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Early response to platinum-based first-line chemotherapy in non-small cell lung cancer may predict survival.
- Source :
-
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer [J Thorac Oncol] 2007 Aug; Vol. 2 (8), pp. 735-40. - Publication Year :
- 2007
-
Abstract
- Introduction: Response rates in the palliative treatment of non-small cell lung cancer, with combination platinum-based chemotherapy, vary from 20% to 40%, leaving a large number with either stable or progressive disease. We examined radiographic response after two courses of platinum-based induction chemotherapy to see whether this is an early predictor of outcome.<br />Methods: In this retrospective study, 320 patients with stage III/IV NSCLC were identified who received 4 or more courses of first-line platinum-based chemotherapy and attained partial response (PR) or stable disease (SD).<br />Results: After two courses, 115 patients attained PR and 205 SD. Cox regression analysis shows that response after two courses of chemotherapy remains an independent significant prognostic factor for survival. The 2-year survival for patients attaining PR after two courses (n = 115) was 23% compared with 11% (n = 205) for those with SD (p = 0.002). Patients who achieve an objective response after two courses also have a better symptomatic response (p = 0.003) and it was significantly longer (p = 0.04). Of the 205 with SD, 51 attained PR with four courses, whereas 154 (48%) remained with SD; there was no difference in survival outcome of these two groups.<br />Conclusions: These data suggest that NSCLC patients who only have SD after two cycles of first-line chemotherapy have poorer survival outcome and less symptomatic benefit than those in PR. Trials looking at change in management at this point are warranted.
- Subjects :
- Adenocarcinoma drug therapy
Adenocarcinoma, Bronchiolo-Alveolar drug therapy
Adult
Aged
Aged, 80 and over
Carcinoma, Large Cell drug therapy
Carcinoma, Non-Small-Cell Lung mortality
Carcinoma, Squamous Cell drug therapy
Cohort Studies
Female
Humans
Lung Neoplasms mortality
Male
Middle Aged
Neoplasm Staging
Organoplatinum Compounds administration & dosage
Prognosis
Prospective Studies
Retrospective Studies
Survival Rate
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Carcinoma, Non-Small-Cell Lung drug therapy
Lung Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1556-1380
- Volume :
- 2
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
- Publication Type :
- Academic Journal
- Accession number :
- 17762340
- Full Text :
- https://doi.org/10.1097/JTO.0b013e31811f3a7d