Triplet platinum-based combination sequential chemotherapy improves survival outcome and quality of life of advanced non-small cell lung cancer patients

• Published in: Asian Pacific journal of cancer prevention : APJCP Vol. 13; no. 5; pp. 1863 - 1867
• Main Authors: Chen, Li-Kun, Liang, Ying, Yang, Qun-Ying, Xu, Fei, Zhou, Ning-Ning, Xu, Guang-Chuan, Liu, Guo-Zhen, Wei, Wei-Dong
• Format: Journal Article
• Language: English
• Published: Thailand 01.01.2012
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - mortality; Adenocarcinoma - secondary; Adolescent; Adrenal Gland Neoplasms - drug therapy; Adrenal Gland Neoplasms - mortality; Adrenal Gland Neoplasms - secondary; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bone Neoplasms - drug therapy; Bone Neoplasms - mortality; Bone Neoplasms - secondary; Brain Neoplasms - drug therapy; Brain Neoplasms - mortality; Brain Neoplasms - secondary; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - secondary; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - secondary; Cisplatin - administration & dosage; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Female; Humans; Liver Neoplasms - drug therapy; Liver Neoplasms - mortality; Liver Neoplasms - secondary; Lung Neoplasms - drug therapy; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Male; Middle Aged; Neoplasm Staging; Paclitaxel - administration & dosage; Prognosis; Prospective Studies; Quality of Life; Survival Rate; Vinblastine - administration & dosage; Vinblastine - analogs & derivatives; Vinorelbine; Young Adult
• ISSN: 1513-7368; 2476-762X
• DOI: 10.7314/APJCP.2012.13.5.1863

Maintenance chemotherapy is one strategy pursued in recent years with intent to break through the chemotherapy plateau for advanced non-small cell lung cancer (NSCLC). However, given the toxicity, platinum-based combinations are rarely given for this purpose. We carried out the present prospective study of triplet platinum-based combination sequential chemotherapy in advanced NSCLC to investigate if patients could tolerate and benefit from such intensive treatment. From Dec 2003 to Dec 2007, 190 stage IIIB and IV NSCLC patients in Sun yat-sen University sequentially received the 3 platinum-based combination (TP- NP-GP) treatment (T: paclitaxol 175 mg/m2 d1; N: vinorelbine 25 mg/m2 d1 and 8; G: gemcitabine 1 g/m2 d1 and 8; P: cisplatin 20 mg/m2 d1-5; repeated every 3 weeks). Patients were followed up to at least 3 years to obtain survival data. Treatment toxicities and the quality of life (QOL) were assessed during the whole treatment. There were 187 patients evaluable. The TP, NP and GP response rates with sequential use were 42.8% (80/187), 41.1% (65/158) and 28.8% (21/73) respectively. Median survival time was 18.2 months and the 1, 2 and 3 year overall survival (OS) rates were 78.7%, 38.5% and 21.3%. Patients receiving>6 cycles of chemotherapy had significantly longer OS and TTP (MST 25.3 vs. 14.5 months, TTP 15.1 vs. 9.1 months). The QOL on the whole for the patients was improved after chemotherapy. The sequential chemotherapy strategy with triplet platinum-based combination regimens can improve the survival outcome and the quality of life of advanced non-small cell lung cancer patients.