This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Videtic, G. M.M. Articles by Yu, E. W. Search for Related Content PubMed PubMed Citation Articles by Videtic, G. M.M. Articles by Yu, E. W.

Continued Cigarette Smoking by Patients Receiving Concurrent Chemoradiotherapy for Limited-Stage Small-Cell Lung Cancer Is Associated With Decreased Survival

From the Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA; Departments of Biometry, Radiation Oncology, and Medical Oncology, London Regional Cancer Centre, London; Department of Medical Oncology, Kingston Regional Cancer Centre, Kingston, Ontario; and Department of Radiation Oncology, British Columbia Cancer Agency-Vancouver Island Cancer Centre, Victoria, British Columbia, Canada.

Address reprint requests to Gregory M.M. Videtic, MD, Department of Radiation Oncology, Brigham and Women’s Hospital, 75 Francis St, ASBI, L2, Boston, MA 02115; email: gvidetic{at}lroc.harvard.edu.

Purpose: To determine the impact of continued smoking by patients receiving chemotherapy (CHT) and radiotherapy (RT) for limited-stage small-cell lung cancer (LSCLC) on toxicity and survival.

Patients and Methods: A retrospective review was carried out on 215 patients with LSCLC treated between 1989 and 1999. Treatment consisted of six cycles of alternating cyclophosphamide, doxorubicin, vincristine and etoposide, cisplatin (EP). Thoracic RT was concurrent with EP (cycle 2 or 3) only. Patients were known smokers, with their smoking status recorded at the start of chemoradiotherapy (CHT/RT). RT interruption during concurrent CHT/RT was used as the marker for treatment toxicity.

Results: Of 215 patients, smoking status was recorded for 186 patients (86.5%), with 79 (42%) continuing to smoke and 107 (58%) abstaining during CHT/RT. RT interruptions were recorded in 38 patients (20.5%), with a median duration of 5 days (range, 1 to 18 days). Median survival for former smokers was greater than for continuing smokers (18 v 13.6 months), with 5-year actuarial overall survival of 8.9% versus 4%, respectively (log-rank P = .0017). Proportion of noncancer deaths was comparable between the two cohorts. Continuing smokers did not have a greater incidence of toxicity-related treatment breaks (P = .49), but those who continued to smoke and also experienced a treatment break had the poorest overall survival (median, 13.4 months; log-rank P = .0014).

Conclusion: LSCLC patients who continue to smoke during CHT/RT have poorer survival rates than those who do not. Smoking did not have an impact on the rate of treatment interruptions attributed to toxicity.

This article has been cited by other articles:

				P. Song, H. S. Sekhon, X. W. Fu, M. Maier, Y. Jia, J. Duan, B. J. Proskosil, C. Gravett, J. Lindstrom, G. P. Mark, et al. Activated Cholinergic Signaling Provides a Target in Squamous Cell Lung Carcinoma Cancer Res., June 15, 2008; 68(12): 4693 - 4700. [Abstract] [Full Text] [PDF]

				L. E. Jones and C. C. Doebbeling Beyond the Traditional Prognostic Indicators: The Impact of Primary Care Utilization on Cancer Survival J. Clin. Oncol., December 20, 2007; 25(36): 5793 - 5799. [Abstract] [Full Text] [PDF]

				M. A. Socinski and J. A. Bogart Limited-Stage Small-Cell Lung Cancer: The Current Status of Combined-Modality Therapy J. Clin. Oncol., September 10, 2007; 25(26): 4137 - 4145. [Abstract] [Full Text] [PDF]

				M. S. Walker, D. J. Vidrine, E. R. Gritz, R. J. Larsen, Y. Yan, R. Govindan, and E. B. Fisher Smoking Relapse during the First Year after Treatment for Early-Stage Non-Small-Cell Lung Cancer Cancer Epidemiol. Biomarkers Prev., December 1, 2006; 15(12): 2370 - 2377. [Abstract] [Full Text] [PDF]

				J. Tsurutani, S.S. Castillo, J. Brognard, C. A. Granville, C. Zhang, J. J. Gills, J. Sayyah, and P. A. Dennis Tobacco components stimulate Akt-dependent proliferation and NF{kappa}B-dependent survival in lung cancer cells Carcinogenesis, July 1, 2005; 26(7): 1182 - 1195. [Abstract] [Full Text] [PDF]

				E. E. Vokes, J. Crawford, J. Bogart, M. A. Socinski, G. Clamon, and M. R. Green Concurrent Chemoradiotherapy for Unresectable Stage III Non-Small Cell Lung Cancer Clin. Cancer Res., July 1, 2005; 11(13): 5045s - 5050s. [Abstract] [Full Text] [PDF]

				Y. I. Garces, P. Yang, J. Parkinson, X. Zhao, J. A. Wampfler, J. O. Ebbert, and J. A. Sloan The Relationship Between Cigarette Smoking and Quality of Life After Lung Cancer Diagnosis Chest, December 1, 2004; 126(6): 1733 - 1741. [Abstract] [Full Text] [PDF]

				A. I. Neugut, A. C. Chen, and D. P. Petrylak The "Skinny" on Obesity and Prostate Cancer Prognosis J. Clin. Oncol., February 1, 2004; 22(3): 395 - 398. [Full Text] [PDF]

				C. M. Tammemagi, C. Neslund-Dudas, M. Simoff, and P. Kvale Smoking and Lung Cancer Survival: The Role of Comorbidity and Treatment Chest, January 1, 2004; 125(1): 27 - 37. [Abstract] [Full Text] [PDF]