Cigarette smoking during external beam radiation therapy for prostate cancer is associated with an increased risk of prostate cancer-specific mortality and treatment-related toxicity Journal Article
| Authors: | Steinberger, E.; Kollmeier, M.; McBride, S.; Novak, C.; Pei, X.; Zelefsky, M. J. |
| Article Title: | Cigarette smoking during external beam radiation therapy for prostate cancer is associated with an increased risk of prostate cancer-specific mortality and treatment-related toxicity |
| Abstract: | Objective To evaluate whether a history of smoking or smoking during therapy after external beam radiotherapy (EBRT) for clinically localised prostate cancer is associated with increased treatment-related toxicity or disease progression. Patients and Methods Of 2358 patients receiving EBRT for prostate cancer between 1988 and 2005, 2156 had chart-recorded smoking histories. Patients were classified as 'never smokers', 'current smokers', 'former smokers', and 'current smoking unknown'. Variables considered included quantity of tobacco use in pack-years, duration of smoking, and, for former smokers, how long before initiation of RT the patient quit smoking, when available. The median EBRT dose was 8100 Gy and the median follow-up was 95 months. Toxicity was graded according to the National Cancer Institute's Common Terminology Criteria for Adverse Events. Results Current smoking significantly increased the risks of both prostate-specific antigen relapse [hazard ratio (HR) 1.4, P = 0.02] and distant metastases (HR 2.37, P < 0.001), as well as prostate cancer-specific death (HR 2.25, P < 0.001). Multivariate analysis showed that smoking was also associated with increased risk of EBRT-related genitourinary toxicities (current smoker, HR 1.8, P = 0.02; former smoker, HR 1.45, P = 0.01). Smoking did not increase gastrointestinal toxicity. Conclusions Current smokers with prostate cancer are at increased risk of biochemical recurrence, distant metastasis, and prostate cancer-related mortality after definitive RT to the prostate. Current and former smokers, regardless of duration and quantity of exposure, are at an increased risk of long-term genitourinary toxicity after EBRT. Oncologists should encourage patients to participate in smoking-cessation programmes before therapy to potentially lower their risk of relapsing disease and post-treatment toxicities. © 2014 The Authors © 2014 BJU International Published by John Wiley & Sons Ltd. |
| Keywords: | adult; controlled study; treatment outcome; aged; major clinical study; cigarette smoking; radiation dose; prostate specific antigen; gastrointestinal symptom; radiotherapy; smoking cessation; smoking; cancer mortality; distant metastasis; prostate cancer; smoking habit; radiation hazard; external beam radiotherapy; toxicity; urogenital tract disease; distant metastases; human; male; priority journal; article |
| Journal Title: | BJU International |
| Volume: | 116 |
| Issue: | 4 |
| ISSN: | 1464-4096 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2015-10-01 |
| Start Page: | 596 |
| End Page: | 603 |
| Language: | English |
| DOI: | 10.1111/bju.12969 |
| PROVIDER: | scopus |
| PUBMED: | 25345838 |
| DOI/URL: | |
| Notes: | Export Date: 2 October 2015 -- Source: Scopus |
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