[Effectiveness of gemcitabine in combination with cisplatin in a randomized study of untreated patients with advanced non-small-cell lung carcinoma].
Lung cancer is the leading cause of cancer death in men worldwide. It accounts for 29 percent of all cancer deaths in men in the European community; the corresponding figure for woman is 9 percent.


OBJECTIVE
The evaluation Response Rate (RR) and one-year survival in inoperable locally advanced Non-Small cell Lung Cancer (NSCLC) treated with Gemcitabine (Gemzar/kappa) plus Cisplatin and fractionated chest radiation. The evaluation RR and one-year survival in metastatic NSCLC treated with Gemcitabine plus Cisplatin.


METHODS
Retrospective clinical study on two years clinical material (2000 and 2001). In first group number of evaluated patients was 74 with stage IIIa (N2) and IIIb; mean age 52.5; male 56, female 18; WHO performance status 0-2. Second group was 14 patients with stage IV and next characteristics: mean age 50.3; male 10, female 4; WHO performance status 0-2. Treatment schedule for patients with stage IIIa (N2) and IIIb: Cisplatin 75 mg/m2 plus Gemcitabin 1250 mg/m2, day first, and Gemcitabin 1250 mg/m2, day 8, every 3 weeks, total 3 cycles. After third cycle chemotherapy, in period from 7-14 days started with fractionated radiation therapy. Usually it was 40-46 Gy on tumor and mediastinum during 30 days. Patients with metastatic NSCLC (stage IV) treated with the same schedule, every three weeks, total 4 cycles but without fractionated radiation therapy.


RESULTS
Overall RR for stage IIIa (N2) and stage IIIb was 46.6% and one-year survival 42.5%. RR for stage IV was in the form of partial response at the eight patients (57%) with one-year survival 7.3% (one patient) and median time to disease progression 1.3 months.


CONCLUSIONS
In our two years clinical sample we treated 74 patients with NSCLC stage IIIa (N2) and stage IIIb with schedule--Cisplatin 75 mg/m2 plus Gemcitabin 1250 mg/m2, day first, and Gemcitabin 1250 mg/m2, day 8, every 3 weeks, total 3 cycles and fractionated radiation therapy with 40-46 Gy during 30 days on tumor and mediastinum. It's very effective regime with overall response rate 46.6% and one-year survival 42.5%. For stage IV it's not so effective regime, because, even now, it's so expensive regime for us.
Mehić
Bakir
B
Klinika za plućne bolesti i tuberkulozu, Klinicki centar Univerziteta u Sarajevu.
Zutić
Hasan
H
Dizdarević
Zehra
Z
Lomigorić
Jasenko
J
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D000093542:Gemcitabine
D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine