The effect of smoking status on survival following radiation therapy for non-small cell lung cancer

Lung Cancer. 2004 Jun;44(3):287-93. doi: 10.1016/j.lungcan.2003.11.012.


The dangers of cigarette smoking are numerous and well-known, including the causal relationship to lung cancer. This study investigates the effect that smoking status at initial consultation has on radiation therapy for non-small cell lung cancer (NSCLC). We identified 237 patients treated between 1991 and 2001 with definitive radiation or chemoradiation who had complete smoking histories. Median age was 73, with 56% males. Distribution by stage was as follows: I/II-27%, IIIA-27%, IIIB-45%, recurrent-1%. Two-year overall survival, stratified by stage of disease, was calculated from the time of initiation of treatment. Median follow-up time from the end of treatment was 13 months. Among those with stage I/II disease, current smokers had a 2-year survival rate of 41% and a median survival of 13.7 months while non-smokers had a 2-year survival of 56% and a median survival of 27.9 months (P = 0.01). Patients with stage III disease did not show any significant differences in overall survival. There were no significant differences in cancer-specific survival in either stage. In conclusion, among NSCLC patients diagnosed with early stage disease, current smokers have a poorer prognosis for survival after radiation therapy.

MeSH terms

  • Aged
  • Carcinoma, Non-Small-Cell Lung / drug therapy
  • Carcinoma, Non-Small-Cell Lung / etiology*
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / radiotherapy*
  • Combined Modality Therapy
  • Female
  • Humans
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / etiology*
  • Lung Neoplasms / pathology
  • Lung Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Smoking / adverse effects*
  • Survival Analysis
  • Treatment Outcome