Comparison of the Clinical Effects of Paclitaxel and Paclitaxel plus Oxaliplatin as the Second-line Treatment of Advanced Non-small Cell Lung Cancer.

Abstract

Second-line chemotherapy with taxanes for the patients with non-small cell lung cancer (NSCLC), who had disease recurrence or failure in previously treated with platinum-based chemotherapy, has been shown to be effective. Besides docetaxel, paclitaxel, the other available taxane, has also demonstrated potential activity in the same indication in a few studies. The aim of this study is to compare the treatment efficacy and safety between paclitaxel and paclitaxel plus oxaliplatin as the second-line treatment of advanced NSCLC. Sixty-six patients from Sep 2000 to Sep 2007 whose disease progressed after first-line chemotherapy were enrolled and randomized into 2 groups: one group was administered with only paclitaxel (44 patients), the other was given paclitaxel plus oxaliplatin (22 patients), ECOG 0-2. The regiments were: single agent paclitaxel (175 mg/m(2), d1) or paclitaxel (175 mg/m(2), d1) plus oxaliplatin(130 mg/m(2), d1), 3-4 weeks/cycle. The overall response rate of single paclitaxel and paclitaxel plus oxaliplatin were 13.6% and 18.2%, respectively. The median time to progression were 3.2 months vs 4.5 months. Median survival time were 6.9 months vs 8.2 months. There were no statistical differences. The haematological toxicities of paclitaxel plus oxaliplatin group were more severe than single agent group: grade 3/4 leukopenia (P=0.039). The rate of nausea, vomiting and acroaesthesia in paclitaxel plus oxaliplatin group was higher than that of single-paclitaxel group, but there were no statistical differences. Other adverse effects were mild. Singlepaclitaxel administration as the second-lined treatment of advanced NSCLC is tolerable and has the response effect no worse than the combined chemotherapy.