Smoking and mucosal reactions to radiotherapy.

The pattern of cigarette smoking of 41 patients receiving continuous, hyperfractionated, accelerated radiotherapy for locally advanced head and neck cancer was examined to determine any relationship with the duration of mucositis. The uniformity of the treatment given made it possible to perform an analysis of the factors influencing the duration of the mucositis. There was no correlation with age, sex or weight loss prior to treatment. A highly significant correlation was shown with smoking during and/or after treatment (p = 0.014) and with the volume of mucosa irradiated (p = 0.025). Both appeared to act independently. It is important to encourage patients to cease smoking totally, prior to radiotherapy, to minimize the duration of mucositis associated with radiotherapy.