title: Long-term chemotherapy may prolong survival in advanced non-small-cell lung cancer among responders to first-line chemotherapy.
abstract: Survival in patients with advanced non-small-cell lung cancer (NSCLC) has substantially improved. Long-term chemotherapy with epidermal growth factor tyrosine kinase inhibitors (EGFR-TKIs) and other agents has been associated with long survival. We retrospectively examined the associations between overall survival (OS) and clinical variables in patients with advanced NSCLC who received at least one dose or course of outpatient chemotherapy in our institution. Of 360 patients who received first-line chemotherapy between January 1, 2004 and December 31, 2007, 185 subsequently received additional outpatient chemotherapy and 175 underwent inpatient chemotherapy only. Of the 185 patients, 147 (79.5%), 96 (51.9%), and 60 (32.4%) received second-line, third-line, and fourth-line chemotherapy, respectively. Patients who received outpatient chemotherapy had significantly longer median OS (22.3 months) than did those undergoing inpatient chemotherapy only (7.6 months; P < 0.0001). In univariate analysis of the 185 patients, sex, performance status (PS), smoking status, stage, best response to first-line chemotherapy, use of docetaxel, and EGFR-TKIs were significantly associated with OS (P values: 0.0019, 0.0066, 0.0001, 0.0231, 0.0011, 0.0250, and 0.0023, respectively). In multivariate analysis, PS, stage, best response to first-line chemotherapy, and use of docetaxel were significantly associated with OS (P values: 0.0272, 0.0030, 0.0022, and 0.0376, respectively). Survival was significantly longer among patients who responded to docetaxel and/or EGFR-TKIs. Long-term chemotherapy did not increase cumulative hospitalization. In patients with advanced NSCLC, an effective long-term chemotherapy regimen might prolong survival in responders to first-line chemotherapy.
authors.affiliation: Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1 Habikino, Habikino City, Osaka 583-8588, Japan. hirashimat@opho.jp
authors.forename: Tomonori
authors.initials: T
authors.lastname: Hirashima
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Suzuki
authors.forename: Masashi
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Youko
authors.initials: Y
authors.lastname: Kondoh
authors.forename: Yoshie
authors.initials: Y
authors.lastname: Tokuoka
authors.forename: Yuka
authors.initials: Y
authors.lastname: Matsuura
authors.forename: Motohiro
authors.initials: M
authors.lastname: Tamiya
authors.forename: Naoko
authors.initials: N
authors.lastname: Morishita
authors.forename: Shinji
authors.initials: S
authors.lastname: Sasada
authors.forename: Norio
authors.initials: N
authors.lastname: Okamoto
authors.forename: Kohei
authors.initials: K
authors.lastname: Akazawa
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawase
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents