Impact of Smoking on Pancreatic Cancer Patients Receiving Current Chemotherapy.
OBJECTIVE
Smoking may affect pharmacokinetics of chemotherapeutic agents and hemodynamics of the smokers, thereby influencing adverse events and efficacy of chemotherapy in patients with pancreatic cancer (PC). The aim of this study was to clarify how smoking totally affected patients with PC receiving current chemotherapy.


METHODS
We evaluated the impact of smoking status on the performance of chemotherapy and survival in 262 patients with PC including 158 resectable and 104 unresectable PC.


RESULTS
There were more male and younger patients in current smokers than in nonsmokers. In unresectable PC, current smokers had more metastatic tumors than locally advanced tumors compared with nonsmokers. In current smokers receiving chemotherapy, the baseline white blood cell count, neutrophil count, and hemoglobin concentration were significantly higher in current smokers than in nonsmokers. Furthermore, grades 3 to 4 neutropenia was observed more often in nonsmokers than smokers. On the other hand, the performance and efficacy of the planned adjuvant chemotherapy were similar between smokers and nonsmokers. More importantly, there was no significant difference in overall prognosis between smokers and nonsmokers receiving chemotherapy.


CONCLUSIONS
Smoking status has no significant impact on the efficacy of current chemotherapy for both resectable and unresectable PC.
From the Departments of *Surgery and †Radiology, Nara Medical University, Nara, Japan.
Chihiro
C
Kawaguchi
Masayuki
M
Sho
Toshihiro
T
Tanaka
Takahiro
T
Akahori
Shoichi
S
Kinoshita
Minako
M
Nagai
Satoshi
S
Yasuda
Satoshi
S
Nishiwada
Hideyuki
H
Nishiofuku
Kimihiko
K
Kichikawa
Yoshiyuki
Y
Nakajima
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use; D001772:Blood Cell Count; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000601:surgery; D011379:Prognosis; D012907:Smoking; D016896:Treatment Outcome; D000093542:Gemcitabine
D000964:Antimetabolites, Antineoplastic; D006454:Hemoglobins; D003841:Deoxycytidine; D000093542:Gemcitabine