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David S. Ettinger, MD, FACP, FCCP


ASTRO 2022: Overall Time of Chemoradiotherapy and Outcomes in Stage III Lung Cancer

By: Sarah Lynch
Posted: Wednesday, November 2, 2022

New research has focused on the relationship between missing treatment days and mortality rates for patients with stage III non–small cell lung cancer (NSCLC) being treated with chemoradiation therapy. The study has confirmed that the more treatments a patient skips, the higher their risk of death. The study also showed that certain patients may benefit from receiving higher radiation doses to make up for missed treatment days. These findings were presented at the 2022 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 2846). The investigators are planning a similar study in patients with lung cancer undergoing surgery and chemotherapy in addition to radiation therapy.

“Ideally, we can begin to adapt treatment to the individual patient,” said Peter Lee, MD, PhD, of Fox Chase Cancer Center, Philadelphia, in an institutional press release. “So, if a patient misses a certain number of days, we can change their prescription and add on a higher dose as they finish their treatment.”

The study focused on data from more than 26,000 patients with stage III NSCLC receiving chemoradiotherapy alone. Of this group, 8,644 patients had their treatments prolonged due to missing days. The researchers used multivariable Cox proportional regression models to evaluate the relationship between treatment prolongation and survival rates. These models were adjusted for differing clinical characteristics and patient demographics.

The researchers reported there was not a threshold of missed days that directly caused increased mortality, but the risk of death rose steadily with the number of treatment days patients missed. However, they also found there is a window of missed periods that allows patients to benefit from being administered a higher radiation dose to make up for the missed days. There is still a need for further research, since the relationship between missed treatments and higher mortality is clear, but no cause for the relationship has been established.

Disclosure: Dr. Lee reported no conflicts of interest.

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