吸烟对 III 期结肠癌患者的影响：来自癌症和白血病组 B 89803 的结果。
Impact of smoking on patients with stage III colon cancer: results from Cancer and Leukemia Group B 89803.
机构信息
Division of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02113, USA.
出版信息
Cancer. 2010 Feb 15;116(4):957-66. doi: 10.1002/cncr.24866.
BACKGROUND
Cigarette smoking has been shown to increase the risk of developing colorectal cancer, particularly smoking early in life. Little is known about the impact of tobacco use on colon cancer recurrence among colon cancer survivors.
METHODS
The authors prospectively collected lifetime smoking history from stage III colon cancer patients enrolled in a phase 3 trial via self-report questionnaires during and 6 months after completion of adjuvant chemotherapy. Smoking status was defined as never, current, or past. Lifetime pack-years were defined as number of lifetime packs of cigarettes. Patients were followed for recurrence or death.
RESULTS
Data on smoking history were captured on 1045 patients with stage III colon cancer receiving adjuvant therapy (46% never smokers; 44% past; 10% current). The adjusted hazard ratio (HR) for disease-free survival (DFS) was 0.99 (95% confidence interval [CI], 0.70-1.41), 1.17 (95% CI 0.89-1.55), and 1.22 (95% CI 0.92-1.61) for lifetime pack-years 0-10, 10-20, and 20+, respectively, compared with never smoking (P = .16). In a preplanned exploratory analysis of smoking intensity early in life, the adjusted HR for 12+ pack-years before age 30 years for DFS was 1.37 (95% CI, 1.02-1.84) compared with never smoking (P = .04). The adjusted HR for DFS was 1.18 (95% CI, 0.92-1.50) for past smokers and 1.10 (95% CI, 0.73-1.64) for current smokers, compared with never smokers.
CONCLUSIONS
Total tobacco usage early in life may be an important, independent prognostic factor of cancer recurrences and mortality in patients with stage III colon cancer.
背景
吸烟已被证实会增加罹患结直肠癌的风险，尤其是在年轻时开始吸烟。关于烟草使用对结肠癌幸存者中结肠癌复发的影响知之甚少。
方法
作者通过自我报告问卷，在接受辅助化疗期间和化疗结束后 6 个月，从参加 3 期临床试验的 III 期结肠癌患者前瞻性地收集终生吸烟史。吸烟状态定义为从未吸烟、当前吸烟或过去吸烟。终生吸烟包年数定义为终生吸烟的包数。患者随访复发或死亡情况。
结果
在接受辅助治疗的 1045 例 III 期结肠癌患者中获得了吸烟史数据（46%从不吸烟者；44%既往吸烟者；10%当前吸烟者）。无病生存期（DFS）的调整后的风险比（HR）分别为 0.99（95%置信区间 [CI]，0.70-1.41）、1.17（95% CI，0.89-1.55）和 1.22（95% CI，0.92-1.61），与从不吸烟者相比，终生吸烟包年数分别为 0-10、10-20 和 20+（P=0.16）。在一项对生命早期吸烟强度的预先计划的探索性分析中，30 岁前 12+包年与 DFS 的调整后 HR 为 1.37（95% CI，1.02-1.84），与从不吸烟者相比（P=0.04）。与从不吸烟者相比，过去吸烟者的 DFS 调整后 HR 为 1.18（95% CI，0.92-1.50），当前吸烟者为 1.10（95% CI，0.73-1.64）。
结论
生命早期的总烟草使用可能是 III 期结肠癌患者癌症复发和死亡的一个重要的独立预后因素。
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