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.
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.
Authors: June M Chan; Stacey A Kenfield; Rebecca E Graff; Crystal S Langlais; Erin L Van Blarigan; Claire H Pernar; Meir J Stampfer; Edward L Giovannucci; Lorelei A Mucci Journal: Br J Cancer Date: 2022-08-26 Impact factor: 9.075
Authors: Paul Riviere; Abhishek Kumar; Elaine Luterstein; Lucas K Vitzthum; Vinit Nalawade; Reith R Sarkar; Alex K Bryant; John P Einck; Arno J Mundt; James D Murphy; Brent S Rose Journal: Prostate Cancer Prostatic Dis Date: 2019-10-17 Impact factor: 5.554
Authors: Kyle Wang; Panayiotis Mavroidis; Trevor J Royce; Aaron D Falchook; Sean P Collins; Stephen Sapareto; Nathan C Sheets; Donald B Fuller; Issam El Naqa; Ellen Yorke; Jimm Grimm; Andrew Jackson; Ronald C Chen Journal: Int J Radiat Oncol Biol Phys Date: 2020-12-22 Impact factor: 7.038
Authors: R Muirhead; K Drinkwater; S M O'Cathail; R Adams; R Glynne-Jones; M Harrison; M A Hawkins; D Sebag-Montefiore; D C Gilbert Journal: Clin Oncol (R Coll Radiol) Date: 2016-10-31 Impact factor: 4.126