Head and neck cancer among lifelong never-smokers and ever-smokers: Matched-pair analysis of outcomes after radiation therapy

Allen M. Chen, Leon M. Chen, Andrew T M Vaughan, D Gregory Farwell, Quang Luu, James A. Purdy, Srinivasan Vijayakumar

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: An increasing proportion of patients with head and neck cancer have no history of smoking. The purpose of this analysis was to compare the clinical outcomes between patients without a history of smoking (never-smokers) and those with a previous history of smoking (ever-smokers) treated by radiation therapy. Methods and Materials: Seventy patients with newly diagnosed squamous cell carcinoma of the oropharynx or oral cavity without a previous history of smoking were matched to a control ever-smoker with a positive tobacco history (>10 pack-years) based on age, gender, ethnicity, Karnofsky Performance Status, primary tumor site, disease stage, primary treatment, radiation dose, and start date. Outcome was compared using Kaplan-Meier analysis. Normal tissue effects were graded according to the Radiation Therapy Oncology Group/European Organization for the Treatment of Cancer radiation toxicity criteria. Results: With a median follow-up of 33 months, lifelong never-smokers had an increased 3-year overall survival (86% vs. 69%), disease-free survival (82% vs. 65%), and local-regional control (85% vs. 70%) compared with the ever-smoker control population (P < 0.05, for all). These differences remained statistically significant when patients treated by postoperative or definitive radiation therapy were analyzed separately. The incidence of grade 3+ complications was also significantly lower among never-smokers compared with ever-smokers (10% vs. 29%, P = 0.01). Conclusions: Prognosis differed significantly between never-smokers and ever-smokers with head and neck cancer treated by radiation therapy. Further studies analyzing the biologic and molecular reasons underlying these differences are planned.

Original languageEnglish (US)
Pages (from-to)270-275
Number of pages6
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume34
Issue number3
DOIs
StatePublished - Jun 2011

Fingerprint

Matched-Pair Analysis
Head and Neck Neoplasms
Radiotherapy
Smoking
Radiation
Karnofsky Performance Status
Oropharynx
Radiation Oncology
Kaplan-Meier Estimate
Disease-Free Survival
Tobacco
Mouth
Squamous Cell Carcinoma
Neoplasms
History
Survival
Incidence
Therapeutics
Population

Keywords

  • head and neck cancer
  • radiation therapy
  • smoking
  • squamous cell carcinoma
  • tobacco

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Head and neck cancer among lifelong never-smokers and ever-smokers : Matched-pair analysis of outcomes after radiation therapy. / Chen, Allen M.; Chen, Leon M.; Vaughan, Andrew T M; Farwell, D Gregory; Luu, Quang; Purdy, James A.; Vijayakumar, Srinivasan.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 34, No. 3, 06.2011, p. 270-275.

Research output: Contribution to journalArticle

@article{55d37b9887ad4d75a2454a157139471e,
title = "Head and neck cancer among lifelong never-smokers and ever-smokers: Matched-pair analysis of outcomes after radiation therapy",
abstract = "Purpose: An increasing proportion of patients with head and neck cancer have no history of smoking. The purpose of this analysis was to compare the clinical outcomes between patients without a history of smoking (never-smokers) and those with a previous history of smoking (ever-smokers) treated by radiation therapy. Methods and Materials: Seventy patients with newly diagnosed squamous cell carcinoma of the oropharynx or oral cavity without a previous history of smoking were matched to a control ever-smoker with a positive tobacco history (>10 pack-years) based on age, gender, ethnicity, Karnofsky Performance Status, primary tumor site, disease stage, primary treatment, radiation dose, and start date. Outcome was compared using Kaplan-Meier analysis. Normal tissue effects were graded according to the Radiation Therapy Oncology Group/European Organization for the Treatment of Cancer radiation toxicity criteria. Results: With a median follow-up of 33 months, lifelong never-smokers had an increased 3-year overall survival (86{\%} vs. 69{\%}), disease-free survival (82{\%} vs. 65{\%}), and local-regional control (85{\%} vs. 70{\%}) compared with the ever-smoker control population (P < 0.05, for all). These differences remained statistically significant when patients treated by postoperative or definitive radiation therapy were analyzed separately. The incidence of grade 3+ complications was also significantly lower among never-smokers compared with ever-smokers (10{\%} vs. 29{\%}, P = 0.01). Conclusions: Prognosis differed significantly between never-smokers and ever-smokers with head and neck cancer treated by radiation therapy. Further studies analyzing the biologic and molecular reasons underlying these differences are planned.",
keywords = "head and neck cancer, radiation therapy, smoking, squamous cell carcinoma, tobacco",
author = "Chen, {Allen M.} and Chen, {Leon M.} and Vaughan, {Andrew T M} and Farwell, {D Gregory} and Quang Luu and Purdy, {James A.} and Srinivasan Vijayakumar",
year = "2011",
month = "6",
doi = "10.1097/COC.0b013e3181dea40b",
language = "English (US)",
volume = "34",
pages = "270--275",
journal = "American Journal of Clinical Oncology",
issn = "0277-3732",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Head and neck cancer among lifelong never-smokers and ever-smokers

