A Pilot Smoking Cessation Study for Newly Diagnosed Lung Cancer Patients

描述（由申请人提供）：肺癌是男性和女性癌症死亡的主要原因。吸烟是87%的肺癌的原因，一半的患者在癌症诊断时是当前吸烟者。早期肺癌患者谁是肺切除的候选人有一个相对良好的预后。肺癌诊断是戒烟的强大动力，一半或更多的吸烟者在诊断后戒烟。然而，许多吸烟者并没有戒烟，那些在诊断时戒烟的人往往在手术后不久复发。继续吸烟与较差的治疗结果和更大的风险，第二吸烟相关的原发性肿瘤，包括肺癌。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措施来提高，这种干预措施从手术前开始，在医院和出院后继续进行。此外，我们建议针对新诊断的肺癌吸烟者的特定心理社会问题进行干预，并以一种容易适应肺癌患者临床护理模式的方式实施干预。迄今为止，尚未这样做。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，针对新诊断的等待手术的早期（I-II）肺癌患者。干预措施将在波士顿的马萨诸塞州总医院实施。本初步研究的目的是招募30名受试者，评估干预的可接受性和可行性，并收集术前评估访视（手术前）和手术后3个月的戒烟率数据。干预组的戒烟率将与实施干预前入组的20-30名受试者的历史对照组进行比较。如果干预是可行的，似乎是潜在的有效性，下一步将是开发一个全面的随机对照试验，以测试干预的有效性。项目相关性尽管肺癌诊断后继续吸烟会对这些患者的生存产生不利影响，但尚未确定新诊断早期肺癌吸烟者的有效戒烟干预措施。我们建议评估结合行为和药理学治疗方案的有效性和潜在的可行性，该方案被整合到胸部肿瘤学环境中。

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.