title: Smoking during radiotherapy for head and neck cancer and acute mucosal reaction.
abstract: OBJECTIVE
  We compared the incidence of RTOG/EORTC grade III and higher acute mucositis in patients with head and neck cancer who continued to smoke during radiotherapy with those who quit smoking.
  
  
  BACKGROUND
  There are conflicting data on the relationship between smoking during radiotherapy and the severity of acute mucosal reaction. More studies dealing with this issue are needed.
  
  
  METHODS
  Among 136 patients receiving curative radio(chemo)therapy, 37 (27%) declared that they had not quit smoking during radiotherapy. The intensity of mucositis was scored daily by a nurse and weekly by a physician using the RTOG/EORTC scale. The main end-point of the study was the highest observed RTOG/EORTC grade of mucositis.
  
  
  RESULTS
  Patients who smoked during radiotherapy (smokers) were younger than their counterparts who quit smoking (non-smokers), p = 0.06. There were no other differences in the baseline characteristics between smokers and non-smokers. Grade III/IV acute mucositis was observed in 43.5% of all patients. The percentage of patients with grade III/IV acute mucositis was similar in smokers and non-smokers (46% vs. 42%, p = 0.71). Nine patients (smokers [13.5%]; non-smokers [4%], p = 0.05) required prolonged hospitalization to heal mucositis.
  
  
  CONCLUSIONS
  In the whole group, smoking during radiotherapy was not related to acute mucosal toxicity evaluated as the rate of the highest observed grade of mucositis.
authors.affiliation: Independent Public Health Care Facility of the Ministry of the Interior and Warmian & Mazurian Oncology Centre, Al. Wojska Polskiego 37, 10-228 Olsztyn, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Szeszko
authors.affiliation: Independent Public Health Care Facility of the Ministry of the Interior and Warmian & Mazurian Oncology Centre, Al. Wojska Polskiego 37, 10-228 Olsztyn, Poland.
authors.forename: Karolina
authors.initials: K
authors.lastname: Osowiecka
authors.affiliation: Independent Public Health Care Facility of the Ministry of the Interior and Warmian & Mazurian Oncology Centre, Al. Wojska Polskiego 37, 10-228 Olsztyn, Poland ; Department of Oncology, University of Warmia & Mazury, Olsztyn, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Rucińska
authors.affiliation: Independent Public Health Care Facility of the Ministry of the Interior and Warmian & Mazurian Oncology Centre, Al. Wojska Polskiego 37, 10-228 Olsztyn, Poland ; Department of Oncology, University of Warmia & Mazury, Olsztyn, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Wasilewska-Teśluk
authors.affiliation: Independent Public Health Care Facility of the Ministry of the Interior and Warmian & Mazurian Oncology Centre, Al. Wojska Polskiego 37, 10-228 Olsztyn, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Gliński
authors.affiliation: Independent Public Health Care Facility of the Ministry of the Interior and Warmian & Mazurian Oncology Centre, Al. Wojska Polskiego 37, 10-228 Olsztyn, Poland.
authors.forename: Lucyna
authors.initials: L
authors.lastname: Kępka
keywords: Acute mucositis; Head and neck cancer; Radiochemotherapy; Radiotherapy; Smoking status