Prognosis much worse for head-and-neck radiation patients who smoke

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Active smokers undergoing radiation therapy for head and neck cancer demonstrated significantly worse survival rates than former smokers in a recent study.

The association between tobacco smoking and cancers of the head and neck is well known, but little data existed as to whether continuing to smoke during treatment affected prognosis.

In a review of medical records, 101 persons with newly diagnosed squamous cell carcinoma of the head and neck who continued to smoke during radiation therapy were matched with control patients who had quit smoking before the start of treatment. Over a median follow-up period of 49 months, 5-year survival rates were 23% for the current smokers, compared with 55% for those who had quit. Smokers also fared worse than quitters in disease-free survival (42% vs. 65%) and in incidence of grade 3 or greater late complications (31% vs. 49%).

“I've always told patients, ‘You should really stop smoking,' but I had no tangible evidence to use to convince them that they would be worse off if they continued to smoke,” remarked Allen Chen, MD, lead author of the study, in a statement describing his team's results.

Dr. Chen, a radiation oncologist at the University of California Davis Cancer Center, emphasized that the findings—published in International Journal of Radiation Oncology*Biology*Physics (2011;79:414-419)—are based on observational study, which does not establish a cause-effect relationship between smoking during radiation therapy and poorer outcomes. For example, active smokers may be at a higher risk of death due to heart disease, stroke, diabetes, or other health conditions.

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