Impact of Smoking on Acute HNC RT Toxicities

May, 05, 2024 | Head & Neck Cancer


  • The study aimed to investigate the association between smoking status and acute severe toxicity in patients with HNC undergoing RT.
  • Researchers noticed no significant association between smoking and acute toxicities in HNC RT.

The association between smoking and acute radiation toxicities of head and neck cancer (HNC) is currently unproven.

C. Invernizzi and the research team aimed to compare the occurrence of acute severe toxicity between active and non-active smokers treated for HNC by radiotherapy (RT).

They performed an inclusive analysis on a prospective monocentric cohort study comprising patients treated with (chemo)RT for HNC between January 2021 and January 2023. Smoking status was documented, and patients underwent weekly medical examinations during RT to report acute toxicities based on the Common Terminology Criteria for Adverse Effects system version 5.0. The primary endpoint was the occurrence of at least one grade ≥ 3 acute toxicity, encompassing mucositis, dysphagia, and dermatitis.

They found that among the 102 patients included, 27.4% were active smokers, 58.8% were former smokers, and 13.7% had never smoked. About 23.5% of patients experienced severe mucositis, 37.2% severe dysphagia, 13.7% severe dermatitis, and 54.9% experienced at least 1 severe toxicity. The occurrence of severe acute toxicity was not statistically associated with smoking during RT (64.3% among active smokers versus 51.3% among non-active smokers; P = 0.24).

On multivariate analysis, concurrent chemotherapy (87.5% vs. 65.2%; OR = 5.04 [1.64-15.52]; P = 0.004) and 2.12 Gy versus 2 Gy fractionation schedule (64.3% vs. 41.3%; OR = 2.53 [1.09-5.90]; P = 0.03) were significantly associated with severe acute toxicity.

The study concluded that there was no observed association between smoking during RT for HNC and the occurrence of severe acute toxicities.

The study received no funds.


Invernizzi C, Da Silva Ribeiro Mota A, Barbe C, et al. (2024). “Prospective comparison of acute severe toxicities between smokers and non-smokers during radiotherapy for head and neck cancers.” Oral Oncol. 2024 Jun;153:106833. doi: 10.1016/j.oraloncology.2024.106833. Epub 2024 May 10. PMID: 38729039.


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