Skip to main content
AAO-HNSF 2024 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back

Scientific Oral Presentations

Care Equity, Quality, and Safety

Session: Scientific Oral Presentations 3 - Care Equity, Quality, and Safety

Smoking During Radiation Worsens Symptoms in Head and Neck Cancer Patients

Monday, September 30, 2024
10:06 AM – 10:12 AM EDT
Location: MBCC, 235-237
Disclosure(s):
Lucien Khalil, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Christopher T. Wilke, MD/PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Angela L. Mazul, PhD, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jose P. Zevallos, MD, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Patients with head and neck cancer (HNC) undergoing radiation face challenging treatment-related symptoms. Continued cigarette smoking during treatment may exacerbate symptoms affecting quality of life (QOL). This analysis explored whether patients who continued to smoke during radiation had worse symptoms at the end of treatment compared to those who quit/never smoked.

Methods: This is a secondary analysis of a prospective study examining symptom monitoring in HNC patients undergoing radiation. Patients who completed definitive or adjuvant radiation at an academic-affiliated cancer center from 2020 and 2024 were included. Patients were divided into smokers and non-smokers (quit/never) based on smoking status during radiation. Symptom burden was assessed using the MD Anderson Symptom Inventory, with higher scores indicating greater symptom severity. A two sample t-test was used for statistical analysis.

Results: In total, 221 participants were included in the analysis (mean age 62.93 ± 9.94 years; 170 [85.9%] White; 138 [69.7%] male). Most patients were not actively smoking (198 [89.6%]). The most common cancer sites in non-smokers were oropharynx (48%), oral cavity (21.2%), and larynx/hypopharynx (14.6%) while for smokers, the sites were oropharynx (43.5%), larynx/hypopharynx (30.4%), and oral cavity (13%). Of the non-smokers, 42.4% had stage III/IV cancer compared to 21.7% with stage III/IV in smokers (p = 0.424). Patients who continued smoking reported significantly worse symptoms pertaining to memory, numbness/tingling and voice quality. Compared to non-smokers, smokers had significantly higher scores for memory (2.68 vs 1.44, p = 0.048), numbness/tingling (2.74 vs 0.7, p = 0.012) and voice quality (6.68 vs 3.78, p = 0.001).

Conclusions: Continued smoking during radiation exacerbates certain treatment-related symptoms in HNC patients, most notably cognitive problems, numbness, and voice changes. These results highlight the importance of smoking cessation efforts to potentially reduce symptom burden and improve QOL, during and following radiation

    Presenting Author(s)

  • Marci L. Nilsen, PhD

    Assistant Professor
    University of Pittsburgh, School of Nursing, Department of Acute and Tertiary Care
    Pittsburgh, Pennsylvania, United States

    Disclosure information not submitted.

    • Co-Author(s)

  • Lucien Khalil, MD

    Postdoctoral Research Fellow
    University of Pittsburgh Medical Center
    Pittsburgh, Pennsylvania, United States

    Disclosure information not submitted.

  • JL

    Jinhong Li, MS

    Graduate Student Researcher
    University of Pittsburgh, School of Public Health, Department of Biostatistics
    Pittsburgh, Pennsylvania, United States

    Disclosure information not submitted.

  • Christopher T. Wilke, MD, PhD

    Clinical Assistant Professor
    UPMC
    Pittsburgh, Pennsylvania, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • AM

    Angela L. Mazul, PhD, MPH

    Assistant Professor
    University of Pittsburgh Medical Center, Department of Otolaryngology - Head and Neck Surgery
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Jose P. Zevallos, MD, MPH

    Professor & Chairman, Department of Otolaryngology The Eugene N. Myers, M.D., Professor and Chairman
    Department of Otolaryngology – Head and Neck Surgery, University of Pittsburgh, Medical Center
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • SS

    Sandra Stinnett, MD

    Clinical Assistant Professor
    Department of Otolaryngology, Division of Laryngology, University of Pittsburgh Medical Center, Department of Veteran Affairs, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Marci L. Nilsen, PhD

    Assistant Professor
    University of Pittsburgh, School of Nursing, Department of Acute and Tertiary Care
    Pittsburgh, Pennsylvania, United States

    Disclosure information not submitted.