[Comparison of paclitaxel and carboplatin versus ifosfamide, etoposide, and carboplatin regimen for treatment of patients with advanced non-small cell lung cancer]

Abstract

Background and objective: The platinum-containing combination chemotherapy has been proved to be benefit to the patients with advanced non-small cell lung cancer. Compared with cisplatin-based combination chemotherapy regimens, carboplatin-based regimens result in longer survival time and less toxicity, despite of lower response rate. In the palliative treatment setting, less toxicity and longer survival may be more significant than response rate. So we choose the carboplatin-based combination chemotherapy regimens as our study objects. To compare the efficacy and toxicity of two carboplatin-based combination chemotherapy regimens: paclitaxel and carboplatin regimen(PC) vs ifosfamide, etoposide, and carboplatin regimen(IEC).

Methods: Sixty-eight patients were enrolled in this study, 35 patients received PC regimen and 33 received IEC regimen. Patients in both groups were well-matched with baseline disease characteristics(P > 0.05).

Results: In PC group, the response rate was 40.0% (14/35, 95% confidence interval [CI]: 23.8%-56.2%) (14 PR, 19 NC, 2 PD). Whereas in group IEC, the response rate was 21.2% (7/33, 95% CI: 7.3%-35.1%) (7 PR, 24 NC, 2 PD). The median survival and 1-year survival rate were 9.1 months (95% CI: 7.2-11.0 months) and 25.7% (95% CI: 11.2%-40.2%) for group PC versus 7.8 months (95% CI: 6.2-9.4 months) and 20.0% (95% CI: 6.0%-34.0%) for group IEC. The better response rate, 1-year survival rate, and the longer median survival seen in the group PC were not statistically significant (for response rate, P = 0.094, Chi-square test; for overall survival, P = 0.684, Log-rank test). The hematologic toxicities, especially leukopenia (P < 0.0005, Wilcoxon rank sum test) and anemia (P = 0.006, Wilcoxon rank sum test) were less pronounced in group PC; Hematuria and fever were pronounced more in group IEC, whereas allergic reaction was more in group PC, but there were no statistically significant differences between the two groups(P > 0.05, Wilcoxon rank sum test); Other toxicities were similar.

Conclusions: Compared with IEC regimen, PC regimen result in less hematologic toxicities in the patients with advanced NSCLC, Although whether its efficacy was better should be confirmed by well-controlled randomized clinical trials with more patients.