Somatostatin, retinoids, melatonin, vitamin D, bromocriptine, and cyclophosphamide in advanced non-small-cell lung cancer patients with low performance status.
BACKGROUND
The prognosis of low performance status (PS) patients with advanced non-small-cell-lung cancer (NSCLC) is dismal. In these patients, we have determined the survival, clinical benefits, and toxicity of a multidrug regimen, based on cyclophosphamide and biotherapeutical agents.


METHODS
Patients with a diagnosis of stage IIIB or stage IV NSCLC, no previous surgery or chemoradiotherapy, and an Eastern Cooperative Oncology Group (ECOG) PS equal to or greater than 2 received a daily combination of somatostatin, retinoids, melatonin, vitamin D, bromocriptine, and cyclophosphamide.


RESULTS
Twenty-eight (28) patients were enrolled. The median age was 64 years (range, 35-74). The PS was 2 and 3 in 78.6% and 21.4% of patients, respectively. The median overall survival (intent-to-treat analysis) was 12.9 months (range, 1.5-33.5 months), The overall survival rates at 1 and 2 years were 51.2% and 21.1%, respectively. The side-effects were very mild, mostly consisting of diarrhoea, nausea/vomiting, and drowsiness of grade 1-2. Most patients experienced an improvement of both respiratory (cough and dyspnoea) and general (pain, fatigue, and insomnia) symptoms.


CONCLUSIONS
Low PS patients with advanced NSCLC may benefit from a combination of somatostatin, retinoids, melatonin, vitamin D, bromocriptine, and cyclophosphamide, in terms of survival and quality of life, with very low side-effects.
Thoracic Surgery Unit, Ospedale Maggiore Azienda Ospedaliera, Verona, Italy. norsaachille@yahoo.it
Achille
A
Norsa
Vincenzo
V
Martino
D000328:Adult; D000368:Aged; D001971:Bromocriptine / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D003520:Cyclophosphamide / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008550:Melatonin / Q000627:therapeutic use*; D008875:Middle Aged; D009367:Neoplasm Staging; D011788:Quality of Life; D012176:Retinoids / Q000627:therapeutic use*; D013004:Somatostatin / Q000627:therapeutic use*; D016019:Survival Analysis; D013997:Time Factors; D014807:Vitamin D / Q000627:therapeutic use*
D012176:Retinoids; D014807:Vitamin D; D001971:Bromocriptine; D013004:Somatostatin; D003520:Cyclophosphamide; D008550:Melatonin