Effect of alterations in smoking habit before or during the therapy of squamous cell carcinoma of the head and neck (HNSCC)

Introduction:

A positive smoking history has negative consequences on the survival of HPV-negative and -positive HNSCC-patients. Smoking cessation leads to a decrease in smoking associated diseases. The files of HNSCC-patients were analyzed to elucidate the consequences of altering smoking behavior before or during therapy.

Methods:

Files of 643 patients (treated between 2013 and 2016 at the head and neck tumor center Kiel) were analyzed; follow-up: 0.01 – 4.4yrs; mean: 1.62yrs. age: 64.5 ± 10.2yrs. Kaplan-Meyer-analyses were stratified according to smoking habit, chance of the latter, over all- (OS) and progression free survival (PFS).

Results:

Nonsmoker show better OS when compared to active or ex-smoker (smoking cessation before diagnosis; both p < 0.001). Active and ex-smoker show no differences in OS (p> 0.05). Altering smoking habit at time of diagnosis leads to better OS when compared to active smoker, with no differences whether smoking was ceased or reduced (p> 0.05). PFS shows no differences in all groups analyzed (p> 0.05).

Conclusion:

Interestingly Ex-smoker with HNSCC show no better OS than patients with active smoking habit at time of diagnosis. The advantage of chancing smoking habit before diagnosis results in a decreased incidence of smoking associated diseases. Smoking reduction or cessation at time of diagnosis positively affects OS, this might be due to the tobacco associated peri-tumoral hypoxia during RCT, this effect can also be seen after surgical treatment only. Reduction of tobacco consumption at time of diagnosis should be advised.

Dr. Asita Fazel

Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie des Universitä,

Arnold-Heller-Str. 3, Haus 27, 24105

Kiel

Email: [e-mail]

Publication History

Publication Date:
23 April 2019 (online)