Comparison of cisplatin- and carboplatin-based third-generation chemotherapy in 1,014 Chinese patients with advanced non-small-cell lung cancer.
The outcome of patients with stage IIIB/IV non-small-cell lung cancer treated with platinum-based chemotherapy as first-line therapy was investigated to determine if cisplatin- or carboplatin-based combination therapy have similar efficacy by comparing the overall survival and safety profile for each combination regimen. A total of 1,014 patients, treated for stage IIIB and IV NSCLC between January 2002 and December 2008, with initial ECOG performance status of 0 and 1, adequate hematologic, hepatic, and renal function, who received at least two cycles of third-generation platinum-based chemotherapy, survived greater than 90 days, and experienced death were included for survival and safety analysis. Of them, 788 patients received cisplatin-based chemotherapy and 226 carboplatin-based. Cisplatin-based regimen yield significant better overall survival with a median survival time of 324 days compared to that of the carboplatin-based regimen of 286 days, attributable to the survival benefit of patients with stage III B (379 days vs. 283 days, Log-rank P=0.003), or with histology of squamous (308 days vs. 262 days, Log-rank P=0.01). Patients of the carboplatin-based arm were more likely to experience thrombocytopenia (OR=0.560, 95% CI=0.332-0.944, P=0.028), while cisplatin-based chemotherapy was associated with more nausea and vomiting (OR=3.720, 95% CI=1.971-7.021, P<0.0001). Non-small-cell lung cancer patients with stage IIIB disease and good performance status have a better survival advantage when treated with third-generation cisplatin-based chemotherapy compared to carboplatin-based regimen, and patients with squamous histology type may have experienced greater survival benefit than those with adenocarcinoma.
Luo
Jie
J
Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zhengmin Road, 200433, Shanghai, China.
Leaw
Shiang J
SJ
Xu
Ying
Y
Zheng
Di
D
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D044466:Asian People; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D000077143:Docetaxel; 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; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D000077235:Vinorelbine; D000093542:Gemcitabine
D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D014747:Vinblastine; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin; D000077235:Vinorelbine; D000093542:Gemcitabine