Survival of patients with stage IV non-small cell lung cancer
Possible benefit of chemotherapy in clinical practice
Keywords:
Non-Small-Cell Lung Carcinoma, SURVIVAL RATEAbstract
The objective of this study was to evaluate the survival of patients with stage IV non-small cell lung cancer (NSCLC) managed according to standard clinical practice, according to the instituted treatment. All patients with stage IV NSCLC and without previous treatment assisted in the period January 1994 - July 1997 were retrospectively evaluated. 86 patients were studied, 71 males and 15 females. The median age was 61 years (range: 35-85). Thirty-four patients received chemotherapy (CT) based on a platinum salt, associated or not with radiotherapy (RT) (group 1); 26 were treated with chest RT (group 2), and 26 received exclusive symptomatic treatment (group 3). Survival analysis was performed according to the treatment performed and taking into account other variables with a possible influence on survival. The median survival time of all the patients studied was 4.5 months (95% CI: 3.0-6.5 months). The risk of dying was significantly higher for patients in group 1 compared to patients in groups 2 and 3 (Cox model, p = 0.0002). Median survival times for groups 1, 2, and 3 were 7 months versus 3.2 months versus 2 months, respectively. It is concluded that the survival of patients with stage IV NSCLC managed according to standard clinical practice is similar to that reported in prospective clinical studies, being higher in the group treated with cisplatin-based CT.
References
1) Vasallo JA, Barrios E. Atlas de mortalidad por cáncer en el Uruguay. Comparación de dos quinquenios. Montevideo: Comisión Honoraria de Lucha contra el Cáncer. 1999: 284 p.
2) American Cancer Society. Cancer facts and figures, 2003. [en línea] http://www.cancer.org/downloads/STT/CAFF2003PWSecured.pdf [consulta: ene 2004]
3) Ginsberg RJ, Vokes EE, Rosenzweig K. Non small cell lung cancer. In: De Vita VT Jr, Helman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. 6th ed. Philadelphia PA: Lippincott-Raven, 2001: 925-82.
4) Mountain CF. The international system for staging lung cancer. Semin Surg Oncol 2000; 18(2): 106-15.
5) Non Small Cell Lung Cancer Collaborative Group. Chemotherapy in non small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials. BMJ 1995; 311(7010): 899-909.
6) Gandara DR, Edelman MJ, Lara P, Lau D. Current status and novel therapeutic approaches in advanced non small cell lung cancer. American Society of Clinical Oncolgy. Educational Book Spring 1999: 361-9.
7) Bunn PA Jr, Kelly K. New chemotherapeutic agents prolong survival and improve quality of life in non small cell lung cancer: a review of the literature and future directions. Clin Cancer Res 1998; 4(5): 1087-100.
8) Wozniak AJ, Crowley JJ, Balcerzak SP, Weiss GR, Spiridonidis CH, Baker LH, et al. Randomized trial comparing cisplatin with cisplatin plus vinorelbine in the treatment of advanced non small cell lung cancer: a Southwest Oncology Group study. J Clin Oncol 1998; 16(7): 2459-65.
9) Kosmidis P, Mylonakis N, Nicolaides C, Kalophonos C, Samantas E, Boukovinas J, et al. Paclitaxel plus carboplatin versus gemcitabine plus paclitaxel in advanced non-small-cell lung cancer: a phase III randomized trial. J Clin Oncol 2002; 20(17): 3578-85.
10) Le Chevalier T, Brisgand D, Douillard JY, Pujol JL, Alberola V, Monnier A, et al. Randomized study of vinorelbine and cisplatin versus vindesine and cisplatin versus vinorelbine alone in advanced non small cell lung cancer: results of a European multicenter trial including 612 patients. J Clin Oncol 1994; 12(2): 360-7.
11) Bonomi P, Kim K, Chang A. Phase III trial comparing etoposide (e) cisplatin (c) versus taxol (T) with cisplatin G-CSF (G) versus taxol-cisplatin in advanced non small cell lung cancer. An Eastern Cooperative Oncology Group (ECOG) trial. Proc Am Soc Clin Oncol 1996; 15: 1145a.
12) Belani CP, Natale RB, Lee JS. Randomised phase III trial comparing cisplatin/etoposide versus carboplatin/paclitaxel in advanced and metastatic non-small cell lung cancer. Proc Am Soc Clin Oncol 1998; 17: 455a. (abstr 1751).
13) Delgado L, Suárez L, Afonzo Y, Rigby R, Barrios E, Musé I, et al. Cáncer broncopulmonar a células no pequeñas estadio III irresecable: ¿cuál es la sobrevida en la práctica asistencial? Rev Med Uruguay 2000; 16(3): 193-200.
