[Comparison of treatment efficacy of the second and the third generations of chemoradiotherapy regimens containing platinum on advanced non-small cell lung cancer]

Abstract

Background & objective: Platinum-based chemotherapy regimens are better than other regimens when treating patients with advanced non-small cell lung cancer (NSCLC). The third generation of platinum-based regimens {NP [Navelbine (NVB), cisplatin (DDP)], TP (Taxol, DDP), GP (Gemzar, DDP)} is better than the second generation {MVP [mitomycin (MMC), desacetylvinblastin amide (VDS), DDP], MIP [MMC, ifosfamide (IFO), DDP], EP [etopside (VP-16), DDP], VDS+DDP}. This study was to compare the efficacy between the second and the third generations of platinum-based regimens combined with radiotherapy on advanced non-small cell lung cancer (NSCLC).

Methods: From Jul. 1999 to Dec. 2001, 47 pathologically confirmed advanced NSCLC patients received chemoradiotherapy: 24 received the second generation of platinum-based regimens, 23 received the third generation; all patients received routine external irradiation of (60)Co (65-76 Gy). Characteristics of the patients were comparable. Kaplan-Meier analysis was used to evaluate survival rates, and log-rank test to study differences between the 2 groups.

Results: The objective response rates were 41.7% in the second generation group, and 56.5% in the third generation group (Chi (2)=0.53, P=0.47). The median time to progression and median survival time were significantly longer in the third generation group than in the second generation group (12.6 months vs. 6.0 months, Chi(2)=6.93, P=0.01; 14.0 months vs. 9.0 months, Z=-2.17, P=0.03). The 1-, and 2-year survival rates were significantly higher in the third generation group than in the second generation group (56.3% vs. 30.7%, 15.6% vs. 0%, Chi(2)=6.59, P=0.01). The major adverse events were leukocytopenia, nausea and vomiting, radiation-induced esophagitis and pneumonia, which were tolerable.

Conclusions: The third generation of platinum-based regimens in combination with radiotherapy for advanced non-small lung cancer may be more advantageous over the second generation of platinum-based regimens in prolonging survival of advanced NSCLC patients, which would be worth being studied further.