Smoking is a risk factor for the development of lung cancer and reduces life expectancy within the general population. Retrospective studies suggest that non-smokers have better outcomes after treatment for lung cancer. We used a prospective database to investigate relationships between pre-treatment smoking status and survival for a cohort of patients with stage III non-small-cell lung cancer (NSCLC) treated with curative-intent concurrent chemoradiotherapy (CRT). All patients treated with CRT for stage III NSCLC at a major metropolitan cancer centre were prospectively registered to a database. A detailed smoking history was routinely obtained at baseline. Kaplan-Meier statistics were used to assess overall survival and progression-free survival in never versus former versus current smokers. Median overall survival for 265 eligible patients was 2.21 years (95 % Confidence Interval 1.78, 2.84). It was 5.5 years (95 % CI 2.1, not reached) for 25 never-smokers versus 1.9 years (95 % CI 1.5, 2.7) for 182 former smokers and 2.2 years (95 % CI 1.3, 2.7) for 58 current smokers. Hazard ratio for death was 2.43 (95 % CI 1.32–4.50) for former smokers and 2.75 (95 % CI 1.40, 5.40) for current smokers, p = 0.006. Actionable tumour mutations (EGFR, ALK, ROS1) were present in more never smokers (14/25) than former (9/182) or current (3/58) smokers. TKI use was also higher in never smokers but this was not significantly associated with superior survival (Hazard ratio 0.71, 95 % CI 0.41, 1.26). Never smokers have substantially better overall survival than former or current smokers after undergoing CRT for NSCLC.

中文翻译：

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治疗前吸烟状况对局部晚期非小细胞肺癌放化疗后生存的影响

吸烟是罹患肺癌的危险因素，并会缩短一般人群的预期寿命。回顾性研究表明，非吸烟者在肺癌治疗后有更好的结果。我们使用前瞻性数据库来研究一组接受治疗性同步放化疗 (CRT) 的 III 期非小细胞肺癌 (NSCLC) 患者的治疗前吸烟状况与生存率之间的关系。所有在主要城市癌症中心接受 CRT 治疗的 III 期 NSCLC 患者均前瞻性地登记到数据库中。在基线时定期获取详细的吸烟史。 Kaplan-Meier 统计数据用于评估从未吸烟者、以前吸烟者和当前吸烟者的总生存期和无进展生存期。 265 名符合条件的患者的中位总生存期为 2.21 年（95% 置信区间 1.78、2.84）。 25 名从不吸烟者的寿命为 5.5 年（95% CI 2.1，未达到），而 182 名戒烟者的寿命为 1.9 年（95% CI 1.5, 2.7），58 名当前吸烟者的寿命为 2.2 年（95% CI 1.3, 2.7）。曾经吸烟者的死亡风险比为 2.43 (95% CI 1.32–4.50)，当前吸烟者的死亡风险比为 2.75 (95% CI 1.40, 5.40)，p = 0.006。可操作的肿瘤突变（EGFR、ALK、ROS1）在从不吸烟者 (14/25) 中出现的比例高于以前 (9/182) 或当前 (3/58) 吸烟者。从不吸烟者中 TKI 的使用率也较高，但这与较高的生存率没有显着相关（风险比 0.71，95% CI 0.41，1.26）。接受非小细胞肺癌 CRT 治疗后，从不吸烟者的总体生存率明显优于以前或当前吸烟者。