Purpose:
Smoking has negative impact on survival of HNSCC patients. In addition, smoking is associated with the incidence of co-morbidities and, thus, it is assumed that not smoking per se but co-morbidities impact the course of therapy in terms of dose-reduction or even cessation of therapy. However, data addressing this issue is missing at present.
Method:
Patient files and tumour documentation from 656 cases of the head and neck cancer centre Kiel were retrospectively analyzed. Smoking habit in pack years (py) was assessed and correlated to co-morbidities and course of treatment.
Results:
116/656 (18%), 359 (55%) and 180 (27%) patients were non-smokers smokers, and former smokers, respectively. 327 (50%) were treated by surgery only; 123 (19%) received surgery + adjuvant RCT and 70 (11%) surgery + adjuvant RT. 118 (18%) received primary RCT and 17 (2%) primary RT. 122 (19%) had no and 534 (81%) had co-morbidities. Smoking (> 10py) is significantly associated with co-morbidities (p = 0.003). However, smoking and co-morbidities, either alone or in combination, are not correlated to dose-reduction or cessation of therapy (p > 0.05).
Conclusions:
As expected, smoking is significantly associated with co-morbidities. Cessation and dose-reduction of treatment are as common among smokers and patients with co-morbidities as among non-smokers and patients without co-morbidities. Reason for the latter can possibly be found in appropriate medication treating these co-morbidities.
