Prospective comparison of acute severe toxicities between smokers and non-smokers during radiotherapy for head and neck cancers.

Oral Oncol

Health Division, University of Reims Champagne-Ardenne, 51100 Reims, France; Department of Otorhinolaryngology Head and Neck Surgery, Robert Debré University Hospital Center, 51100 Reims, France. Electronic address:

Published: June 2024

AI Article Synopsis

  • The study aimed to investigate whether smoking impacts the severity of acute radiation toxicity in head and neck cancer patients undergoing radiotherapy.
  • Out of 102 patients studied, severe acute toxicities like mucositis and dysphagia occurred in various percentages, but no significant link was found between smoking status and these toxicities during treatment.
  • Factors like concurrent chemotherapy and different radiation fractionation schedules were identified as significant contributors to the occurrence of severe acute toxicity, rather than smoking.

Article Abstract

Background And Purpose: The association between smoking and acute radiation toxicities of head and neck cancer (HNC) is currently unproven. The aim of the study was to compare the occurrence of acute severe toxicity between active and non-active smokers treated for HNC by radiotherapy.

Materials And Methods: A prospective monocentric cohort study included patients treated by (chemo)radiotherapy for HNC from January 2021 to January 2023. Smoking status was recorded. Patients underwent a medical exam weekly during the radiotherapy to report acute toxicities according to the Common Terminology Criteria for Adverse Effects system version 5.0. Primary endpoint was the occurrence of at least one grade ≥ 3 acute toxicity among mucositis, dysphagia and dermatitis.

Results: Among the 102 patients included, 27.4 % were active smokers, 58.8 % were former smokers and 13.7 % had never smoked. Regarding toxicity, 23.5 % (n = 24) patients experienced severe mucositis, 37.2 % (n = 38) severe dysphagia, 13.7 % (n = 14) severe dermatitis and 54.9 % (n = 56) experienced at least one of them. Occurrence of severe acute toxicity was not statistically associated with smoking during radiotherapy (64.3 % among active smokers versus 51.3 % among non-active smokers; p = 0.24). On multivariate analysis, concurrent chemotherapy (87.5 % vs 65.2 %; OR = 5.04 [1.64-15.52]; p = 0.004) and 2.12 Gy versus 2 Gy fractionation schedule (64.3 % vs 41.3 %; OR = 2.53 [1.09-5.90]; p = 0.03) were significantly associated with severe acute toxicity.

Conclusion: This study did not find an association between smoking during radiotherapy for HNC and occurrence of severe acute toxicities.

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Source
http://dx.doi.org/10.1016/j.oraloncology.2024.106833DOI Listing

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