T2 - Matched-pair analysis of outcomes after radiation therapy

AU - Chen, Allen M.

AU - Chen, Leon M.

AU - Vaughan, Andrew T M

AU - Farwell, D Gregory

AU - Luu, Quang

AU - Purdy, James A.

AU - Vijayakumar, Srinivasan

PY - 2011/6

Y1 - 2011/6

N2 - Purpose: An increasing proportion of patients with head and neck cancer have no history of smoking. The purpose of this analysis was to compare the clinical outcomes between patients without a history of smoking (never-smokers) and those with a previous history of smoking (ever-smokers) treated by radiation therapy. Methods and Materials: Seventy patients with newly diagnosed squamous cell carcinoma of the oropharynx or oral cavity without a previous history of smoking were matched to a control ever-smoker with a positive tobacco history (>10 pack-years) based on age, gender, ethnicity, Karnofsky Performance Status, primary tumor site, disease stage, primary treatment, radiation dose, and start date. Outcome was compared using Kaplan-Meier analysis. Normal tissue effects were graded according to the Radiation Therapy Oncology Group/European Organization for the Treatment of Cancer radiation toxicity criteria. Results: With a median follow-up of 33 months, lifelong never-smokers had an increased 3-year overall survival (86% vs. 69%), disease-free survival (82% vs. 65%), and local-regional control (85% vs. 70%) compared with the ever-smoker control population (P < 0.05, for all). These differences remained statistically significant when patients treated by postoperative or definitive radiation therapy were analyzed separately. The incidence of grade 3+ complications was also significantly lower among never-smokers compared with ever-smokers (10% vs. 29%, P = 0.01). Conclusions: Prognosis differed significantly between never-smokers and ever-smokers with head and neck cancer treated by radiation therapy. Further studies analyzing the biologic and molecular reasons underlying these differences are planned.

AB - Purpose: An increasing proportion of patients with head and neck cancer have no history of smoking. The purpose of this analysis was to compare the clinical outcomes between patients without a history of smoking (never-smokers) and those with a previous history of smoking (ever-smokers) treated by radiation therapy. Methods and Materials: Seventy patients with newly diagnosed squamous cell carcinoma of the oropharynx or oral cavity without a previous history of smoking were matched to a control ever-smoker with a positive tobacco history (>10 pack-years) based on age, gender, ethnicity, Karnofsky Performance Status, primary tumor site, disease stage, primary treatment, radiation dose, and start date. Outcome was compared using Kaplan-Meier analysis. Normal tissue effects were graded according to the Radiation Therapy Oncology Group/European Organization for the Treatment of Cancer radiation toxicity criteria. Results: With a median follow-up of 33 months, lifelong never-smokers had an increased 3-year overall survival (86% vs. 69%), disease-free survival (82% vs. 65%), and local-regional control (85% vs. 70%) compared with the ever-smoker control population (P < 0.05, for all). These differences remained statistically significant when patients treated by postoperative or definitive radiation therapy were analyzed separately. The incidence of grade 3+ complications was also significantly lower among never-smokers compared with ever-smokers (10% vs. 29%, P = 0.01). Conclusions: Prognosis differed significantly between never-smokers and ever-smokers with head and neck cancer treated by radiation therapy. Further studies analyzing the biologic and molecular reasons underlying these differences are planned.

KW - head and neck cancer

KW - radiation therapy

KW - smoking

KW - squamous cell carcinoma

KW - tobacco

UR - http://www.scopus.com/inward/record.url?scp=79958245221&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79958245221&partnerID=8YFLogxK

U2 - 10.1097/COC.0b013e3181dea40b

DO - 10.1097/COC.0b013e3181dea40b

M3 - Article

C2 - 20622648

AN - SCOPUS:79958245221

VL - 34

SP - 270

EP - 275

JO - American Journal of Clinical Oncology

JF - American Journal of Clinical Oncology

SN - 0277-3732

IS - 3

ER -