Cycles Of Chemotherapy In Patients Research Articles

Tumor Marker for Diagnosis and Monitoring Response to chemotherapy for Oesophagus Cancer Patients

Purpose: - To analyze the level of serum Carcinoembryonic antigen (CEA) before and after Different Cycle Of chemotherapy in oesophagus cancer patients. Methods: - For the study total 120 cases of carcinoma of esophagus of stage I, stage II stage III and Stage IV (before and after different cycle of chemotherapy) were selected. All patients were clinically and histological diagnosed. 42 age and sex matched healthy normal subjects selected as control. CEA activity was measured in the in the serum of control group (n=42) and in patients with esophagus cancer (n=120). Results: - Mean CEA activity in serum was significantly higher in oesophagus cancer patients as compared to control (p<0.001). After chemotherapy (stage II) the activity of CEA was significantly higher than before chemotherapy (stage I). In stage II (after first cycle of chemotherapy) activity was significantly decreased than stage III (before chemotherapy) and the activity of CEA was significantly decreased in stage IV (after third cycle of chemotherapy) than stage III (after second cycle of chemotherapy). Conclusion:- Based on the data from our study, it can be stated that serum CEA measurement in plasma may be useful tumor marker in esophageal cancer, its activity might helpful to predict the response of chemotherapy in advance stage of cancer. An initial increased level of CEA before and first cycle of chemotherapy may not indicate tumor progression, but may be represent a transient tumor marker surge phenomenon after second and third cycle of chemotherapy in patients responding to treatment.. Statistically significant change in tumor marker CEA level during the process of treatment in esophageal cancer patients, with a positive response and no established disease progression during study period, near about 12 months after the treatment, point to CEA as an important predictive factor.

Impact of timing and cycles of systemic chemotherapy on survival outcome of colorectal liver metastases patients treated by percutaneous microwave ablation

Purpose: The aim of this retrospective study is to determine the optimal timing and number of cycles of systemic chemotherapy in patients with colorectal liver metastases (CLM) treated by ultrasound-guided percutaneous microwave ablation (PMWA).Materials and methods: In total 199 patients with 318 CLM, median number of tumours one per patient and median maximum size of tumours 3.0 cm, treated by PMWA combined with or without systemic chemotherapy were included in our study. Chemotherapy was administered pre-ablatively in 148 of those patients (74.4%), and post-ablatively in 142 (73.6%). Chemotherapy regimens included FOLFOX/XELOX, FOLFIRI/XELIRI, and sequential monotherapy. Prognostic factors were evaluated by univariate and multivariate analyses, using log-rank test and Cox proportional hazards model, respectively.Results: The estimated 5-year rates of progression free survival (PFS) and overall survival (OS) were 10.1% and 27.9%, respectively. The number of CLM (P = 0.003), maximum size of CLM (P < 0.001) and topography (P = 0.030) were independent prognostic factors for PFS of patients with CLM while age (P = 0.002), maximum size of CLM (P = 0.006) and post-ablative chemotherapy (P = 0.046) for OS. In further analysis, CLM patients receiving more than six cycles of post-ablative chemotherapy had significantly better OS (P = 0.015) than those without post-ablative chemotherapy.Conclusion: This study revealed chemotherapy administered after (more than six cycles) PMWA improved the OS of CLM patents. And, PMWA was a safe procedure in view of the absence of procedure-related death and low rate of major complications.

Diffusion-weighted MRI compared to FDG PET/CT for assessment of early treatment response in lymphoma

18F fluoro-deoxyglucose (FDG) positron emission tomography / computed tomography (PET/CT) is a well-recognized diagnostic tool used for staging and monitoring of therapy response for lymphomas. During the past decade diffusion-weighted (DW) magnetic resonance imaging (MRI) is increasingly being included in the assessment of tumor response for various cancers. To compare the change in maximum standardized uptake value (ΔSUVmax) from FDG PET/CT with the change in apparent diffusion coefficient (ΔADC) from DW MRI after initiation of the first cycle of chemotherapy in patients with Hodgkin's lymphoma (HL) and in patients with diffuse large B-cell lymphoma (DLBCL). Twenty-seven consecutive patients with histologically proven lymphoma and lymphomatous lymph nodes (LLN) of the neck (19 with HL, 8 with DLBCL) underwent FDG PET/CT and MRI of the neck before and after initiation of the first cycle of chemotherapy. The mean time interval from initiation of chemotherapy to imaging was 19 days and 2 days for FDG PET/CT and MRI, respectively. For each patient ΔSUVmax, ΔADC, and change in volume of the same LLN were compared. There was a significant mean decrease of SUVmax by 70%, but no significant change in ADC. There was no significant reduction in LLN volume. There was no significant correlation between ΔSUVmax and ΔADC. Thus, our data do not support that FDG PET/CT can be replaced by early DW MRI for response evaluation in lymphoma patients.

