Smoking During Treatment Decreases Survival in Small-Cell Lung Cancer

Smoking During Treatment Decreases Survival in Small-Cell Lung Cancer

According to results published in the Journal of Clinical Oncology, patients with limited small-cell lung cancer who continue to smoke while they are being treated with chemotherapy and radiation therapy have a decreased survival compared to patients who don’t smoke during treatment.

Lung cancer remains the leading cause of cancer-related deaths in the United States. Small-cell lung cancer (SCLC) refers to the type of cell within the lung that the cancer originated. SCLC is a very aggressive type of lung cancer, and accounts for only approximately 20% of lung cancers in the U.S. It is most often diagnosed in smokers or former smokers. Limited SCLC refers to cancer that is present in only one location in the chest and has not spread to distant sites in the body. The most common form of treatment for patients with limited SCLC is combination chemotherapy plus radiation to the chest and sometimes, preventive radiation to the head.

Researchers recently reviewed data from 189 patients with limited SCLC treated between 1989 and 1999 at the London Regional Cancer Center in Canada. Patients were treated with chemotherapy consisting of cyclophosphamide, doxorubicin, epirubicin, vincristine, etoposide and Platinol®, as well as radiation therapy. Seventy-nine patients continued to smoke during treatment, and 107 quit smoking during treatment. The average duration of survival was 18 months for patients who had quit smoking, and only 13.6 months for patients who continued smoking. At 5 years, overall survival rates were nearly 9% for patients who had quit smoking during therapy, compared to only 4% for those who continued to smoke. Death rates from causes other than cancer were similar between the two groups of patients. Patients who continued smoking did not have an increased incidence of delays in treatment due to side effects.

The researchers concluded that patients with limited SCLC who continue smoking during treatment with chemotherapy and radiation have a decreased survival compared to patients who quit smoking during treatment. Patients with SCLC who are to undergo treatment and are still smoking may with to speak with their physician about possible smoking cessation programs.

Reference: Videtic G, Stitt L, Dar A, et al. Continued cigarette smoking by patients receiving concurrent chemoradiotherapy for limited-stage small-cell lung cancer is associated with decreased survival.

Journal of clinical oncology. 2003;21:1544-1549.

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