Chemotherapy for advanced lung cancer: a 5-year experience

Lung cancer is an important cause of cancer related deaths worldwide. There are few publications from India on treatment outcomes for non-small cell lung cancer (NSCLC). This study was done to analyze the response rates (RR), progression free survival (PFS), overall survival (OS), one and two-year survival of patients with advanced NSCLC treated with chemotherapy.

Data of all patients who received chemotherapy for stage IIIB and IV NSCLC between the years 2002-2006 was analyzed. Only patients who received at least two cycles of chemotherapy and had a radiological response evaluation were eligible for assessment of outcome parameters.

There were 294 patients who received chemotherapy. Of these 194 (66%) were evaluable for outcome parameters. The RR, median PFS, OS, one and two-year survivals were 35.4%, six months (range, 2-70), seven months (range, 2-72), and 29.8% and 9.7% respectively. On univariate analysis, the strongest predictors for overall survival were female gender, absence of smoking and performance status (PS) (P= 0.0057, 0.0013, 0.0074). On multivariate analysis, only PS (P= 0.0387) was significant. The survival of patients treated with I generation platinum based doublet was not different from those treated with a II generation doublet (P= 0.45). The overall survival of patients who took II line chemotherapy was superior to those who did not receive it (P= < 0.0001).

Treatment outcomes for patients with advanced NSCLC continue to be poor. The II generation platinum doublets were not superior to I generation doublets. Chemotherapy at disease progression significantly improves survival.