title: Evaluation of the combination of oxaliplatin and 5-fluorouracil or gemcitabine in patients with sporadic metastatic pulmonary carcinoid tumors.
abstract: The aim of this retrospective study was to analyse the efficacy of gemcitabine-oxaliplatin (gemox) or 5-fluorouracil-oxaliplatin (folfox) in the treatment of metastatic pulmonary carcinoid tumors.
  
  
  
  45 patients were included in two tertiary referral centers between January 1999 and January 2013. Typical, atypical carcinoids or not otherwise specified carcinoids were diagnosed according to WHO criteria in 19%, 57%, and 24% of cases by two expert pathologists. Patients had synchronous (38%) or metachronous (62%) metastastic disease (median of 2 (1-5) metastatic sites). Seventy-nine percent had progressive disease before start of chemotherapy. Treatment consisted of: gemcitabine 1000mg/m(2) and oxaliplatin 100mg/m(2) every 2 weeks (gemox regimen, n=24) or 5-fluorouracil (5-FU) (400mg/m(2) in bolus injection and 5-FU 2400mg/m(2) in 46h-infusion) and oxaliplatin 85mg/m(2) (folfox regimen, n=21) every 2 weeks. Tumor response was assessed according to RECIST criteria every 8-12 weeks. Progression free survival and overall survival were assessed using Kaplan Meier curves.
  
  
  
  Patients received oxaliplatin-based chemotherapy in first-line (20%), second-line (33%), or post-second-line (47%) systemic treatment. The median number of cycles was 8 (1-12). Nine (20%) stopped oxaliplatin before 8 cycles because of toxicity. Nine patients (20%) had a partial response and 29 (64%) had stable disease. Median progression free survival (PFS) was 15 (6-25) months. Median overall survival (OS) was 34 (21-49) months. No significant difference was observed in response and PFS between either regimens.
  
  
  
  Our results suggest that either gemcitabine-oxaliplatin or 5-fluorouracil-oxaliplatin combinations are attractive chemotherapy regimen in metastatic pulmonary carcinoid tumors.
authors.affiliation: Hospices Civils de Lyon, Hôpital Edouard Herriot, Département d'Oncologie Médicale, 69437 Lyon cedex 03, France. Electronic address: thomas.walter@chu-lyon.fr.
authors.forename: T
authors.initials: T
authors.lastname: Walter
authors.affiliation: Gustave Roussy, Département d'Oncologie Médicale, 94805 Villejuif cedex, France.
authors.forename: D
authors.initials: D
authors.lastname: Planchard
authors.affiliation: Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Département de Pneumologie, Pierre-Bénite, France.
authors.forename: K
authors.initials: K
authors.lastname: Bouledrak
authors.affiliation: Gustave Roussy, Département de Biologie et Pathologie Médicales, 94805 Villejuif cedex, France.
authors.forename: J Y
authors.initials: JY
authors.lastname: Scoazec
authors.affiliation: Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Département de Pneumologie, Pierre-Bénite, France.
authors.forename: P J
authors.initials: PJ
authors.lastname: Souquet
authors.affiliation: Hospices Civils de Lyon, Hôpital Edouard Herriot, Département d'Oncologie Médicale, 69437 Lyon cedex 03, France.
authors.forename: A S
authors.initials: AS
authors.lastname: Dussol
authors.affiliation: Gustave Roussy, Département d'Oncologie Médicale, 94805 Villejuif cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Guigay
authors.affiliation: Hospices Civils de Lyon, Hôpital Edouard Herriot, Service Central d'Anatomie et Cytologie Pathologiques, 69437 Lyon cedex 03, France.
authors.forename: V
authors.initials: V
authors.lastname: Hervieu
authors.affiliation: Gustave Roussy, Département d'Oncologie Endocrinienne, 94805 Villejuif cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Berdelou
authors.affiliation: Gustave Roussy, Département d'Oncologie Médicale, 94805 Villejuif cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Ducreux
authors.affiliation: L'Hôpital Nord-Ouest, Service de Pneumologie et d'Oncologie thoracique, 69655 Villefranche-sur-Saône, France.
authors.forename: D
authors.initials: D
authors.lastname: Arpin
authors.affiliation: Hospices Civils de Lyon, Hôpital Edouard Herriot, Département d'Oncologie Médicale, 69437 Lyon cedex 03, France.
authors.forename: C
authors.initials: C
authors.lastname: Lombard-Bohas
authors.affiliation: Gustave Roussy, Département d'Oncologie Endocrinienne, 94805 Villejuif cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Baudin
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002276:Carcinoid Tumor / Q000188:drug therapy* / Q000473:pathology; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D009944:Organoplatinum Compounds; D003841:Deoxycytidine; D002955:Leucovorin; D005472:Fluorouracil
keywords: Carcinoid; Chemotherapy; Folfox; Gemox; Lung; Pulmonary