of patients are reluctant to entertain the idea of smoking cessation,” said Dr. Chen. “Many patients can't or won't connect the dots, and unfortunately, our data shows that by continuing to smoke, they are more likely to gamble away the possibility of cure.”

Dr Chen and his team explained that their findings suggest that smoking deprives the body of much needed oxygen and radiation therapy requires oxygenation for the production of free radicals.

“Regardless of the underlying reasons, our finding should provide both clinicians and patients alike with compelling evidence supporting the role of smoking cessation in this setting,” Dr. Chen concluded. “Counseling these patients on its importance, both here at UC Davis and in the community, is a must.”

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