Smoking is associated with worse outcomes in patients with prostate cancer treated by radical radiotherapy.
OBJECTIVE
To investigate the effect of smoking on the outcome in a cohort of men treated for localized prostate cancer at one institution with a uniform protocol of radical external beam radiotherapy (EBRT).


METHODS
The study was a retrospective review of 434 patients with cT1-T4 N0m0 prostate cancer treated with curative intent with EBRT (66 Gy in 33 fractions) between 1990 and 1999. Univariate and multivariate Cox regression analyses were used to estimate the risk associated with smoking on biochemical failure (American Society for Therapeutic Radiology and Oncology definition), local failure, distant failure, overall and disease-specific survival.


RESULTS
The median follow-up was 70.3 months. A smoking history was obtained in 96% of cases; 16.8% were current smokers, 54.4% previous smokers and 28.8% non-smokers. Current smokers presented at a younger median age, by 3.6 years (P = 0.06). There were no differences in clinical T stage, Gleason score or prostate-specific antigen level amongst the three patient groups. Smoking conferred a higher risk of developing metastatic disease in both current smokers (hazard ratio 5.24; 95% confidence interval 1.75-15.72) and previous smokers (2.90, 1.09-7.67). There were also increases in risk, although not quite significant, for biochemical failure (1.49, 0.88-2.40) and overall survival (1.72, 0.94-3.15).


CONCLUSIONS
After curative treatment with EBRT, a history of smoking was associated with a greater risk of developing metastatic disease. Smoking status was not associated with worse disease on presentation.
Pantarotto
Jason
J
Department of Radiation Oncology, The Ottawa Hospital Regional Cancer Centre, 503 Smyth Road, Ottawa, Ontario, Canada.
Malone
Shawn
S
Dahrouge
Simone
S
Gallant
Victor
V
Eapen
Libni
L
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*
D017430:Prostate-Specific Antigen