Combined Positron Emission Tomography and Computed Tomography: Option or necessity?

Combined Positron Emission Tomography and Computed Tomography: Option or necessity?

Lung cancer. How much platinum-based chemotherapy is enough in NSCLC?

With no large randomized phase III trials to provide definitive answers, the ideal number of platinum-based chemotherapy cycles in patients with advanced non-small-cell lung cancer has long been unclear. Most guidelines recommend a maximum of 4–6 cycles. Rossi and colleagues now suggest that four chemotherapy cycles is the optimal regimen.

18F-fluorodeoxyglucose-positron emission tomography/computed tomography after one cycle of chemotherapy in patients with diffuse large B-cell lymphoma: results of a Nordic/US intergroup study

We evaluated the predictive value of interim positon emission tomography (I-PET) after one course of chemoimmunotherapy in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL). One hundred and twelve patients with DLBCL were enrolled. All patients had PET/computed tomography (CT) scans performed after one course of chemotherapy (PET-1). I-PET scans were categorized according to International Harmonization Project criteria (IHP), Deauville 5-point scale (D 5PS) with scores 1–3 considered negative (D 5PS > 3) and D 5PS with scores 1–4 considered negative (D 5PS = 5). Ratios of tumor maximum standardized uptake value (SUVmax) to liver SUVmax were also analyzed. We found no difference in progression-free survival (PFS) between PET-negative and PET-positive patients according to IHP and D 5PS > 3. The 2-year PFS using D 5PS = 5 was 50.9% in the PET-positive group and 84.8% in the PET-negative group (p = 0.002). A tumor/liver SUVmax cut-off of 3.1 to distinguish D 5PS scores of 4 and 5 provided the best prognostic value. PET after one course of chemotherapy was not able to safely discriminate PET-positive and PET-negative patients in different prognostic groups.

Predictive and prognostic value of circulating endothelial cells in non-small cell lung cancer patients treated with standard chemotherapy

Monitoring circulating endothelial cells (CECs) count reflects the tumor vasculature in cancer patients and might be a predictor of response to chemotherapy. We therefore investigated the clinical significance of changes in CECs count after three cycles of platinum-based chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). Peripheral blood samples were collected from 89 naive NSCLC patients at diagnosis and after chemotherapy. The CECs were quantified by an immuno-magnetic technique and fluorescent microscopy. After chemotherapy, patients were assessed according to the response evaluation criteria in solid tumors as partial response (PR), stable disease (SD) or progression disease (PD). Baseline CECs levels were significantly higher in PR patients (n = 62) than those in patients with SD/PD (n = 27) (p = 0.0007). Although there was no significant correlation between baseline CECs levels and progression-free survival (PFS) (p = 0.287), patients with high percentage change in CECs count after chemotherapy had significantly longer PFS than those with low percentage change (p = 0.048). Regarding treatment efficacy, CECs count significantly decreased after chemotherapy in comparison with CECs count at baseline in patients with PR (p < 0.0001). By contrast, CECs levels after chemotherapy were significantly higher than those at diagnosis in patients with PD (p = 0.002). Moreover, there was no significant change between pre- and post-treatment CECs amount in patients with SD (p = 0.681). Baseline CECs levels might be an early predictive biomarker for treatment efficacy in advanced NSCLC patients. Our results suggest the change in CECs count after chemotherapy as a prognostic factor for tumor response and PFS in NSCLC.

