Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2004 Oct;59(10):828-36.
doi: 10.1136/thx.2003.020164.

Chemotherapy versus supportive care in advanced non-small cell lung cancer: improved survival without detriment to quality of life

S G Spiro  1 , R M Rudd, R L Souhami, J Brown, D J Fairlamb, N H Gower, L Maslove, R Milroy, V Napp, M K B Parmar, M D Peake, R J Stephens, H Thorpe, D A Waller, P West; Big Lung Trial participants
Affiliations
Clinical Trial

Chemotherapy versus supportive care in advanced non-small cell lung cancer: improved survival without detriment to quality of life

S G Spiro et al. Thorax. 2004 Oct.

Abstract

Background: In 1995 a meta-analysis of randomised trials investigating the value of adding chemotherapy to primary treatment for non-small cell lung cancer (NSCLC) suggested a small survival benefit for cisplatin-based chemotherapy in each of the primary treatment settings. However, the meta-analysis included many small trials and trials with differing eligibility criteria and chemotherapy regimens.

Methods: The aim of the Big Lung Trial was to confirm the survival benefits seen in the meta-analysis and to assess quality of life and cost in the supportive care setting. A total of 725 patients were randomised to receive supportive care alone (n = 361) or supportive care plus cisplatin-based chemotherapy (n = 364).

Results: 65% of patients allocated chemotherapy (C) received all three cycles of treatment and a further 27% received one or two cycles. 74% of patients allocated no chemotherapy (NoC) received thoracic radiotherapy compared with 47% of the C group. Patients allocated C had a significantly better survival than those allocated NoC: HR 0.77 (95% CI 0.66 to 0.89, p = 0.0006), median survival 8.0 months for the C group v 5.7 months for the NoC group, a difference of 9 weeks. There were 19 (5%) treatment related deaths in the C group. There was no evidence that any subgroup benefited more or less from chemotherapy. No significant differences were observed between the two groups in terms of the pre-defined primary and secondary quality of life end points, although large negative effects of chemotherapy were ruled out. The regimens used proved to be cost effective, the extra cost of chemotherapy being offset by longer survival.

Conclusions: The survival benefit seen in this trial was entirely consistent with the NSCLC meta-analysis and subsequent similarly designed large trials. The information on quality of life and cost should enable patients and their clinicians to make more informed treatment choices.

PubMed Disclaimer

Comment in

References

    1. Thorax. 2000 Jun;55(6):463-5 - PubMed
    1. Rev Hosp Clin Fac Med Sao Paulo. 2001 Mar-Apr;56(2):53-8 - PubMed
    1. Patient Educ Couns. 2001 Nov;45(2):149-57 - PubMed
    1. Cancer. 2001 Nov 15;92(10):2639-47 - PubMed
    1. N Engl J Med. 2002 Jan 10;346(2):92-8 - PubMed

MeSH terms