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

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.

• Authors: Neil D Wallace, Marliese Alexander, Jing Xie, David Ball, Fiona Hegi-Johnson, Nikki Plumridge, Shankar Siva, Mark Shaw, Susan Harden, Tom John, Ben Solomon, Ann Officer, Michael MacManus
• Journal: Lung cancer (Amsterdam, Netherlands) (Lung Cancer) Vol. 190 Pg. 107531 (Apr 2024) ISSN: 1872-8332 [Electronic] Ireland
• PMID: 38513538 (Publication Type: Journal Article)
• Copyright: Copyright © 2024 Elsevier B.V. All rights reserved.

Chemical References

• Protein-Tyrosine Kinases
• Proto-Oncogene Proteins

Topics

• Humans
• Carcinoma, Non-Small-Cell Lung (drug therapy)
• Lung Neoplasms (drug therapy)
• Retrospective Studies
• Protein-Tyrosine Kinases
• Proto-Oncogene Proteins
• Smoking (adverse effects)
• Chemoradiotherapy