Comparison of self-reported smoking status and physician-recorded smoking status among patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN).

摘要

Smoking is a major risk factor for the development of SCCHN. Following a diagnosis of SCCHN, previous and current history of tobacco use negatively impacts overall survival and development of distant metastases [1,2]. Pytynia et al. [3] found a three-fold increased risk of death and recurrence in a matched-pair analysis of never versus ever smokers treated for SCCHN; this risk strongly trended towards significance on multivariate analysis (recurrence HR 2.73, 0.96-7.80, p = 0.061; death HR 3.04, 0.94-9.80, p = 0.062). The recently reported RTOG 0129 phase III trial showed a 1% increased risk of death and recurrence for each additional pack-year of smoking [4]. In particular, smoking exposure negatively impacted survival outcomes among patients with HPV-associated oropharyngeal SCC treated with chemoradiation, therefore suggesting reduced sensitivity to chemoradiation when there is a history of prolonged tobacco exposure (i.e. >10 pack years). Patient self-reported smoking status has therefore become a fundamental component of a patient's medical history to predict treatment response and long term outcome.