Utility of commonly available clinical parameters for predicting concurrent chemoradiotherapy toxicity following treatment of inoperable stage III non-small cell lung cancer. — ASN Events
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  3. Utility of commonly available clinical parameters for predicting concurrent chemoradiotherapy toxicity following treatment of inoperable stage III non-small cell lung cancer.

Utility of commonly available clinical parameters for predicting concurrent chemoradiotherapy toxicity following treatment of inoperable stage III non-small cell lung cancer. (#182)

Hamed Shahnam 1 , Neetu Tejani 2 , Terry Neeman 3 , Eddie O'Brien 1 , sayed ali 4
  1. Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
  2. Radiation Oncology, Canberra Hospital, Canberra, ACT, Australia
  3. Statistics Unit, Australian National University , Canberra, Australian Capital Territory, Australia
  4. Medical Oncology Department, Canberra Hospital, Canberra, ACT, Australia

Aims: Concurrent chemoradiotherapy is employed for treating inoperable stage III non-small-cell lung cancer (NSCLC) but causes significant toxicities. Primary aim was to identify patient characteristics that may predict treatment-related toxicities. Secondary aim was to investigate overall survival and whether toxicities or blood transfusion administration could predict overall survival.

Methods: Conducted a ten year retrospective clinical audit of inoperable stage III NSCLC patients treated with concurrent chemoradiotherapy. Baseline patient demographic, haematological, biochemical and treatment parameters were collected. To predict toxicities, multivariate regression models were developed by grouping baseline characteristics. False discovery rate analysis controlled for false positive models. Odds ratio (OR) and 95% confidence interval (CI) for statistically significant model characteristics were reported. Overall survival and association with toxicities and blood transfusion administration was assessed with Kaplan Meier and log-rank analysis.

Results: Fifty patients were investigated (72% male, mean participant age of 62). Thrombocytopenia and renal dysfunction were predicted by models. Renal function parameters model (comprised of baseline creatinine, creatinine clearance, weight, height and age), was most predictive, p=0.002 and p=0.001 respectively. In this model higher creatinine clearance was associated with reduced risk of thrombocytopenia (OR=0.92, 95% CI, 0.857 to 0.988). According to the model, older age was associated with renal dysfunction (OR=1.14, 95% CI, 1.034 to 1.266). Median overall survival was 44 months and blood transfusion recipients faced poorer survival (16 months vs 45 months, p=0.013).

Conclusion: Clinical parameters may identify inoperable stage III NSCLC patients at risk of developing concurrent chemoradiotherapy toxicities. Blood transfusion during treatment was associated with reduced patient survival.

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