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S. Campainha

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    P1.01 - Poster Session with Presenters Present (ID 453)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Epidemiology/Tobacco Control and Cessation/Prevention
    • Presentations: 1
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      P1.01-023 - Smoking Cessation before Initiation of Chemotherapy in Metastatic Non-Small Lung Cancer: Influence on Prognosis (ID 5610)

      14:30 - 15:45  |  Author(s): S. Campainha

      • Abstract

      The association between cigarette smoking and lung cancer mortality is well known. Some studies have shown a decreased overall survival (OS) in early stage non-small cell carcinoma (NSCLC) patients that continue to smoke after diagnosis. It is documented that in patients with metastatic disease, continued smoking increases resistance to systemic therapies but the impact of smoking cessation during treatment on outcomes for these patients is not well defined. Objective: To evaluate the impact of smoking cessation, before initiation of chemotherapy (CT), on survival in advanced NSCLC.

      Patients referred to our centre, between January 2010 and June 2016, and diagnosed with metastatic NSCLC were analysed. Patients defined as smokers at diagnosis and treated with at least one cycle of chemotherapy were included. Clinical characteristics and survival outcome were reviewed and compared between patients who quit smoke before and after the initiation of chemotherapy.

      A total of 113 patients were included [mean age 59±10 years; 89.4% (n=101)]. The histological type more predominant was adenocarcinoma (70.8%) and the most common sites of metastasis were lung, bone and brain (35.4%, 23.9% and 23%, respectively). The majority of patients had performance status 1 and no weight loss at time of diagnosis (53.1% and 58.4%, respectively) and the comorbidity most prevalent was hypertension (19.5%). The average number of cigarettes smoked was 51±23pack-years and 81.4% of patients smoked >30pack-years. The most used CT regimen was platinum combined with pemetrexed (63.7%). Patients who quit smoking before CT showed a better median OS although not statistical significant (8 vs. 7 months; p=0.478). This was also seen in heavy smokers ≥30 pack-years, with a median OS of 8 vs. 6.5 months (p=0.674). The multivariate analysis only showed an influence of type of CT on survival.

      Although not significant differences in OS between groups were observed in our sample, the median survival was better in patients that quit smoking before the initiation of CT, even in heavy smokers. Continued smoking after CT initiation is known to adversely affect treatment response and quality of life and efforts to encourage smoking cessation even among this population of patients should be made.