Post-treatment mortality after definitive chemoradiotherapy versus trimodality therapy for locally advanced non-small cell lung cancer

•Definitive chemoradiation associated with lower post-treatment mortality.•Larger differences were observed in 30-day post-treatment mortality.•Pneumonectomy associated with the worst surgical mortality. Locally advanced non-small cell lung cancer (NSCLC) is commonly managed with either definitive c...

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Bibliographic Details
Published in:Lung cancer (Amsterdam, Netherlands) Netherlands), 2019-01, Vol.127, p.76-83
Main Authors: Haque, Waqar, Verma, Vivek, Butler, E. Brian, Teh, Bin S., Rusthoven, Chad G.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung - mortality
Carcinoma, Non-Small-Cell Lung - therapy
Chemoradiation
Chemoradiotherapy
Combined Modality Therapy
Female
Humans
Lobectomy
Lung Neoplasms - mortality
Lung Neoplasms - therapy
Male
Middle Aged
Mortality
Neoadjuvant Therapy
Neoplasm Staging
Non-Small cell lung cancer
Pneumonectomy
Risk Factors
Survival Analysis
Treatment Outcome
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Summary:•Definitive chemoradiation associated with lower post-treatment mortality.•Larger differences were observed in 30-day post-treatment mortality.•Pneumonectomy associated with the worst surgical mortality. Locally advanced non-small cell lung cancer (NSCLC) is commonly managed with either definitive chemoradiation (dCRT) or neoadjuvant chemoradiation followed by surgery (nCRT + S). This study sought to compare 30- and 90-day mortality between nCRT + S and dCRT for these patients. The National Cancer Database was queried (2004–2014) for clinicall staged T1-3N2 or T3-4N0-1 (except T3N0) NSCLC that received nCRT + S or dCRT. Statistics included cumulative incidence analysis of 30- and 90-day mortality (before and following propensity score matching) and Cox proportional hazards regressions. Of 28,379 patients, 4063 (14.3%) underwent nCRT-S, and 24,316 (85.6%) dCRT. Of the trimodality patients, 79.2% received lobectomy, 8.2% sublobar resection, and 12.5% pneumonectomy. Trimodality therapy and age, in addition to several soceiodempographic and oncologic variables, were associated with 30- and 90-day mortality. Short-term mortality was significantly higher with nCRT + S compared to dCRT at both 30 (3.4% vs. 0.8%, p 
ISSN:0169-5002
1872-8332
DOI:10.1016/j.lungcan.2018.11.026