Gemcitabine Plus Platinum Combination Chemotherapy for Elderly Patients with Advanced Non-small Cell Lung Cancer: A Retrospective Analysis
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose This study aimed to analyze the efficacy and toxicity of gemcitabine plus platinum chemotherapy for patients aged 70 years or older with advanced non-small-cell lung cancer (NSCLC). Materials and Methods We reviewed the records of stage IIIB, IV NSCLC patients or surgically inoperable stage II, IIIA NSCLC patients who were aged 70 years or older when treated with gemcitabine (1,250 mg/m2)plus cisplatin (75 mg/m2) or carboplatin (AUC5) chemotherapy from 2001 to 2010 at Seoul St. Mary’s Hospital, Uijeongbu St. Mary’s Hospital and St. Vincent’s Hospital. Gemcitabine was administered on days 1 and 8, and cisplatin or carboplatin was administered on day 1. Treatments were repeated every 3 weeks for a maximum of 4 cycles. Results The median age of the 62 patients was 73.5 years (range, 70 to 84 years). Forty-one (66%) patients exhibited comorbidity. The mean number of treatment cycles was 3.9. The compared average relative dose intensity of gemcitabine plus platinum chemotherapy was 84.8%. The median progression-free survival and overall survival (OS) were 5.0 months and 9.4 months, respectively. Reduced Eastern Cooperative Oncology Group (ECOG) performance status (none vs. ≥1) and weight loss (<5% vs. ≥5%) after treatment were found to have a significant effect on OS (p=0.01). Conclusion Gemcitabine plus platinum chemotherapy is an effective treatment option with an acceptable level of toxicity in patients aged 70 years or older with good performance status in advanced NSCLC.
Abstract
Purpose This study aimed to analyze the efficacy and toxicity of gemcitabine plus platinum chemotherapy for patients aged 70 years or older with advanced non-small-cell lung cancer (NSCLC). Materials and Methods We reviewed the records of stage IIIB, IV NSCLC patients or surgically inoperable stage II, IIIA NSCLC patients who were aged 70 years or older when treated with gemcitabine (1,250 mg/m2)plus cisplatin (75 mg/m2) or carboplatin (AUC5) chemotherapy from 2001 to 2010 at Seoul St. Mary’s Hospital, Uijeongbu St. Mary’s Hospital and St. Vincent’s Hospital. Gemcitabine was administered on days 1 and 8, and cisplatin or carboplatin was administered on day 1. Treatments were repeated every 3 weeks for a maximum of 4 cycles. Results The median age of the 62 patients was 73.5 years (range, 70 to 84 years). Forty-one (66%) patients exhibited comorbidity. The mean number of treatment cycles was 3.9. The compared average relative dose intensity of gemcitabine plus platinum chemotherapy was 84.8%. The median progression-free survival and overall survival (OS) were 5.0 months and 9.4 months, respectively. Reduced Eastern Cooperative Oncology Group (ECOG) performance status (none vs. ≥1) and weight loss (<5% vs. ≥5%) after treatment were found to have a significant effect on OS (p=0.01). Conclusion Gemcitabine plus platinum chemotherapy is an effective treatment option with an acceptable level of toxicity in patients aged 70 years or older with good performance status in advanced NSCLC.
참고문헌 (18)
- 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2008", Cancer Research and Treatment, 43(1), pp.1~11 (2011), 대한암학회
- Lewis JH, "Participation of patients 65 years of age or older in cancer clinical trials", J Clin Oncol, 21, pp.1383~1389 (2003)
- Hurria A, "Clinical trials in older adults with cancer: past and future", Oncology, 21, pp.351~358 (2007)
- Sawhney R, "Physiologic aspects of aging: impact on cancer management and decision making, part I", Cancer J, 11, pp.449~460 (2005)
- Ferrari AU, "Invited review: aging and the cardiovascular system", J Appl Physiol, 95, pp.2591~2597 (2003)
- Chatelut E, "Prediction of carboplatin clearance from standard morphological and biological patient characteristics", J Natl Cancer Inst, 87, pp.573~580 (1995)
- Natale RB, "Gemcitabine-containing regimens vs others in first-line treatment of NSCLC", Oncology, 18(8), pp.27~31 (2004)
- Schiller JH, "Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer", N Engl J Med, 346, pp.92~98 (2002)
- Berardi R, "Elderly patients with advanced non-small cell lung cancer. A pase II study with weekly cisplatin and gemcitabine", Oncology, 65, pp.198~203 (2003)
- Feliu J, "Combination of low-dose cisplatin and gemcitabine for treatment of elderly patients with advanced nonsmall- cell lung cancer", Cancer Chemother Pharmacol, 52, pp.247~252 (2003)
- Minami H, "Comparison of pharmacokinetics and pharmacodynamics of docetaxel and Cisplatin in elderly and non-elderly patients: why is toxicity increased in elderly patients", J Clin Oncol, 22, pp.2901~2908 (2004)
- Kubota K, "Cisplatin-based combination chemotherapy for elderly patients with non-small-cell lung cancer", Cancer Chemother Pharmacol, 40, pp.469~474 (1997)
- Langer CJ, "Cisplatin-based therapy for elderly patients with advanced non-small-cell lung cancer: implications of Eastern Cooperative Oncology Group 5592, a randomized trial", J Natl Cancer Inst, 94, pp.173~181 (2002)
- Gridelli C, "The ELVIS trial: a phase III study of single-agent vinorelbine as first-line treatment in elderly patients with advanced non-small cell lung cancer. Elderly Lung Cancer Vinorelbine Italian Study", Oncologist, 6(1), pp.4~7 (2001)
- Frasci G, "Gemcitabine plus vinorelbine yields better survival outcome than vinorelbine alone in elderly patients with advanced non-small cell lung cancer. A Southern Italy Cooperative Oncology Group (SICOG) phase III trial", Lung Cancer, 34(4), pp.S65~S69 (2001)
- Gridelli C, "Chemotherapy for elderly patients with advanced non-small-cell lung cancer: the Multicenter Italian Lung Cancer in the Elderly Study (MILES) phase III randomized trial", J Natl Cancer Inst, 95, pp.362~372 (2003)
- Davidoff AJ, "Chemotherapy and survival benefit in elderly patients with advanced non-small-cell lung cancer", J Clin Oncol, 28, pp.2191~2197 (2010)
- Quoix EA, "Weekly paclitaxel combined with monthly carboplatin versus single-agent therapy in patients age 70 to 89: IFCT-0501 randomized phase III study in advanced non-small cell lung cancer (NSCLC)", J Clin Oncol, 28(18S), pp.2~ (2010)
