Analysis of Combination Chemotherapies In Advanced Non-Small Cell Lung Cancer (NSCLC) : Srinagarind Hospital, Khon Kaen University Experience

Abstract

Background : Lung cancer is the third leading cancer in Srinagarind hospital, Khon Kaen University. At the time of diagnosis, most lung cancer patients always ghave advance disease.

Objective : To study the activity of combination chemotherapies in advanced NSCLC

Design : A descriptive study.

Setting : Division of Pulmonary and critical care medicine, Department of Medicine, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University

Subject : Thirty patients who were diagnosed with advanced NSCLC (stage IIIB and IV), good performance status (ECOG 0-2), and with no contraindication for chemotherpay in department of medicine service between June 1996 and June 1998. Those patients were assigned to receive one of the two combination chemotherapies : 1. Paclitaxel and Carboplatin (Pac/CP), 2. Ifosfamide, Epirubicin and Cisplatin (IEP).  This study was not randomized, but it was a series of phase II trials.

Measurement : Evaluation of the response and toxicities by standard criteria for chemotherapy.  Calculation lf survival by Kaplan-Meier method.

Results: There ware 30 cases, 19 male and 11 female.  The patients’ median age was 51.75 years (range 36-63).  The most common histomorphological type of lung cancer was adenocarcinoma (76.67%), 56.67% had stage IIIB disease; 43.33% had stage IV disease.  Of the 30 patients enrolled; 19 patients were assigned to receive IEP, and 11 patients were received Pac/CP; 10 patients who received Pac/CP were evaluable.  The overall response rate for Pac/CP and IEP was 30% and 26.4%, respectively.  The toxicities for Pac/CP were grade 3 neutropenia 10%, grad 2 thrombocytopenia 20%, grade 2 anemia 40% and grade 2 neuropathy 80%.  The toxicities for IEP were grade 3 anemia 18.2%, grade 2 elevated transminase enzyme 5.3% grade 2 elevated creatinine 5.3% and grade 3 infecgtious complication 15.8%.  The median survival time of both regimens were 7 months. One year survival probability was 45% and 11% for Pac/CP regimen and IEP regimen, respectively.

Conclusion: The response rate of Pac/CP and IEP were similar.  The one year survival probability seem to be better in Pac/CP regimen.

Keword : Chemotherapy, Non-Small Cell Lung Cancer (NSCLC), Paclitaxel, Carboplation (Pac/CP), Ifosfamide, Epirubicin, Cisplatin (IEP)