Significance of serum CA-125 level as a prognostic factor after the first cycle of chemotherapy in patients with advanced serous epithelial ovarian cancer

Significance of serum CA-125 level as a prognostic factor after the first cycle of chemotherapy in patients with advanced serous epithelial ovarian cancer

Prognostic significance of the number of postoperative intraperitoneal chemotherapy cycles for patients with advanced epithelial ovarian cancer

Prognostic significance of the number of postoperative intraperitoneal chemotherapy cycles for patients with advanced epithelial ovarian cancer

A phase II trial of the Src-kinase inhibitor saracatinib after four cycles of chemotherapy for patients with extensive stage small cell lung cancer: NCCTG trial N-0621

IntroductionTo assess the efficacy and the Src-kinase inhibitor saracatinib (AZD-0530) after four cycles of platinum-based chemotherapy for extensive stage small cell lung cancer (SCLC). MethodsPatients with at least stable disease received saracatinib at a dose of 175mg/day by mouth until disease progression, unacceptable toxicity, or patient refusal. The primary endpoint was the 12-week progression-free survival (PFS) rate from initiation of saracatinib treatment. Planned interim analysis in first 20 patients, where 13 or more patients alive and progression-free at 12-weeks would allow continued enrollment to 40 total patients. ResultsAll 23 evaluable patients received platinum based standard chemotherapy. Median age was 58 years (range: 48–82). 96% of patients had a performance status of 0/1. Median of two cycles given (range: 1–34). All 23 (100%) patients have ended treatment, most for disease progression (19/23). The 12-week PFS rate was 26% (6/23; 95% CI: 10–48%). From start of standard chemotherapy, median PFS was 4.7 months (95% CI: 4.5–5.1) and median OS was 11.2 months (95% CI: 9.9–13.8). Eight (35%) and three (13%) patients experienced at least one grade 3/4 or grade 4 AE, respectively. Commonly occurring grade 3/4 adverse events were thrombocytopenia (13%), fatigue (9%), nausea (9%), and vomiting (9%). ConclusionsSaracatinib at a dose of 175mg/day by mouth is well tolerated. However, the PFS rate observed at the pre-planned interim analysis did not meet the criteria for additional enrollment.

Quantitative and Qualtitative Evaluation Of Circulating Cell-Free DNA As a Prognostic Biomarker In Hodgkin Lymphoma

Tumor tissue is known to release cell-free DNA, that can be detected in peripheral blood. Cell-free DNA (cfDNA) is significantly higher and more fragmented in plasma of cancer patients and levels have been reported to associate with prognosis. The aim of our study was to further explore cfDNA as a biomarker in Hodgkin lymphoma (HL) at diagnosis, during treatment and at follow-up. We studied cfDNA levels in pre-treatment plasma samples of 163 consecutive HL patients diagnosed at our Institution and 64 healthy volunteers. cfDNA was analyzed by quantitative PCR for the beta-globin gene. cfDNA at diagnosis was significantly increased in patients with HL when compared to controls (median, 21.83 vs 12.18 ng/ml; p<0.0001). Using the cfDNA levels of normal volunteers to determine the cut-off point for pathologically elevated cfDNA levels, cfDNA levels were elevated in 62 (38%) patients. Increased cfDNA at diagnosis was associated to parameters indicating an unfavorable prognosis as an IPS score>2 (p=0.0008). In a group of 31 patients and 19 controls, we also evaluated cfDNA fragmentation, amplifying fragments of different length. DNA integrity indices were calculated according to Mouliere et al, PLoS One 2011. At diagnosis, cfDNA was more fragmented in HL patients than in controls resulting in a lower DNA integrity index (median: 0.15 vs 0.22; p=0.016). However, cfDNA in HL patients resulted less fragmented when compared to cfDNA form patients with aggressive tumors like Burkitt lymphoma or solid tumors. Patients received treatment with ABVD (101 patients), BEACOPP (42 young patients with advanced HL) and other types of chemotherapy (17 patients). Seventy patients were also evaluated after two cycles of chemotherapy. cfDNA levels significantly decreased after 2 cycles of chemotherapy in patients with increased pre-treatment levels, while they remained in the normal range in patients with low cfDNA at diagnosis (ratio 0.32 and 1.44, respectively; p<0.0001). Patients with elevated cfDNA levels at diagnosis had an inferior outcome compared to patients with cfDNA levels within the normal range both in univariate and in a multivariate analysis that included IPS and was adjusted for the type of chemotherapy (EFS, p<0.03). In conclusion, our data suggest that cfDNA could serve as a biomarker in HL, that it is frequently elevated at diagnosis of HL, tends to normalize during treatment, and is associated to an inferior outcome. The study of DNA fragmentation suggests that most of the increase of cfDNA in HL is probably due to the tumor microenvironment rather than to the neoplastic cells. Disclosures:No relevant conflicts of interest to declare.

