| High VPP combination chemotherapy for advanced non-small cell lung cancer. |
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Seok Cheol Hong, Pyo Seong Han, Jong Jin Lee, Hai Jeong Cho, Ju Ock Kim, Sun Young Kim |
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Department of Internal Medicine, College of Medicine Chungnam National University, Chung Nam, Korea |
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| Abstract |
Background
The benefits of combination chemotherapy in unresectable non-small cell lung cancer remain uncertain. But, according to the recent reports, the response rates of cisplatin-based poly-
chemotherapy regimens are higher than those of single agent. Also, the response rates of high-dose cisplatin group are higher than those of low-dose cisplatin group. In attemp to answer the question whether treatments, combination chemotherapy (high VPP) and combination chemotherapy with radiation therapy, improve survival in advanced non-small cell lung cancer, we begin to study.
Methods
Thirty-five patients above stage III , diagnosed histologically as non-small cell lung cancer, were enrolled. Among them, nineteen received a combination chemotherapy consisting of VP-16 & high-dose cisplatin (100 mg/ m2 ) and/ or radiation therapy. The other group (16 subjects) received no therapy. To investigate the differences of survival and response rates between two groups and the side effects related to therapy, we reviewed patients’ records.
Results
1) The overall objective response rate was 47%(9/ 19) with one complete remission.
2) In patients who received polychemotherapy and radiation therapy, the response rate was 60%(6/ 10) with one complete remission and survival rates of 3 months, 6 months and 12 months were 100% , 70% and 40% 3) In patients who received polychemotherapy, the response rate was 33% (3/ 9) with no complete remission and survival rates of 3 months, 6 months and 12 months were 78% , 67% and 33%.
4) Overall, treated patients survived significantly longer (p < 0.05) than non.treated patients (median survival 307 days versus 95 days).
5) Analysis of the various prognostic factors disclosed that good performance status, stage III and squamous cell type showed the good response rates 6) The toxicities were nausea and/ or vomiting (100%), alopecia (90%), anemia (79%), leukopenia (69%), thrombocytopenia (2%), increased creatinine (1 6%) and neurotoxicity (5%) Conclusion: According to above results, there are relatively good results that high VPP combination chemotherapy in advanced non-small cell lung cancer improves survival in the treated group than in the non-treated group. Thus, it is considered that we select the patients with proper indications and treat them with effective chemotherapy and radiation therapy. But, because improvement related to high VPP polychemotherapy is not marked in this study, it is necessary that we should investigate follow-up studies in many cases. |
| Key Words:
High VPP chemotherapy, Non-small cell lung cancer, Cisplatin, Etoposide |
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