title: Initial partial response and stable disease according to RECIST indicate similar survival for chemotherapeutical patients with advanced non-small cell lung cancer.
abstract: BACKGROUND
  Stable disease (SD) has ambiguous clinical significance for patients according to the dominant Response Evaluation Criteria in Solid Tumours (RECIST). The primary aims of the study were: (1) to clarify the clinical significance of SD by comparing the progression-free survival (PFS) of response and SD patients with advanced non-small cell lung cancer (NSCLC) after the first two courses of the standard first-line platinum-based chemotherapy; (2) to explore the relationship between the percentage change in tumour size and PFS among initial SD patients, in order to provide some guidance for clinicians in deciding continuation/termination of the current treatment at a relative early time.
  
  
  METHODS
  A total of 179 advanced NSCLC patients whose baseline CT image was available for review were included in the study. Another CT image was taken in the initial assessment after chemotherapy. A comparison of PFS between initial partial response (PR) and SD was used to determine whether significant differences exist. The relationship between the early percentage of change in tumour size of initial SD patients and their PFS was investigated. In addition, overall survival (OS), the secondary endpoint in this study, was investigated as well.
  
  
  RESULTS
  Patients with initial PR are not significantly distinguished from those with initial SD when their PFS is concerned (median PFS 249 days [95% confidence interval, 187-310 days] versus 220 days [95% confidence interval, 191-248 days], p > 0.05). Their median OS was 364 days (95% confidence interval, 275-452 days) for the initial PR patients versus 350 days (95% confidence interval, 293-406 days) for the initial SD patients, which suggests no significant difference as well p > 0.05). In addition, all the initial SD patients enjoyed similar PFS and OS.
  
  
  CONCLUSIONS
  Initial PR and SD enjoy similar PFS and OS for patients with advanced NSCLC. Within the initial SD subgroup, different percentages of tumour shrinkage or increase undergo similar PFS and OS. RECIST remains a reliable norm in assessing the effectiveness of chemotherapy for patients with advanced NSCLC before functional assessment has been integrated into the criteria.
authors.affiliation: Department of Medical Oncology, The First Hospital, China Medical University, NO,155, North Nanjing Street, Heping District, Shenyang City, China.
authors.forename: Lijie
authors.initials: L
authors.lastname: He
authors.forename: Yuee
authors.initials: Y
authors.lastname: Teng
authors.forename: Bo
authors.initials: B
authors.lastname: Jin
authors.forename: Mingfang
authors.initials: M
authors.lastname: Zhao
authors.forename: Ping
authors.initials: P
authors.lastname: Yu
authors.forename: Xuejun
authors.initials: X
authors.lastname: Hu
authors.forename: Jingdong
authors.initials: J
authors.lastname: Zhang
authors.forename: Songbai
authors.initials: S
authors.lastname: Li
authors.forename: Yaling
authors.initials: Y
authors.lastname: Gao
authors.forename: Yunpeng
authors.initials: Y
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D002681:China; D018572:Disease-Free Survival; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden / Q000187:drug effects*