Hypofractionated Chemoradiation Therapy With Gemcitabine Plus Oxaliplatin for Unresectable Nonmetastatic Locally-Advanced Pancreatic Cancer

We previously published our experience of hypofractionated radiation therapy in 30 patients with locally advanced pancreatic cancer (LAPC). In this study we present our preliminary data on feasibility and efficacy of hypofractionated radiation therapy at higher doses “sandwiched” between chemotherapy cycles in patients with locally advanced inoperable pancreatic cancer.

Optimal cycles of fluoropyrimidine-based adjuvant chemotherapy for patients with resectable gastric cancer.

e15160 Background: Although several clinical trials have suggested that postoperative adjuvant chemotherapy could improve survival, there has no study on the optimal cycles of treatment. This retrospective analysis was carried out to evaluate the outcomes of gastric cancer patients treated with 5-6 cycles of FU-based treatment as compared to a cohort treated with 3-4 cycles or 7-8 cycles. Methods: We retrospective identified 254 patients with stage IB-IIIC gastric cancer who received 3-8 cycles of adjuvant chemotherapy after gastrectomy with D1 or D2 lymphadenectomy. The endpoint was overall survival. Factors associated with prognosis were also analyzed. Results: Of the 254 patients, 74 patients treated with 3-4 cycles, 112 patients treated with 5-6 cycles and 68 patients treated with 7-8 cycles. The 3-year OS rates for 3-4 cycles, 5-6 cycles and 7-8 cycles cohort was 56.6%, 73.9% and 67.7%, respectively. Patients who received 5-6 cycles were more likely to have better OS than those received 3-4 cycles (p=0.003), two further cycles of treatment did not improved OS (p=0.885). In the multivariate analysis, cycles of chemotherapy were associated with OS independent of clinical covariates (p=0.008). Subgroup analysis was suggested that for patients with older adult (age ≥60), FU-platinum combined chemotherapy, stage III, poorly differentiation, and gastrectomy with D2 lymph node dissection, 5-6 cycles of adjuvant chemotherapy was associated with a statistically significant benefit of OS (P&lt;0.05). Conclusions: Our result indicated that 5-6 cycles of adjuvant chemotherapy may lead to a favorable outcome for gastric cancer patients following primary surgical treatment. In view of the limited resources of medication, reduced incidences of toxicity and better quality-of-life with shorter duration of treatment, optimal cycles of adjuvant treatment should be explored further.

Primary Granulocyte Colony-Stimulating Factor Prophylaxis During the First Two Cycles Only or Throughout All Chemotherapy Cycles in Patients With Breast Cancer at Risk for Febrile Neutropenia

Early breast cancer is commonly treated with anthracyclines and taxanes. However, combining these drugs increases the risk of myelotoxicity and may require granulocyte colony-stimulating factor (G-CSF) support. The highest incidence of febrile neutropenia (FN) and largest benefit of G-CSF during the first cycles of chemotherapy lead to questions about the effectiveness of continued use of G-CSF throughout later cycles of chemotherapy. In a multicenter study, patients with breast cancer who were considered fit enough to receive 3-weekly polychemotherapy, but also had > 20% risk for FN, were randomly assigned to primary G-CSF prophylaxis during the first two chemotherapy cycles only (experimental arm) or to primary G-CSF prophylaxis throughout all chemotherapy cycles (standard arm). The noninferiority hypothesis was that the incidence of FN would be maximally 7.5% higher in the experimental compared with the standard arm. After inclusion of 167 eligible patients, the independent data monitoring committee advised premature study closure. Of 84 patients randomly assigned to G-CSF throughout all chemotherapy cycles, eight (10%) experienced an episode of FN. In contrast, of 83 patients randomly assigned to G-CSF during the first two cycles only, 30 (36%) had an FN episode (95% CI, 0.13 to 0.54), with a peak incidence of 24% in the third cycle (ie, first cycle without G-CSF prophylaxis). In patients with early breast cancer at high risk for FN, continued use of primary G-CSF prophylaxis during all chemotherapy cycles is of clinical relevance and thus cannot be abandoned.

