title: Paclitaxel-etoposide-carboplatin/cisplatin versus etoposide-carboplatin/cisplatin as first-line treatment for combined small-cell lung cancer: a retrospective analysis of 62 cases.
abstract: OBJECTIVE
  To compare the efficacy and adverse effects of paclitaxel-etoposide-carboplatin/cisplatin (TEP/TCE) regimen with those of etoposide-carboplatin/cisplatin (EP/CE) regimen as first-line treatment for combined small-cell lung cancer (CSCLC).
  
  
  METHODS
  A retrospective study was conducted on 62 CSCLC patients who were treated at Tianjin Medical University Cancer Institute and Hospital from July 2000 to April 2013 and administered with TEP/TCE regimen (n=19) or EP/CE regimen (n=43) as first-line CSCLC treatment. All patients received more than two cycles of chemotherapy, and the response was evaluated every two cycles. The primary endpoint was overall survival (OS), and the secondary endpoints were progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse effects.
  
  
  RESULTS
  ORR between the TEP/TCE and EP/CE groups showed a statistical difference (90% vs. 53%, P=0.033). Both groups failed to reach a statistical difference in DCR (100% vs. 86%, P=0.212). The median PFS and OS of the TEP/TCE group were slightly longer than those of the EP/CE group, although both groups failed to reach a statistical difference (10.5 vs. 8.9 months, P=0.484; 24.0 vs. 17.5 months, P=0.457). However, stratified analysis indicated that the PFS of patients with stages III and IV CSCLC showed marginally significant difference between the TEP/TCE and EP/CE groups (19.5 vs. 7.6 months; P=0.071). Both rates of grade IV bone marrow depression and termination of chemotherapy in the TEP/TCE group were significantly higher than those in the EP/CE group (26.3% vs. 7.0%, P=0.036; 31.6% vs. 14.7%, P=0.004).
  
  
  CONCLUSIONS
  The TEP/TCE regimen may not be preferred for CSCLC, and this three-drug regimen requires further exploration and research. To date, the EP/CE regimen remains the standard treatment for CSCLC patients.
authors.affiliation: Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Diagnosis and Treatment Center, Tianjin 300060, China.
authors.forename: Yue-Ya
authors.initials: YY
authors.lastname: Li
authors.affiliation: Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Diagnosis and Treatment Center, Tianjin 300060, China.
authors.forename: Chan
authors.initials: C
authors.lastname: Zhou
authors.affiliation: Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Diagnosis and Treatment Center, Tianjin 300060, China.
authors.forename: Deng-Xia
authors.initials: DX
authors.lastname: Yang
authors.affiliation: Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Diagnosis and Treatment Center, Tianjin 300060, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Diagnosis and Treatment Center, Tianjin 300060, China.
authors.forename: Zhu-Jun
authors.initials: ZJ
authors.lastname: Liu
authors.affiliation: Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Diagnosis and Treatment Center, Tianjin 300060, China.
authors.forename: Xin-Yue
authors.initials: XY
authors.lastname: Wang
authors.affiliation: Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Diagnosis and Treatment Center, Tianjin 300060, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Li
keywords: CE regimen; Small cell lung carcinoma (SCLC); adverse effects; chemotherapy; prognosis; survival analysis