[Effect of nicotine abuse on treatment results in primary irradiated cervical cancer]

In view of the fact that frequent occurrence of cervical carcinoma in smokers is referred in literature, the authors examined the effects of cigarette smoking on primary irradiation therapy results in cervical carcinoma. Whereas of 410 patients with cervical carcinoma of stage I and II, 260 (63.4%) attained the 5-year limit, out of 115 smokers only 62 survived (53.9%). In the advanced cases of stage III and IV, on the other hand, the rates of cure achieved in patients who were habitual smokers were significantly poorer. Of 626 non-smokers with cervical carcinoma in stages III and IV, 212 survived (33.9%), whereas of 153 smokers only 31 (20.3%) were cured (p less than 0.01). The incidence of side effects of primary irradiation was also distinctly higher in smokers than in non-smokers. Reversible complications occurred in 17.5% of the smokers and in 15.5% of the non-smokers. Severe irreversible changes occurred in 28% of smokers but in only 15.2% of the comparative group of non-smokers (p less than 0.01). The noxious effects of smoking not only impaired the biological effectiveness of ionising radiation but also increased the incidence of side effects owing to deterioration of the regenerative capacity of the tissue surrounding the tumour.