Comparison of “sandwich chemo-radiotherapy” and six cycles of chemotherapy followed by adjuvant radiotherapy in patients with stage IIIC endometrial cancer: a single center experience

To compare "sandwich chemo-radiotherapy" with six cycles of chemotherapy followed by adjuvant radiotherapy with respect to tolerability and acute toxicity. Twenty-five women with surgically staged IIIC endometrial cancer were included. Treatment consisted of either three cycles of paclitaxel (175mg/m²) and carboplatin (AUC 6) on a q21-day schedule followed by irradiation (45-50.4Gy) or six cycles of the same chemotherapy followed by radiotherapy. Acute toxicity related to either chemotherapy or radiotherapy was evaluated. Median age was 61.5years (range 36-83years). Eleven patients had sandwich chemo-radiotherapy, and the other 14 patients had 6 cycles of chemotherapy followed by radiotherapy. Three out of the five patients who could not complete all the cycles in the sandwich chemo-radiotherapy group had pelvic and para-aortic radiotherapy. Acute radiotherapy related grade 1-2 gastrointestinal system (GIS) and genitourinary system (GUS) toxicities were observed in 72.8 and 63.6% of patients, respectively, for sandwich group. Undesired treatment breaks in the course of radiotherapy were observed in six patients for sandwich chemo-radiotherapy and in one patient receiving six cycles of chemotherapy followed by radiotherapy. All the patients who had undesired treatment breaks in the sandwich chemo-radiotherapy group had pelvic and para-aortic radiotherapy. Sandwich chemo-radiotherapy seems to be more toxic particularly for patients who had pelvic and para-aortic irradiation. Therefore, it might be more convenient to delay radiotherapy after six cycles of chemotherapy for patients with the indication of pelvic para-aortic radiotherapy.

Fluoro-deoxy-glucose positron emission tomography/computed tomography in lymphoma: A pictorial essay

F-18 fluoro-deoxy-glucose (FDG) positron emission tomography/computed tomography (PET/CT) has emerged as a powerful imaging modality in the field of oncology. F-18 FDG PET/CT is now an established tool in the management of lymphoma. This has been shown to be useful in staging, detection of bone marrow involvement (BMI), early response assessment and end of therapy response assessment in lymphoma. Interpretation of F-18 FDG PET/CT in lymphoma is carried out by various qualitative response assessment criteria. London criteria are used for interpretation of interim PET/CT and International Harmonization Project (IHP) criteria are used to interpret PET/CT done after the end of chemotherapy. Quantitative analysis is also found to be useful in assessment of response early after two cycles of chemotherapy in patients with diffuse large B cell lymphoma (DLBCL). This pictorial essay provides few images describing the FDG avidity of lymphoma, patterns of bone marrow uptake and their relevance in predicting BMI, role of staging PET/CT, quantitative analysis in response assessment, example images of response according to London criteria and IHP criteria. Few pitfalls in imaging of lymphoma with PET/CT are also discussed in the images legend.

Circulating tumor cells in small-cell lung cancer: a predictive and prognostic factor

Initial response of small-cell lung cancer (SCLC) to chemotherapy is high, and recurrences occur frequently, leading to early death. This study investigated the prognostic value of circulating tumor cells (CTCs) in patients with SCLC and whether changes in CTCs can predict response to chemotherapy. Patients and methods In this multicenter prospective study, blood samples for CTC analysis were obtained from 59 patients with SCLC before, after one cycle, and at the end of chemotherapy. CTCs were measured using CellSearch systems. At baseline, lower numbers of CTCs were observed for 21 patients with limited SCLC (median = 6, range 0-220) compared with 38 patients with extensive stage (median = 63, range 0-14,040). Lack of measurable CTCs (27% of patients) was associated with prolonged survival (HR 3.4; P ≤ 0.001). CTCs decreased after one cycle of chemotherapy; this decrease was not associated with tumor response after four cycles of chemotherapy. CTC count after the first cycle of chemotherapy was the strongest predictor for overall survival (HR 5.7; 95% CI 1.7-18.9; P = 0.004). Absolute CTCs after one cycle of chemotherapy in patients with SCLC is the strongest predictor for response on chemotherapy and survival. Patients with low initial CTC numbers lived longer than those with higher CTCs.

584P - Fdg-Pet Tumor Load Parameters Measured by Total Lesion Glycolysis as Predictors of Treatment Response and Outcome in Metastatic Colorectal Cancer

