Factors Associated With Early Mortality in Patients Treated With Concurrent Chemoradiation Therapy for Locally Advanced Non-Small Cell Lung Cancer

Andrew Warner, Max Dahele, Bo Hu, David A. Palma, Suresh Senan, Cary Oberije, Kayoko Tsujino, Marta Moreno-Jimenez, Tae Hyun Kim, Lawrence B. Marks, Ramesh Rengan, Luigi De Petris, Sara Ramella, Kim De Ruyck, Nuria Rodriguez De Dios, Jeffrey D. Bradley, George Rodrigues*

*Corresponding author for this work

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Abstract

Concurrent chemoradiation therapy (con-CRT) is recommended for fit patients with locally advanced non-small cell lung cancer (LA-NSCLC) but is associated with toxicity, and observed survival continues to be limited. Identifying factors associated with early mortality could improve patient selection and identify strategies to improve prognosis.Analysis of a multi-institutional LA-NSCLC database consisting of 1245 patients treated with con-CRT in 13 institutions was performed to identify factors predictive of 180-day survival. Recursive partitioning analysis (RPA) was performed to identify prognostic groups for 180-day survival. Multivariate logistic regression analysis was used to create a clinical nomogram predicting 180-day survival based on important predictors from RPA.Median follow-up was 43.5 months (95% confidence interval [CI]: 40.3-48.8) and 127 patients (10%) died within 180 days of treatment. Median, 180-day, and 1- to 5-year (by yearly increments) actuarial survival rates were 20.9 months, 90%, 71%, 45%, 32%, 27%, and 22% respectively. Multivariate analysis adjusted by region identified gross tumor volume (GTV) (odds ratio [OR] ?100 cm(3): 2.61; 95% CI: 1.10-6.20; P=.029) and pulmonary function (forced expiratory volume in 1 second [FEV1], defined as the ratio of FEV1 to forced vital capacity [FVC]) (OR
Original languageEnglish
Pages (from-to)612-620
JournalInternational Journal of Radiation Oncology Biology Physics
Volume94
Issue number3
DOIs
Publication statusPublished - 1 Mar 2016

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