14) Kaplan EL, Meier P. Nonparametric Estimationf from Incomplete Observations. J Am Statiss 1958; 53: 457-81.
15) Cox DR. Regression Models And Life Tables. J R Stat Soc [Ser B] 1972; 30: 248-75.
16) Aguiar S, Barrios E, Buccino A, Dalla Rosa M, Rodríguez R, Luongo A. Cáncer de pulmón no a pequeñas células. Análisis de la sobrevida de acuerdo al tratamiento. Hospital de Clínicas 1990-1996. Arch Med Int 2000; 22(3): 119-23.
17) Cormier Y, Bergeron D, La Forge J, Lavandier M, Fournier M, Chenard J, et al. Benefits of polychemo-therapy in advanced non small cell lung bronchogenic carcinoma. Cancer 1982; 50(5): 845-9.
18) Woods RL, Williams CJ, Levi J, Page J, Bell D, Byrne M, et al. A randomized trial of cisplatin and vindesine versus supportive care only in advanced non small cell lung cancer. Br J Cancer 1990; 61(4): 608-11.
19) Kaasa S, Lund E, Thorud E, Hatlevoll R, Host H. Symptomatic treatment versus combination chemotherapy for patients with extensive non small cell lung cancer. Cancer 1991; 67(10): 2443-7.
20) Cellerino R, Tummarello D, Guidi F, Isidori P, Raspugli M, Biscottini B, et al. A randomized trial of alternating chemotherapy versus best supportive care in advanced non small cell lung cancer. J Clin Oncol 1991; 9(8): 1453-61.
21) Cartei G, Cartei F, Cantone A, Causarano D, Genco G, Tobaldin A, et al. Cisplatin-cyclophosphamide-mitomicyn combination chemotherapy with supportive care versus supportive care alone for treatment of metastatic non small cell lung cancer. J Natl Cancer Int 1993; 85(10): 794-800.
22) Gatzemeier U. Targeting the HER1/EGFR receptor to improve outcomes in non-small-cell lung cancer. Oncology (Huntingt) 2003; 17(11 Suppl 12): 7-10.
23) Bonomi P. Clinical studies with non-iressa EGFR tyrosine kinase inhibitors. Lung Cancer 2003; 41 (Suppl 1): S43-8.
24) Kris MG, Natale RB, Herbst RS, Lynch TJ, Prager D, Belani CP, et al. A phase II trial of ZD1839 ('Iressa') in advanced non-small cell lung cancer (NSCLC) patients who had failed platinum- and taxotere based regimens (IDEAL 2). Proc Am Soc Clin Oncol 2002; 21: 292a (abst 1166).
25) Fukuoka M, Yano S, Giaccone G, Tamura T, Nakagawa K, Douillard JY, et al. Final results from a phase II trial of ZD1839 ("Iressa") for patients with advanced non-small-cell lung cancer (IDEAL 1). Proc Am Assoc Cancer Res 2002; 21: 326a (abst 1188).
2) American Cancer Society. Cancer facts and figures, 2003. [en línea] http://www.cancer.org/downloads/STT/CAFF2003PWSecured.pdf [consulta: ene 2004]
3) Ginsberg RJ, Vokes EE, Rosenzweig K. Non small cell lung cancer. In: De Vita VT Jr, Helman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. 6th ed. Philadelphia PA: Lippincott-Raven, 2001: 925-82.
4) Mountain CF. The international system for staging lung cancer. Semin Surg Oncol 2000; 18(2): 106-15.
5) Non Small Cell Lung Cancer Collaborative Group. Chemotherapy in non small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials. BMJ 1995; 311(7010): 899-909.
6) Gandara DR, Edelman MJ, Lara P, Lau D. Current status and novel therapeutic approaches in advanced non small cell lung cancer. American Society of Clinical Oncolgy. Educational Book Spring 1999: 361-9.
7) Bunn PA Jr, Kelly K. New chemotherapeutic agents prolong survival and improve quality of life in non small cell lung cancer: a review of the literature and future directions. Clin Cancer Res 1998; 4(5): 1087-100.
8) Wozniak AJ, Crowley JJ, Balcerzak SP, Weiss GR, Spiridonidis CH, Baker LH, et al. Randomized trial comparing cisplatin with cisplatin plus vinorelbine in the treatment of advanced non small cell lung cancer: a Southwest Oncology Group study. J Clin Oncol 1998; 16(7): 2459-65.
9) Kosmidis P, Mylonakis N, Nicolaides C, Kalophonos C, Samantas E, Boukovinas J, et al. Paclitaxel plus carboplatin versus gemcitabine plus paclitaxel in advanced non-small-cell lung cancer: a phase III randomized trial. J Clin Oncol 2002; 20(17): 3578-85.
