A Pilot Smoking Cessation Study for Newly Diagnosed Lung Cancer Patients

描述(申请人提供)：肺癌是导致男性和女性癌症死亡的主要原因。吸烟是87%的肺癌的原因，一半的患者在被诊断为癌症时是当前吸烟者。选择肺切除的早期肺癌患者预后相对较好。肺癌的诊断是戒烟的强大动力，一半或更多的吸烟者在确诊后戒烟。然而，许多吸烟者并不戒烟，那些在确诊时戒烟的人往往在手术后不久就复发。继续吸烟与较差的治疗结果和较高的第二次吸烟相关原发肿瘤(包括肺癌)的风险有关。我们假设，肺癌诊断后的戒烟率可以通过提供最先进的戒烟干预来提高，持续的戒烟干预从手术前开始，一直持续到医院和出院后。此外，我们建议针对新诊断为肺癌的吸烟者的特定心理社会问题量身定做干预措施，并以一种易于适应肺癌患者临床护理模式的方式实施干预措施。到目前为止，还没有做到这一点。我们将开发一种结合认知行为和药物治疗的简短戒烟干预措施，目标是正在等待手术的新诊断的早期(I-II)肺癌患者。干预措施将在波士顿的马萨诸塞州综合医院实施。这项初步研究的目的是招募30名受试者，评估干预措施的可接受性和可行性，并收集在术前评估访问(就在手术前)和手术后3个月获得的戒断率数据。干预组的戒毒率将与历史对照组进行比较，对照组由20-30名参与者组成，他们将在实施干预之前登记。如果干预是可行的，并且似乎有潜在的效果，下一步将是开发一项全面的随机对照试验，以测试干预的效果。项目相关性尽管在肺癌确诊后继续吸烟对这些患者的生存有不利影响，但尚未确定对新诊断为早期肺癌的吸烟者进行有效的戒烟干预。我们建议评估整合到胸部肿瘤环境中的行为和药物联合治疗方案的有效性和潜在的可行性。

DESCRIPTION (provided by applicant): Lung cancer is the leading cause of cancer death in both men and women. Cigarette smoking is responsible for 87% of lung cancers, and half of patients are current smokers at the time of cancer diagnosis. Patients with earlier stages of lung cancer who are candidates for lung resection have a relatively good prognosis. Lung cancer diagnosis is a powerful motivator to quit smoking, and half or more of smokers quit after the diagnosis is made. However, many smokers do not quit, and those who quit at the time of diagnosis often relapse soon after surgery. Continuing to smoke is associated with poorer treatment outcomes and greater risk for second smoking-related primary tumors including lung cancer. We hypothesize that cessation rates after lung cancer diagnosis can be improved by providing a state-of-the-art smoking cessation intervention in a sustained fashion that begins before surgery and continues in the hospital and after discharge. Further, we propose to tailor the intervention to the specific psychosocial issues of newly diagnosed smokers with lung cancer and implement an intervention in a way that fits easily into the pattern of clinical care for lung cancer patients. To date, this has not been done. We will develop a brief smoking cessation intervention that combines cognitive-behavioral and pharmacological treatment and is targeted to newly diagnosed early stage (I-II) lung cancer patients who are awaiting surgery. The intervention will be implemented at Massachusetts General Hospital in Boston. The aims of this pilot study are to enroll 30 subjects, assess the intervention's acceptability and feasibility, and gather data on cessation rates attained at the pre-operative evaluation visit (just prior to surgery) and 3 months after surgery. Cessation rates in the intervention group will be compared to a historical control group of 20-30 participants who will be enrolled prior to implementation of the intervention. If the intervention is feasible and appears to be potentially efficacious, the next step will be to develop a full-scale randomized controlled trial to test the efficacy of the intervention. PROJECT RELEVANCE Despite the fact that continued smoking after a lung cancer diagnosis adversely affects the survival of these patients, an effective smoking cessation intervention for smokers with newly diagnosed early stage lung cancer has not been identified. We propose to assess the efficacy and potential feasibility of a combined behavioral and pharmacological treatment program that is integrated into the thoracic oncology setting.