title: Front-line paclitaxel/cisplatin-based chemotherapy in brain metastases from non-small-cell lung cancer.
abstract: OBJECTIVE
  Paclitaxel-cisplatin is considered to be a standard therapy for metastatic non-small-cell lung cancer (NSCLC). The aim of this study was to evaluate the activity and toxicity of this combination with vinorelbine or gemcitabine as front-line therapy in brain metastases from NSCLC.
  
  
  METHODS
  Twenty-six chemotherapy-naive patients with an ECOG performance status of 0-2 were treated with paclitaxel (135 mg/m(2)) on day 1, cisplatin (120 mg/m(2)) on day 1, and either vinorelbine (30 mg/m(2)) on days 1 and 15 or gemcitabine (800 mg/m(2)) on days 1 and 8. Whole-brain irradiation was offered early in case of progression and later as consolidation treatment.
  
  
  RESULTS
  All patients were evaluated for toxicity and 25 for response. An intracranial response rate was observed in 38% of the patients (95% CI: 22-59%). WHO grade 3-4 neutropenia and thrombocytopenia occurred in 31 and 4% of the patients, respectively. There was one treatment-related death. Non-hematological toxicities were mild. After a median follow-up of 46 months, the median overall survival for all patients was 21.4 weeks and the median time to progression was 12.8 weeks.
  
  
  CONCLUSIONS
  Paclitaxel and cisplatin combined with vinorelbine or gemcitabine as front-line therapy in brain metastases seem to achieve responses similar to those for extracranial disease, suggesting a meaningful role in this setting.
authors.affiliation: Department of Oncology and Radiation Oncology, Clínica Universitaria de Navarra, Pamplona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Cortes
authors.forename: Javier
authors.initials: J
authors.lastname: Rodriguez
authors.forename: Jose Manuel
authors.initials: JM
authors.lastname: Aramendia
authors.forename: Esteban
authors.initials: E
authors.lastname: Salgado
authors.forename: Alfonso
authors.initials: A
authors.lastname: Gurpide
authors.forename: Jesus
authors.initials: J
authors.lastname: Garcia-Foncillas
authors.forename: Jose Javier
authors.initials: JJ
authors.lastname: Aristu
authors.forename: Angela
authors.initials: A
authors.lastname: Claver
authors.forename: Ana
authors.initials: A
authors.lastname: Bosch
authors.forename: Jose Maria
authors.initials: JM
authors.lastname: Lopez-Picazo
authors.forename: Salvador
authors.initials: S
authors.lastname: Martin-Algarra
authors.forename: Antonio
authors.initials: A
authors.lastname: Brugarolas
authors.forename: Emiliano
authors.initials: E
authors.lastname: Calvo
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077235:Vinorelbine; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D014747:Vinblastine; D017239:Paclitaxel; D002945:Cisplatin; D000077235:Vinorelbine; D000093542:Gemcitabine