ABSTRACT Objectives Early metabolic response measured by the change of FDG maximum Standardized Uptake Value (SUVmax) on PET-CT after 1 cycle of chemotherapy in patients with metastatic colorectal cancer (mCRC) can predict negative objective response and is correlated to Overall Survival (OS) (Hendlisz et al. 2011). The aim of this work is to assess the correlation between the change in FDG-PET whole body metabolic tumoral load parameters and the RECIST response, progression free survival (PFS), OS. Methods FDG-PET/CT scans were performed at baseline and on Day 14, in 41 patients with unresectable mCRC undergoing a biweekly chemotherapy regimen. Patients were followed-up for up to 28 months. The change in Functional Tumor Volume (FTV) and Total Lesion Glycolysis (TLG) (TLG = FTV x SUVmean) of all the lesions was calculated using a fixed threshold segmentation algorithm (threshold for segmentation = SUV mean of 30 mm sphere in the right lobe of the liver plus 3 standard deviations) corrected to lean body mass (Wahl et al 2009). Predictive and prognostic value was tested through correlation with RECIST response (using independent dedicated CT), PFS and OS. A cutoff value for TLG responding patients was set at 40% or more decrease in the baseline value. Results 39 patients were evaluable for analysis. The median OS was 20 months (95% CI, 10 to 28), the change in whole body FTV and TLG were significantly related to RECIST response (p-value: 0.015 and 0.0038), to PFS (P-value: 0.009, 0.018) and to OS (p-value: 0.002, 0.0027). Patients with > 40% decrease in TLG have better PFS: median 12 months compared to median 3 months in the rest of the patients [log rank test p-value 0.004; HR 0.31 (95% CI, 0.14 to 0.72)], and a better median OS 27 months compared to 11 months [log rank test p-value 0.05; HR 0.38 (95% CI, 0.14 to 1.04)]. Conclusions Changes in the metabolic tumoral load parameters after one cycle of standard chemotherapy for mCRC are predictors of RECIST response, progression free and overall survival. Disclosure All authors have declared no conflicts of interest.

Cognitive effects of chemotherapy in breast cancer patients: a dose–response study

The purpose of this study was to determine if cognition progressively worsens with cumulative chemotherapy exposure. We reasoned that the demonstration of such a 'dose-response' relationship would help to establish whether cognitive changes are caused by neurotoxic effects of chemotherapy or whether they are due to other confounding factors such as mood and pre-treatment differences in cognition. Sixty women with early stage breast cancer, aged 65 years or younger with no previous history of cancer or chemotherapy, were matched to 60 healthy women on age and education. Neuropsychological assessment was conducted after surgery but prior to commencing chemotherapy and then again following each chemotherapy cycle in patients and at yoked intervals in healthy controls. We used multilevel modeling to assess change over time in an overall cognitive summary score as well as domain-specific cognitive scores. After controlling for baseline performance, age, education, and mood, the chemotherapy group showed a significant progressive decline over time relative to a matched healthy control group in an overall cognitive summary score, as well as in working memory, processing speed, verbal memory, and visual memory scores. A linear model best fit the trajectory of cognitive change over the course of treatment in the chemotherapy group supporting a dose-response hypothesis. These results are in keeping with a dose-response relationship and provide the most compelling clinical evidence to date that cognitive decline is caused by chemotherapy exposure.

Number of cycles of chemotherapy in patients with advanced non-small cell lung caner: Efficacy and relationship with histology.

e18125 Background: Platinum based regimens are standard first-line treatment in patients with advanced non mall cell lung cancer. We intend to evaluate their effectiveness according to the number of cycles administered, and investigate whether histology is a predictor of benefit from a greater number of infusions. Methods: 124 patients with stage IV NSCLC were evaluated retrospectively. They were divided according to whether they made 4 or 6 cycles of chemotherapy. The schemes used were: Cisplatin / Gemcitabine and Carboplatin / Paclitaxel, at standard doses. We studied the efficacy in both groups according to the most common histologies (adenocarcinoma and squamous cell carcinoma). PFS (progression-free survival) and OS (overall survival) were calculated by the Kaplan-Meier curves and compared by the Log Rank Test. Results: Those who underwent 4 cycles had a PFS of 7.77 months and OS of 12.2 months vs. 8.64 and 10.8 months those who received 6 cycles (p = 0.47, p = 0.76). Within the subgroup with squamous histology (n = 43), PFS and OS were 7.38 and 13.38 months respectively in the group that received 4 cycles vs. 7.97 and 9.76 months in those receiving 6 (p = 0.70, p = 0.32 ). Within adenocarcinoma histology (n = 81), those who received 4 cycle, has a PFS of 8.17 months and they lived 11.56 month, vs 8.96 and 10.79 months for those receiving 6 cycles (p = 0.29, p = 0.88) Conclusions: In our population, a greater number of cycles showed no advantages in terms of progression-free survival or overall survival. Histology is not a predictive factor for deciding how many chemotherapy cycles administer.