Docetaxel and cisplatin as first-line chemotherapy in advanced NSCLC

Abstract

7343 Background: Untreated cases of advanced lung cancer in India have a median survival of few weeks only (less than 2 months). However, use of various chemotherapeutic agents increases the survival (Behera- Ind J Paed Oncol, 1995). Docetaxel in combination with cisplatin for first-line treatment is a good choice for locally advanced or metastatic NSCLC (Med Clin, Barc 2004). We describe our experience with Docetaxel and Cisplatin in a group of Indian patients with advanced NSCLC. Method: 130 patients of stage IIIB/IV histologically proved Non-small Cell Lung Cancer were included in the study. There were 116 males with their age ranging from 40 to 81 years and 14 females (age range 40–67). The performance status ranged from 60 to 100 (Kornofsky scale). Docetaxel 100mg/m2 and Cisplatin 60 mg/m2 was administered on day 1. The course was repeated every 28 days and the target was to give 5 such courses of chemotherapy. Fourty three patients received additional local radiotherapy of 20 to 50Gy. 84 patients completed 5 cycles of therapy. Result: Complete radiological response was observed in 22 (18.5%) and partial response in 28 (33%). The lesions remained stable ranging from 10 weeks to 41 weeks before they showed progression. At the time of data analysis the median survival has been 44.5+ weeks for those who completed five cycles. 118 patients (91%) are surviving beyond 6 months and 42 patients (32.3%) are alive beyond one year and 14 patients (10.7%) are still alive after 2 years. Thirty two patients gained weight during therapy with the mean increase of 4.1kg and 24 lost weight with a mean of 2.8 kg. Performance status improved in 24 and deteriorated in 9; in the remaining patients it was static. Side effects were minimal (alopecia, nausea, vomiting, diarrhea, skin changes and neuropathy) and not serious. Diarrhoea was observed in 32 (24.6%)of the patients that could be managed with usual antidiarrhoeals. Conclusion: Docetaxel and cisplatin combination as first line chemotherapy in advanced non small cell lung cancer is effective and comparable to other commonly used regimens. Although the regimen is costlier in Indian standards, it is effective with minimal side effects and should be tried in those who could afford it. No significant financial relationships to disclose.