ABSTRACT
Objective To compare the efficacy and tolerance of platinum-based doublet chemotherapy versus single-agent chemotherapy as second-line treatment in elderly patients with advanced non-small cell lung cancer(NSCLC).Methods A total of 85 elderly patients with advanced NSCLC after first-line treatment were retrospectively analyzed and divided into the combination therapy group(n=40,taking platinum-based doublet chemotherapy)and the single-agent chemotherapy group(n=45,receiving single-agent second-line chemotherapy).Results There were no significant differences in the objective response rate (ORR)and the disease control rate (DCR)between the combination therapy group and the single-agent chemotherapy group(27.5 ％ or 11/40 vs.20.0 ％ or 9/45,60.0％ or 24/40 vs.73.3％ or 33/45,x2 =0.662 and 1.704,P=0.416 and 0.192).The median progression-free survival(PFS)was 3.8 months for the combination therapy group and 2.8 months for the single-agent chemotherapy group(P =0.045).The rate of grade Ⅲ/Ⅳ hematological toxicity was higher in the combination therapy group than in the single-agent chemotherapy group.Conclusions Platinum-based doublet chemotherapy has longer PFS than the single-agent chemotherapy as secondline treatment in elderly patients with advanced non-small cell lung cancer,and more attention should be paid to its high hematological toxicity.
ABSTRACT
BACKGROUND@#Bevacizumab combined with platinum-based chemotherapy has been recommended as the first-line agent in advanced nonsquamous non-small cell lung cancer (NSCLC) without driven gene, but this regimen is not common in the second-line or later-line treatment of non-squamous NSCLC. The aim of this study is to investigate the efficacy and safety of bevacizumab combined with chemotherapy as second-line or later-line treatment in advanced non-squamous NSCLC.@*METHODS@#We retrospectively reviewed the clinical data of advanced nonsquamous NSCLC patients who were treated with bevacizumab after first-line treatment failure and they were hospitalized in the Affiliated Cancer Hospital of Zhengzhou University from January 2014 to June 2017, and Kaplan-Meier method, Log-rank test and Cox model were used for analysis.@*RESULTS@#A total of 62 patients were included in the analysis. The total objective response rate (ORR) was 32.2%, and the disease control rate (DCR) was 96.8%. The median progression-free survival (PFS) was 6.4 months (95%CI: 6.05-6.83), and the median overall survival (OS) was 20.4 months (95%CI: 12.98-27.76). In the subgroup analysis, there was no significant difference in median PFS between patients with brain metastases and those without brain metastases (6.2 months vs 6.4 months, P=0.052). Cycles of bevacizumab (>6 or ≤6 cycles) was an independent influencing factor of PFS (P=0.004). The most common adverse events were leukopenia, fatigue, nausea, thrombocytopenia and hypertension.@*CONCLUSIONS@#In the second-line or later-line treatment, bevacizumab combined with chemotherapy is an effective and safe regimen for advanced non-squamous NSCLC.