Prognostic Impact of Missed Chemotherapy Doses During Chemoradiation Therapy for Non–Small Cell Lung Cancer. (April 2018)

• Record Type: Journal Article
• Authors: Deek, Matthew P.; Kim, Sinae; Ahmed, Inaya; Fang, Bruno S.; Zou, Wei; Malhotra, Jyoti; Aisner, Joseph; Jabbour, Salma K.
• Is Part Of: American journal of clinical oncology. Volume 41:Number 4(2018)
• Publication Date: 2018-04
• Subjects: missed chemotherapy -- non–small cell lung cancer -- chemoradiation therapy -- toxicity -- survival; Cancer -- Treatment -- Periodicals; Oncology -- Periodicals; Tumors -- Periodicals; 616.994005
• DOI: 10.1097/COC.0000000000000293
• Languages: English
• ISSNs: 0277-3732

Abstract

Abstract : Objective: The aim of this study is to investigate the impact of missed chemotherapy administrations (MCA) on the prognosis of non–small cell lung cancer (NSCLC) patients treated with definitive chemoradiation therapy (CRT). Materials and Methods: In total, 97 patients with NSCLC treated with definitive CRT were assessed for MCA due to toxicities. Logistic regression was used to determine factors associated with MCA. Kaplan-Meier curves, log-rank tests, and Cox Proportional Hazards models were conducted. Results: MCA occurred in 39% (n=38) of the patients. Median overall survival was 9.6 months for patients with MCA compared with 24.3 months for those receiving all doses ( P =0.004). MCA due to decline in performance status was associated with the worst survival (4.6 mo) followed by allergic reaction (10.0 mo), hematologic toxicity (11 mo), and esophagitis (17.2 mo, P =0.027). In multivariate models, MCA was associated with higher mortality (hazard ratio, 1.97; P =0.01) and worse progression-free survival (hazard ratio, 1.96; P =0. 009). Conclusions: MCA correlated with worse prognosis and increased mortality. Methods to reduce toxicity may improve administration of all chemotherapy doses and increase overall survival in NSCLC treated with CRT.