Tobacco smoking influences the side effects of radiation therapy-managed patients with various malignancies: A systematic review

Tobacco smoking may decrease the effectiveness of radiation therapy. This is because tobacco smoking can cause inflammation and damage to surrounding tissues, which may interfere with radiation delivery to the tumor. Our aim of this study is to investigate the effect of tobacco smoking use on complications in radiotherapy as a systematic review. The articles searched from the MEDLINE, PubMed, EMBASE, and Web of Science databases. The search terms used were “radiotherapy”, “outcome”, “radiation therapy”, “tobacco”, “smoking”, “complications”, “side effects”, “cancer”, and “malignancy”. PRISMA check list was used to assess the overall quality of evidence for each outcome. The outcomes of radiotherapy-inducing tobacco smoking in smokers are more than non-smokers including; high SPC (second primary cancer), decreased median overall survival, higher infections during treatment, increased fatigue (p = 0.027), increased pain (p = 0.009), poorer cognitive function (0.041), affected mouth opening (0.049), more speech disturbances (p = 0.017), higher metastasis risk (p = 0.031 and 0.019), higher locoregional recurrence risk (p = 0.027), oral mucositis (p = 0.03), mucositis severity related to higher tobacco exposure (p = 0.008), severe acute radiation skin reactions, and myocardial infarction. Tobacco smoking appears to be the most significant modifiable factor influencing cancer treatment outcomes. As such, healthcare providers should take detailed notes on patients' smoking histories during both routine and future clinical studies. Beyond immediate cessation, cancer patients should undertake comprehensive smoking cessation programs. These programs can significantly boost the efficacy of radiotherapy and enhance overall patient outcomes. Le tabagisme peut diminuer l'efficacité de la radiothérapie. En effet, le tabagisme peut provoquer une inflammation et endommager les tissus environnants, ce qui peut interférer avec l'irradiation de la tumeur. L'objectif de cette étude est d'examiner l'effet du tabagisme sur les complications de la radiothérapie dans le cadre d'une analyse systématique. Les articles ont été recherchés dans les bases de données MEDLINE, PubMed, EMBASE et Web of Science. Les termes de recherche utilisés étaient « radiotherapy », « outcome », « radiation therapy », « tobacco », « smoking », « complications », « side effects », « cancer » et « malignancy ». La liste de contrôle PRISMA a été utilisée pour évaluer la qualité globale des preuves pour cha