title: Risk factors for treatment-related death associated with chemotherapy and thoracic radiotherapy for lung cancer.
abstract: BACKGROUND
  The aim of the study is to evaluate the current status of treatment-related death (TRD) in lung cancer patients.
  
  
  METHODS
  We retrospectively analyzed the incidence and risk factors of TRD in lung cancer patients who received chemotherapy and/or thoracic radiotherapy using logistic regression analyses.
  
  
  RESULTS
  Between January 2001 and December 2005, 1225 (222 small cell and 1003 non-small cell lung cancers) patients received chemotherapy and/or thoracic radiotherapy as the initial treatment. Of these, 43 patients receiving chemotherapy followed by thoracic radiotherapy were included into both the chemotherapy-alone and radiotherapy-alone groups. There were a total of 23 (1.9%) TRDs. Chemotherapy-related deaths occurred in 7 of 927 (0.8%) patients, including 4 from drug-induced lung injury, 2 from pneumonia, and 1 from unknown cause. Concurrent chemoradiotherapy-related deaths occurred in 12 of 245 (4.9%) patients, including 11 from radiation pneumonitis and 1 from pneumonia. Thoracic radiotherapy-related deaths occurred in 4 of 96 (4.2%) patients. The incidence of chemotherapy-related death was correlated with poor performance status (odds ratio [OR]: 11.4, 95% confidence interval [CI]: 3.53-37.1), the presence of hypoxia (OR: 19.3, CI: 6.06-61.7), hyponatremia (OR: 45.5, CI: 13.4-154), and treatment with epidermal growth factor receptor-tyrosine kinase inhibitors (OR: 8.56, CI: 2.48-29.5), whereas the incidence of concurrent chemoradiotherapy-related death was correlated with pulmonary fibrosis (OR: 22.2, CI: 5.61-87.8). Radiotherapy results were not analyzed because there were too few patients.
  
  
  CONCLUSIONS
  TRD occurred in 1.9% of the patients as a result of treatment-related lung injury in the majority of the cases.
authors: Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors: Yuko
authors: Y
authors: Minami-Shimmyo
authors: Yuichiro
authors: Y
authors: Ohe
authors: Seiichiro
authors: S
authors: Yamamoto
authors: Minako
authors: M
authors: Sumi
authors: Hiroshi
authors: H
authors: Nokihara
authors: Hidehito
authors: H
authors: Horinouchi
authors: Noboru
authors: N
authors: Yamamoto
authors: Ikuo
authors: I
authors: Sekine
authors: Kaoru
authors: K
authors: Kubota
authors: Tomohide
authors: T
authors: Tamura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002289:Carcinoma, Non-Small-Cell Lung / Q000628:therapy*; D018288:Carcinoma, Small Cell / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000401:mortality*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000150:complications; D000860:Hypoxia / Q000150:complications; D015994:Incidence; D016015:Logistic Models; D055370:Lung Injury / Q000139:chemically induced / Q000401:mortality; D008175:Lung Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000139:chemically induced / Q000401:mortality; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D011658:Pulmonary Fibrosis / Q000150:complications; D017564:Radiation Pneumonitis / Q000209:etiology / Q000401:mortality; D011878:Radiotherapy / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D047428:Protein Kinase Inhibitors; D066246:ErbB Receptors