10) Le Chevalier T, Brisgand D, Douillard JY, Pujol JL, Alberola V, Monnier A, et al. Randomized study of vinorelbine and cisplatin versus vindesine and cisplatin versus vinorelbine alone in advanced non small cell lung cancer: results of a European multicenter trial including 612 patients. J Clin Oncol 1994; 12(2): 360-7.
11) Bonomi P, Kim K, Chang A. Phase III trial comparing etoposide (e) cisplatin (c) versus taxol (T) with cisplatin G-CSF (G) versus taxol-cisplatin in advanced non small cell lung cancer. An Eastern Cooperative Oncology Group (ECOG) trial. Proc Am Soc Clin Oncol 1996; 15: 1145a.
12) Belani CP, Natale RB, Lee JS. Randomised phase III trial comparing cisplatin/etoposide versus carboplatin/paclitaxel in advanced and metastatic non-small cell lung cancer. Proc Am Soc Clin Oncol 1998; 17: 455a. (abstr 1751).
13) Delgado L, Suárez L, Afonzo Y, Rigby R, Barrios E, Musé I, et al. Cáncer broncopulmonar a células no pequeñas estadio III irresecable: ¿cuál es la sobrevida en la práctica asistencial? Rev Med Uruguay 2000; 16(3): 193-200.
14) Kaplan EL, Meier P. Nonparametric Estimationf from Incomplete Observations. J Am Statiss 1958; 53: 457-81.
15) Cox DR. Regression Models And Life Tables. J R Stat Soc [Ser B] 1972; 30: 248-75.
16) Aguiar S, Barrios E, Buccino A, Dalla Rosa M, Rodríguez R, Luongo A. Cáncer de pulmón no a pequeñas células. Análisis de la sobrevida de acuerdo al tratamiento. Hospital de Clínicas 1990-1996. Arch Med Int 2000; 22(3): 119-23.
17) Cormier Y, Bergeron D, La Forge J, Lavandier M, Fournier M, Chenard J, et al. Benefits of polychemo-therapy in advanced non small cell lung bronchogenic carcinoma. Cancer 1982; 50(5): 845-9.
18) Woods RL, Williams CJ, Levi J, Page J, Bell D, Byrne M, et al. A randomized trial of cisplatin and vindesine versus supportive care only in advanced non small cell lung cancer. Br J Cancer 1990; 61(4): 608-11.
19) Kaasa S, Lund E, Thorud E, Hatlevoll R, Host H. Symptomatic treatment versus combination chemotherapy for patients with extensive non small cell lung cancer. Cancer 1991; 67(10): 2443-7.
20) Cellerino R, Tummarello D, Guidi F, Isidori P, Raspugli M, Biscottini B, et al. A randomized trial of alternating chemotherapy versus best supportive care in advanced non small cell lung cancer. J Clin Oncol 1991; 9(8): 1453-61.
21) Cartei G, Cartei F, Cantone A, Causarano D, Genco G, Tobaldin A, et al. Cisplatin-cyclophosphamide-mitomicyn combination chemotherapy with supportive care versus supportive care alone for treatment of metastatic non small cell lung cancer. J Natl Cancer Int 1993; 85(10): 794-800.
22) Gatzemeier U. Targeting the HER1/EGFR receptor to improve outcomes in non-small-cell lung cancer. Oncology (Huntingt) 2003; 17(11 Suppl 12): 7-10.
23) Bonomi P. Clinical studies with non-iressa EGFR tyrosine kinase inhibitors. Lung Cancer 2003; 41 (Suppl 1): S43-8.
24) Kris MG, Natale RB, Herbst RS, Lynch TJ, Prager D, Belani CP, et al. A phase II trial of ZD1839 ('Iressa') in advanced non-small cell lung cancer (NSCLC) patients who had failed platinum- and taxotere based regimens (IDEAL 2). Proc Am Soc Clin Oncol 2002; 21: 292a (abst 1166).
25) Fukuoka M, Yano S, Giaccone G, Tamura T, Nakagawa K, Douillard JY, et al. Final results from a phase II trial of ZD1839 ("Iressa") for patients with advanced non-small-cell lung cancer (IDEAL 1). Proc Am Assoc Cancer Res 2002; 21: 326a (abst 1188).
Downloads
How to Cite
1.
Suárez L, Delgado L, Afonso Y, Barrios E, Musé I, Viola A. Survival of patients with stage IV non-small cell lung cancer: Possible benefit of chemotherapy in clinical practice. Rev. Méd. Urug. [Internet]. 2004 Dec. 31 [cited 2024 Nov. 23];20(3):187-92. Available from: https://revista.rmu.org.uy/index.php/rmu/article/view/868
Issue
Section
Original Articles
