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Considering the different co-morbidities of the patients and the potential toxicities of combined chemo- and radiotherapy when treating stage III unresectable non-small cell lung cancer (NSCLC), early mortality rates are a concern. With this study our aim was to assess the 90 day mortality of the stage III NSCLC patients treated at our center, and explore predictive factors.

Consecutive patients were included who commenced concurrent or sequential chemoradiotherapy between 04-2011 and 06-2018. Baseline clinical case-mix variables (age, performance status, pack years, T-stage, pathology, N-stage, charlson comorbidity Index (CCI) and baseline pulmonary function) and treatment-related variables (number of chemotherapy cycles, sequential vs concurrent chemotherapy, fractionation dose, overall treatment time, tumor volume heart V5, V20, V50, mean heart dose, Lung V5 and mean lung dose) were retrieved. The 90 day mortality was calculated from the last day of radiotherapy to the date of death. Univariable logistic regression was performed for all clinical case-mix and treatment related factor. Multivariable logistic regression was performed with the uncorrelated (r<0.6) variables that had a univariable p<0.1 (age, sequential vs concurrent, performance status, Lung V5).

A total of 148 patient were included in this preliminary analysis. Ninety days mortality in this population was 8.8%.  Univariable analysis of all factors are depicted in table 1.

After multivariable analysis performance status remained  significantly associated with 90 day mortality after radical chemo-radiotherapy (p=0.003, OR=0.85 (0.77; 0.95)), while the lung V5 remained borderline correlated (p=0.08, OR 1.040 (0.995;1.095)). Sequential versus concurrent chemotherapy and age were no longer significant.

The initial performance status seems to be the most important predictor of 90 day mortality after chemoradiotherapy. A larger dataset will be constructed to further analyze the influence of the lung V5 on early mortality.