TY - JOUR
T1 - Head and neck cancer among lifelong never-smokers and ever-smokers
T2 - Matched-pair analysis of outcomes after radiation therapy
AU - Chen, Allen M.
AU - Chen, Leon M.
AU - Vaughan, Andrew
AU - Farwell, Donald Gregory
AU - Luu, Quang
AU - Purdy, James A.
AU - Vijayakumar, Srinivasan
PY - 2011/6/1
Y1 - 2011/6/1
N2 - Purpose: An increasing proportion of patients with head and neck cancer have no history of smoking. The purpose of this analysis was to compare the clinical outcomes between patients without a history of smoking (never-smokers) and those with a previous history of smoking (ever-smokers) treated by radiation therapy. Methods and Materials: Seventy patients with newly diagnosed squamous cell carcinoma of the oropharynx or oral cavity without a previous history of smoking were matched to a control ever-smoker with a positive tobacco history (>10 pack-years) based on age, gender, ethnicity, Karnofsky Performance Status, primary tumor site, disease stage, primary treatment, radiation dose, and start date. Outcome was compared using Kaplan-Meier analysis. Normal tissue effects were graded according to the Radiation Therapy Oncology Group/European Organization for the Treatment of Cancer radiation toxicity criteria. Results: With a median follow-up of 33 months, lifelong never-smokers had an increased 3-year overall survival (86% vs. 69%), disease-free survival (82% vs. 65%), and local-regional control (85% vs. 70%) compared with the ever-smoker control population (P < 0.05, for all). These differences remained statistically significant when patients treated by postoperative or definitive radiation therapy were analyzed separately. The incidence of grade 3+ complications was also significantly lower among never-smokers compared with ever-smokers (10% vs. 29%, P = 0.01). Conclusions: Prognosis differed significantly between never-smokers and ever-smokers with head and neck cancer treated by radiation therapy. Further studies analyzing the biologic and molecular reasons underlying these differences are planned.
AB - Purpose: An increasing proportion of patients with head and neck cancer have no history of smoking. The purpose of this analysis was to compare the clinical outcomes between patients without a history of smoking (never-smokers) and those with a previous history of smoking (ever-smokers) treated by radiation therapy. Methods and Materials: Seventy patients with newly diagnosed squamous cell carcinoma of the oropharynx or oral cavity without a previous history of smoking were matched to a control ever-smoker with a positive tobacco history (>10 pack-years) based on age, gender, ethnicity, Karnofsky Performance Status, primary tumor site, disease stage, primary treatment, radiation dose, and start date. Outcome was compared using Kaplan-Meier analysis. Normal tissue effects were graded according to the Radiation Therapy Oncology Group/European Organization for the Treatment of Cancer radiation toxicity criteria. Results: With a median follow-up of 33 months, lifelong never-smokers had an increased 3-year overall survival (86% vs. 69%), disease-free survival (82% vs. 65%), and local-regional control (85% vs. 70%) compared with the ever-smoker control population (P < 0.05, for all). These differences remained statistically significant when patients treated by postoperative or definitive radiation therapy were analyzed separately. The incidence of grade 3+ complications was also significantly lower among never-smokers compared with ever-smokers (10% vs. 29%, P = 0.01). Conclusions: Prognosis differed significantly between never-smokers and ever-smokers with head and neck cancer treated by radiation therapy. Further studies analyzing the biologic and molecular reasons underlying these differences are planned.
KW - head and neck cancer
KW - radiation therapy
KW - smoking
KW - squamous cell carcinoma
KW - tobacco
UR - http://www.scopus.com/inward/record.url?scp=79958245221&partnerID=8YFLogxK
U2 - 10.1097/COC.0b013e3181dea40b
DO - 10.1097/COC.0b013e3181dea40b
M3 - Article
C2 - 20622648
AN - SCOPUS:79958245221
SN - 0277-3732
VL - 34
SP - 270
EP - 275
JO - American Journal of Clinical Oncology: Cancer Clinical Trials
JF - American Journal of Clinical Oncology: Cancer Clinical Trials
IS - 3
ER -