Ethnic Difference In Chemoradiation-Induced Esophagitis In Unresectable Stage Iii Non-Small Cell Lung Cancer (Nsclc).

e18518 Background: Patients with unresectable stage III NSCLC are currently treated with platinum-containing concurrent chemoradiation. One of dose limiting toxicities is severe (grade 3 or higher) esophagitis (G3E). The difference among ethnic groups has never been investigated in detail. Methods: Prospective trials including treatment arm(s) of concurrent platinum-containing chemoradiation in unresectable stage III NSCLC were identified by Pub Med search. Eligible studies/arms must have reported the number cases with G3E that occurred during concurrent phase of chemoradiation. Phase I/dose escalation studies, neoadjuvant chemoradiation with intent of surgery, and non-platinum only arms were excluded. Clinical variables available in more than 50% of treatment arms were investigated if there is any correlation with G3E. Two-sided univariate and multivariate multi-level mixed-effects logistic regression models were used with a significant p-value <0.05. Results: A total of 116 treatment arms with 7,520 patients were identified. Information about the types of chemotherapy (single agent vs. multi-agent, cisplatin vs carboplatin, induction vs. no induction), radiation (once-daily (QD) vs. twice daily (BID), Dose >60Gy vs. ≤60Gy, Split course radiation + vs. -), year of enrollment (starting in 1998 and later vs. before 1998), and study location (corresponding author’s location in Asian vs. non-Asian countries) were available as variables for correlation analysis. Univariate analysis demonstrated that Asian/Non-Asian, Multi-/Single-Agent therapy, BID/QID, Dose, and Split are all individually predictive of G3E. Of note, treatment arms conducted in Asia had significantly lower incidence of G3E (170/2,534, 6.7%, Odds Ratio 0.289) than in other nations (1,025/4,986, 20.6%). In the multivariable model, Asian/Non-Asian, Multi-/Single-Agent and Split are jointly significant predictors after adjusting for all possible factors. Conclusions: This publication based meta-analysis suggests that G3E occurs less frequently in Asian population as compared to non-Asian population treated with chemoradiation. Further research is required to verify the result.