Chemotherapy for advanced lung cancer: a 5-year experience.
BACKGROUND
Lung cancer is an important cause of cancer related deaths worldwide. There are few publications from India on treatment outcomes for non-small cell lung cancer (NSCLC). This study was done to analyze the response rates (RR), progression free survival (PFS), overall survival (OS), one and two-year survival of patients with advanced NSCLC treated with chemotherapy.


METHODS
Data of all patients who received chemotherapy for stage IIIB and IV NSCLC between the years 2002-2006 was analyzed. Only patients who received at least two cycles of chemotherapy and had a radiological response evaluation were eligible for assessment of outcome parameters.


RESULTS
There were 294 patients who received chemotherapy. Of these 194 (66%) were evaluable for outcome parameters. The RR, median PFS, OS, one and two-year survivals were 35.4%, six months (range, 2-70), seven months (range, 2-72), and 29.8% and 9.7% respectively. On univariate analysis, the strongest predictors for overall survival were female gender, absence of smoking and performance status (PS) (P= 0.0057, 0.0013, 0.0074). On multivariate analysis, only PS (P= 0.0387) was significant. The survival of patients treated with I generation platinum based doublet was not different from those treated with a II generation doublet (P= 0.45). The overall survival of patients who took II line chemotherapy was superior to those who did not receive it (P= < 0.0001).


CONCLUSIONS
Treatment outcomes for patients with advanced NSCLC continue to be poor. The II generation platinum doublets were not superior to I generation doublets. Chemotherapy at disease progression significantly improves survival.
Rajappa
S
S
Department of Medical Oncology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad - 500 016, India. siddharth142@sify.com
Gundeti
S
S
Talluri
M R
MR
Digumarti
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012737:Sex Factors; D016896:Treatment Outcome