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Research: MEYER and COLLEAGUES,
Listed in Issue 160
Abstract
MEYER and COLLEAGUES, Laval University Cancer Research Center, Quebec City, QC, Canada. francois.meyer@chuq.qc.ca studied whether smoking during radiation therapy modified the effects of beta carotene supplementation in head and neck cancer (HNC) patients.
Background
There has been concern that the efficacy of radiation therapy may be reduced when patients smoke or take antioxidant vitamins during treatment. Cancer prevention trials with beta carotene supplements documented adverse effects only among smokers.
Methodology
The authors conducted a randomized trial with alpha tocopherol (400 IU/day) and beta carotene (30 mg/day) supplements among 540 head and neck cancer (HNC) patients treated by radiation therapy and examined whether smoking during radiation therapy modified the effects of the supplementation on HNC recurrence and on mortality.
Results
During the follow-up, 119 patients had a HNC recurrence and 179 died. Cox models were used to test the interaction between smoking and supplementation and to estimate the hazard ratios (HR) for HNC recurrence and death associated with the supplementation. Cigarette smoking either before or after radiation therapy did not modify the effects of the supplementation. In contrast, the interactions between supplementation and cigarette smoking during radiation therapy were statistically significant for HNC recurrence (p = 0.03), all-cause mortality (p = 0.02) and mortality from the initial HNC (p = 0.04). Among cigarette smokers, the HR were 2.41 (95% CI: 1.25-4.64) for recurrence, 2.26 (95% CI: 1.29-3.97) for all-cause mortality and 3.38 (95% CI: 1.11-10.34) for HNC mortality. All corresponding HR among nonsmokers were close to 1.
Conclusion
These results could best be explained by the hypothesis that the combined exposures reduced the efficacy of radiation therapy. Particular attention should be devoted to prevent patients from both smoking and taking antioxidant supplements during radiation therapy. (c) 2007 Wiley-Liss, Inc.
References
Meyer F, Bairati I, Fortin A, Gelinas M, Nabid A, Brochet F and Tetu B. Interaction between antioxidant vitamin supplementation and cigarette smoking during radiation therapy in relation to long-term effects on recurrence and mortality: a randomized trial among head and neck cancer patients. International Journal of Cancer. 122(7):1679-83, Apr 1 2008.
