Predictors of Missed On-Treatment Visits During Concurrent Chemoradiotherapy for Locally Advanced Non-Small Cell Lung Cancer.

PURPOSE/OBJECTIVE(S) Standard monitoring during fractionated radiotherapy includes weekly on-treatment visits (OTVs). For NSCLC patients receiving concurrent chemoradiotherapy (CRT), who are at risk for severe acute toxicities, weekly OTVs are particularly important. Here we examine OTV completion rates for NSCLC patients who received CRT in our department to test the hypothesis that specific demographic or clinical factors may predict missed OTVs. MATERIALS/METHODS Patients who received CRT with curative intent for locally advanced NSCLC between 2014 and 2019 were included in this analysis. Records were reviewed for instances of missed OTVs during 5-fraction windows (1-5, 6-10, etc.). Demographic factors (age, gender, race, ethnicity, primary language spoken, employment status, private insurance coverage, an address-based socioeconomic status estimate) and clinical variables (performance status, radiotherapy course length) were tabulated and tested as predictors of missed OTVs using chi-square tests and logistic regression models RESULTS: 167 patients met inclusion criteria. The median age was 67 (range: 38-85), 47 patients (28%) were Hispanic, 63 (38%) were Black or African American, and 138 (83%) spoke English as their primary language. Twenty-six patients (16%) missed an OTV during radiotherapy. In univariate analyses, only age and ethnicity were statistically significantly associated with missed OTVs. Young patients were more likely to have a missed OTV, with a missed OTV rate of 22% for patients aged 67 or younger and a missed OTV rate of 9% for older patients (P = 0.020). Hispanic patients were less likely than others to have a missed OTV (6% v. 19%, P = 0.040). In a multivariable model, young age was associated with increased risk of missed OTV (OR = 1.68 per decade, P = 0.026), and there was a trend suggesting Hispanic ethnicity was associated with reduced risk of missed OTV (OR = 0.30, P = 0.064). CONCLUSION We identified demographic factors that may be associated with risk of missed on-treatment visits during concurrent chemoradiotherapy for NSCLC. These findings could have implications for improving patient care and clinic efficiency. Validation studies in a larger patient cohort are planned.