title: [Analysis of drug therapy of lung cancer in Hungary].
abstract: Hungary is a world leader in lung cancer deaths, so it is particularly important that patients could have access to modern treatments. The aim of our analysis was to find how drug treatments are used in Hungary and how they are compatible with international practice. The in-patient and prescription database of the National Health Insurance Fund for three years (2008-2010) was used to study the frequency of certain chemotherapy protocols, the duration of therapies, and the changes in the individual protocols and drugs used for lung cancer treatment (ICD: C33H0-C34) during the reviewed period. We did not differentiate between neoadjuvant and adjuvant treatment and therapy after progression. During the study period 12326 lung cancer patients received first-line chemotherapy, one third of those (n=3791) received second-line, and one third of those (n=1174) third-line treatment. The average treatment duration was between 3 and 4 months. The first-line treatment of NSCLC mainly consisted of platinum treatment in combination with third generation cytotoxic agents. A downward trend of gemcitabine, still the most common combination compound, was observed, in parallel with the increased use of paclitaxel, and as a consequence carboplatin replaced cisplatin. Among new agents the use of pemetrexed and bevacizumab has increased. Pemetrexed appeared mainly in second-line treatment, while erlotinib also in second, but mostly in third line. The first-line treatment of SCLC consisted of a platinum-etoposide combination, and in second-line setting topotecan was the most commonly used drug. According to our results the chemotherapeutic combinations and sequencing are in accordance with international and national recommendations. Further detailed analysis of the available data may help to obtain more accurate picture of the efficacy of lung cancer treatments as well.
authors.affiliation: Pulmonológiai Klinika, Semmelweis Egyetem, Budapest, Hungary. drmoldvay@hotmail.com
authors.forename: Judit
authors.initials: J
authors.lastname: Moldvay
authors.forename: György
authors.initials: G
authors.lastname: Rokszin
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Abonyi-Tóth
authors.forename: Lajos
authors.initials: L
authors.lastname: Katona
authors.forename: Gábor
authors.initials: G
authors.lastname: Kovács
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000068258:Bevacizumab; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000401:mortality; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D016208:Databases, Factual; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077143:Docetaxel; D004334:Drug Administration Schedule; D000069347:Erlotinib Hydrochloride; D005047:Etoposide / Q000008:administration & dosage; D005971:Glutamates / Q000008:administration & dosage; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007297:Inpatients; D007348:Insurance, Health; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D017239:Paclitaxel / Q000008:administration & dosage; D000068437:Pemetrexed; D055553:Prescription Drugs; D011799:Quinazolines / Q000008:administration & dosage; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage; D019772:Topotecan / Q000008:administration & dosage; D000093542:Gemcitabine
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D005971:Glutamates; D055553:Prescription Drugs; D011799:Quinazolines; D043823:Taxoids; D000068437:Pemetrexed; D003841:Deoxycytidine; D000077143:Docetaxel; D000068258:Bevacizumab; D006147:Guanine; D005047:Etoposide; D019772:Topotecan; D016190:Carboplatin; D000069347:Erlotinib Hydrochloride; D017239:Paclitaxel; D002945:Cisplatin; D000093542:Gemcitabine