The impact of pre-treatment smoking status on survival after chemoradiotherapy for locally advanced non-small-cell lung cancer
- Author(s)
- Wallace, ND; Alexander, M; Xie, J; Ball, D; Hegi-Johnson, F; Plumridge, N; Siva, S; Shaw, M; Harden, S; John, T; Solomon, B; Officer, A; MacManus, M;
- Journal Title
- Lung Cancer
- Publication Type
- Research article
- Abstract
- 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.
- Publisher
- Elsevier
- Keywords
- Chemoradiotherapy; Locally-advanced; Non-small-cell; Smoking status; Survival
- Department(s)
- Radiation Oncology; Pharmacy; Biostatistics and Clinical Trials; Medical Oncology
- Publisher's Version
- https://doi.org/10.1016/j.lungcan.2024.107531
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- Refer to copyright notice on published article.
Creation Date: 2024-05-07 04:32:39
Last Modified: 2024-05-07 04:39:44