Paclitaxel and carboplatin plus megestrol acetate in the treatment of advanced non-small cell lung cancer.
The present study evaluated the efficacy and toxicity of paclitaxel and carboplatin with megestrol acetate for patients with stage IIIb and IV non-small cell lung cancer (NSCLC). Forty patients with no prior chemotherapy and Karnofsky performance status of > or = 60 were enrolled in the study. There were 18 males and 22 females with a median age of 57.5 years, and the median performance status was 70 per cent. Eleven cases were stage IIIb and 29 cases were stage IV. Twenty-five cases were adenoCA, 12 were squamous cell, 2 were large cell and one was undifferentiated NSCLC. These patients received paclitaxel 135 mg/m2 by intravenous infusion over 24 hours before carboplatin was given at AUC=6 by 2 hours infusion. Megestrol acetate 160 mg/day was given to all patients from day 2 to 14. This treatment produced partial remission in 12 of 39 evaluable patients (30.76%). Toxicity caused mild nausea, vomiting, myalgia, neuropathy, 20.95 per cent grade 3 neutropenia and 4.15 per cent grade 4 neutropenia. Grade 3 thrombocytopenia was 5.4 per cent, without grade 4. There were no statistically significant changes in weight, serum albumin, and quality of life throughout the cycle 1-6.


CONCLUSIONS
The addition of megestrol acetate to chemotherapy benefitted these patients by minimizing constitute symptoms throughout the treatment period especially in the quality of life, weight loss and stabilized serum albumin.
Department of Medicine, Faculty of Medicine, Chiang Mai University, Thailand.
Sumitra
S
Thongprasert
Rattiya
R
Cheewakriangkrai
Juntima
J
Euathrongchit
Kanittha
K
Thaikla
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D019290:Megestrol Acetate / Q000008:administration & dosage*; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D016019:Survival Analysis
D016190:Carboplatin; D017239:Paclitaxel; D019290:Megestrol Acetate