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Original article
peer-reviewed

The Impact of Tobacco Use on Outcomes and Toxicity in a Predominantly Minority Population of Males with Prostate Cancer Receiving External Beam Radiation



Abstract

Introduction

To investigate whether current or prior smoking history had any impact on prostate cancer outcomes and toxicity in our predominantly minority population of males receiving dose-escalated external beam radiation therapy (EBRT).

Methods

Of the 500 patients treated with EBRT between 2003-2011, 444 had smoking histories recorded. Patients were classified as current smoker, former smoker, or never smoker. Biochemical failure-free survival (BFFS) and distant metastatic-free survival (DMFS) endpoints were analyzed. Multivariate Cox regression and multivariate logistic regression were used to assess whether smoking had an impact on outcomes and toxicity respectively.

Results 

There were 176 males (39.6%) classified as never smokers, 169 (38.1%) as prior smokers, and 99 (22.3%) as current smokers. The median follow-up was 76 months (range nine-146) and 61.9% of patients were African American. The eight-year BFFS for never smokers, prior smokers and current smokers was 73.6%, 80.2%, and 73.4% respectively, p=0.38. Similarly, the eight-year DMFS was 92.8%, 96.8%, and 95.3% respectively, p=0.54. On multivariate analysis, prior smoking (HR 0.72, p=0.19) and current smoking (HR 1.02, p=0.93) were not associated with increased biochemical failure. Similarly, smoking use was not associated with increased distant metastatic disease (hormone receptor (HR) 0.71, p=0.51 for prior smokers, HR 1.41, p=0.52 for current smokers). The presence of intermediate-risk disease (HR 2.87, p=0.002) was associated with an increased likelihood of biochemical failure. The high-risk disease was associated with both a higher risk of biochemical failure (HR 8.02, p <0.001) as well as distant metastatic disease (HR 17.61, p=0.01). On multivariate regression, prior or current smoking use was not associated with an increased likelihood of late grade two genitourinary or gastrointestinal toxicity.

Conclusion

Current or prior smoking use was not associated with inferior outcomes or increased toxicity in this study comprising a predominantly minority population undergoing dose escalated radiation therapy for prostate cancer.



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Original article
peer-reviewed

The Impact of Tobacco Use on Outcomes and Toxicity in a Predominantly Minority Population of Males with Prostate Cancer Receiving External Beam Radiation


Author Information

Anna Lee Corresponding Author

Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

Meng S. Shao

Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

David Schwartz

Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

Joseph Safdieh

Radiation Oncology, Kings County Hospital Center

Virginia W. Osborn

Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

David Schreiber

Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Animal subjects: This study did not involve animal subjects or tissue. Conflicts of interest: The authors have declared that no conflicts of interest exist.


Original article
peer-reviewed

The Impact of Tobacco Use on Outcomes and Toxicity in a Predominantly Minority Population of Males with Prostate Cancer Receiving External Beam Radiation


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Original article
peer-reviewed

The Impact of Tobacco Use on Outcomes and Toxicity in a Predominantly Minority Population of Males with Prostate Cancer Receiving External Beam Radiation

  • Author Information
    Anna Lee Corresponding Author

    Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

    Meng S. Shao

    Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

    David Schwartz

    Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

    Joseph Safdieh

    Radiation Oncology, Kings County Hospital Center

    Virginia W. Osborn

    Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

    David Schreiber

    Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Animal subjects: This study did not involve animal subjects or tissue. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: May 18, 2017

    DOI

    10.7759/cureus.1259

    Cite this article as:

    Lee A, Shao M S, Schwartz D, et al. (May 18, 2017) The Impact of Tobacco Use on Outcomes and Toxicity in a Predominantly Minority Population of Males with Prostate Cancer Receiving External Beam Radiation. Cureus 9(5): e1259. doi:10.7759/cureus.1259

    Publication history

    Received by Cureus: April 28, 2017
    Peer review began: May 02, 2017
    Peer review concluded: May 12, 2017
    Published: May 18, 2017

    Copyright

    © Copyright 2017
    Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction

To investigate whether current or prior smoking history had any impact on prostate cancer outcomes and toxicity in our predominantly minority population of males receiving dose-escalated external beam radiation therapy (EBRT).

Methods

Of the 500 patients treated with EBRT between 2003-2011, 444 had smoking histories recorded. Patients were classified as current smoker, former smoker, or never smoker. Biochemical failure-free survival (BFFS) and distant metastatic-free survival (DMFS) endpoints were analyzed. Multivariate Cox regression and multivariate logistic regression were used to assess whether smoking had an impact on outcomes and toxicity respectively.

Results 

There were 176 males (39.6%) classified as never smokers, 169 (38.1%) as prior smokers, and 99 (22.3%) as current smokers. The median follow-up was 76 months (range nine-146) and 61.9% of patients were African American. The eight-year BFFS for never smokers, prior smokers and current smokers was 73.6%, 80.2%, and 73.4% respectively, p=0.38. Similarly, the eight-year DMFS was 92.8%, 96.8%, and 95.3% respectively, p=0.54. On multivariate analysis, prior smoking (HR 0.72, p=0.19) and current smoking (HR 1.02, p=0.93) were not associated with increased biochemical failure. Similarly, smoking use was not associated with increased distant metastatic disease (hormone receptor (HR) 0.71, p=0.51 for prior smokers, HR 1.41, p=0.52 for current smokers). The presence of intermediate-risk disease (HR 2.87, p=0.002) was associated with an increased likelihood of biochemical failure. The high-risk disease was associated with both a higher risk of biochemical failure (HR 8.02, p <0.001) as well as distant metastatic disease (HR 17.61, p=0.01). On multivariate regression, prior or current smoking use was not associated with an increased likelihood of late grade two genitourinary or gastrointestinal toxicity.

Conclusion

Current or prior smoking use was not associated with inferior outcomes or increased toxicity in this study comprising a predominantly minority population undergoing dose escalated radiation therapy for prostate cancer.



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Anna Lee, M.D., M.P.H.

Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

For correspondence:
annalee722@gmail.com

Meng S. Shao

Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

David Schwartz

Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

Joseph Safdieh

Radiation Oncology, Kings County Hospital Center

Virginia W. Osborn

Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

David Schreiber

Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

Anna Lee, M.D., M.P.H.

Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

For correspondence:
annalee722@gmail.com

Meng S. Shao

Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

David Schwartz

Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

Joseph Safdieh

Radiation Oncology, Kings County Hospital Center

Virginia W. Osborn

Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System

David Schreiber

Radiation Oncology, SUNY Downstate Medical Center & Veterans Affairs, New York Harbor Healthcare System