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The impact of pre-treatment smoking status on survival after chemoradiotherapy for locally advanced non-small-cell lung cancer

医学 放化疗 肺癌 肿瘤科 内科学 总体生存率
作者
N. Wallace,Marliese Alexander,Jing Xie,David Ball,Fiona Hegi‐Johnson,Nikki Plumridge,Shankar Siva,Margaret Shaw,Susan Harden,Thomas John,Benjamin Solomon,Ann Officer,Michael MacManus
出处
期刊:Lung Cancer [Elsevier]
卷期号:190: 107531-107531
标识
DOI:10.1016/j.lungcan.2024.107531
摘要

Introduction Smoking is a risk factor for the development of lung cancer and reduces life expectancy within the general population. Retrospective studies suggest that non-smokers have better outcomes after treatment for lung cancer. We used a prospective database to investigate relationships between pre-treatment smoking status and survival for a cohort of patients with stage III non-small-cell lung cancer (NSCLC) treated with curative-intent concurrent chemoradiotherapy (CRT). Methods All patients treated with CRT for stage III NSCLC at a major metropolitan cancer centre were prospectively registered to a database. A detailed smoking history was routinely obtained at baseline. Kaplan-Meier statistics were used to assess overall survival and progression-free survival in never versus former versus current smokers. Results Median overall survival for 265 eligible patients was 2.21 years (95 % Confidence Interval 1.78, 2.84). It was 5.5 years (95 % CI 2.1, not reached) for 25 never-smokers versus 1.9 years (95 % CI 1.5, 2.7) for 182 former smokers and 2.2 years (95 % CI 1.3, 2.7) for 58 current smokers. Hazard ratio for death was 2.43 (95 % CI 1.32–4.50) for former smokers and 2.75 (95 % CI 1.40, 5.40) for current smokers, p = 0.006. Actionable tumour mutations (EGFR, ALK, ROS1) were present in more never smokers (14/25) than former (9/182) or current (3/58) smokers. TKI use was also higher in never smokers but this was not significantly associated with superior survival (Hazard ratio 0.71, 95 % CI 0.41, 1.26). Conclusions Never smokers have substantially better overall survival than former or current smokers after undergoing CRT for NSCLC.
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