Early response to platinum-based first-line chemotherapy in non-small cell lung cancer may predict survival.
J Thorac Oncol
; 2(8): 735-40, 2007 Aug.
Article
en En
| MEDLINE
| ID: mdl-17762340
ABSTRACT
INTRODUCTION:
Response rates in the palliative treatment of non-small cell lung cancer, with combination platinum-based chemotherapy, vary from 20% to 40%, leaving a large number with either stable or progressive disease. We examined radiographic response after two courses of platinum-based induction chemotherapy to see whether this is an early predictor of outcome.METHODS:
In this retrospective study, 320 patients with stage III/IV NSCLC were identified who received 4 or more courses of first-line platinum-based chemotherapy and attained partial response (PR) or stable disease (SD).RESULTS:
After two courses, 115 patients attained PR and 205 SD. Cox regression analysis shows that response after two courses of chemotherapy remains an independent significant prognostic factor for survival. The 2-year survival for patients attaining PR after two courses (n = 115) was 23% compared with 11% (n = 205) for those with SD (p = 0.002). Patients who achieve an objective response after two courses also have a better symptomatic response (p = 0.003) and it was significantly longer (p = 0.04). Of the 205 with SD, 51 attained PR with four courses, whereas 154 (48%) remained with SD; there was no difference in survival outcome of these two groups.CONCLUSIONS:
These data suggest that NSCLC patients who only have SD after two cycles of first-line chemotherapy have poorer survival outcome and less symptomatic benefit than those in PR. Trials looking at change in management at this point are warranted.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Protocolos de Quimioterapia Combinada Antineoplásica
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Carcinoma de Pulmón de Células no Pequeñas
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Neoplasias Pulmonares
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Thorac Oncol
Año:
2007
Tipo del documento:
Article
País de afiliación:
Reino Unido