A multicenter, randomized, double-blind, placebo-controlled safety study to evaluate the clinical effects and quality of life of paclitaxel-carboplatin (PC) alone or combined with endostar for advanced non-small cell lung cancer (NSCLC) / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the efficacy and quality of life and safety for paclitaxel and carboplatin (TC) and TC combined with endostar in the treatment of advanced non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>This is a prospective, multicenter, randomized, double-blind, placebo-controlled clinical study. A total of 126 cases of untreated advanced NSCLC were enrolled in this study. There were 63 patients in the TC control arm and TC combined endostar arm, respectively. All enrolled patients were continuously followed-up for disease progression and death.</p><p><b>RESULTS</b>The objective response rate (ORR) of TC combined with endostar arm was 39.3%, and that of TC control arm was 23.0%, P = 0.078. The progression-free survival rates for TC combined with endostar arm and TC control arm were 78.3% and 58.8%, respectively, in 24 weeks (P = 0.017). The hazard ratio for the risk of disease progression was 0.35 (95%CI 0.13 to 0.90, P = 0.030). The median time to progression (TTP) of the TC combined with endostar arm was 7.1 months and TC arm 6.3 months (P > 0.05). The follow-up results showed that the median survival time (mOS) of the TC + Endostar arm was 17.6 months; (95%CI 13.4 to 21.7 months), and the TC + placebo arm 15.8 months (95%CI 9.4 to 22.9 months) (P > 0.05). The quality of life scores (LCSS patient scale) after treatment of the TC combined with endostar arm was improved, and that of the TC group was improved after completion of two cycles and three cycles of treatment. The quality of life scores compared with baseline after the completion of one cycle treatment was significantly improved for both the TC combined with endostar arm (P = 0.028 and), and TC arm (P = 0.036). It Indicated that TC combined with endostar treatment improved the patient's quality of life in the early treatment. The difference of adverse and serious adverse event rates between the two groups was not significant (P > 0.05).</p><p><b>CONCLUSIONS</b>Compared with TC alone treatmrnt, TC combined with endostar treatment can reduce the risk of disease progression at early time (24 weeks), increase the ORR, and can be used as first-line treatment for advanced NSCLC. The TC combined with endostar treatment has good safety and tolerability, improves the quality of life, and not increases serious adverse effects and toxicity for patients with advanced NSCLC.</p>

Comparative analysis of prognosis between surgical or non surgical treatment for non small cell lung cancer with great vessel invasion in chest / 肿瘤

Objective: To compare the prognosis induced by conventional surgery and chemotherapy and radiotherapy for non-small cell lung cancer (NSCLC) with great vessel invasion in chest. Methods: Clinical data from 102 NSCLC patients with great vessel invasion in chest, treated from 2000 to 2002 in our hospital, were reviewed retrospectively. There were 55 patients who received surgical resection and 47 patients who received chemotherapy and radiotherapy. The multiple factors affecting the survival rate and prognosis of patients were analyzed and compared. Results: The median survival time (MST) was 13 months and the 1-, 3-, and 5-year survival rate was 58.18%, 10.91%, and 3.9% for 55 patients who received surgical treatment. The MST was 16 months and the 1-, 3-, and 5-year survival rate was 65.96%, 22.46%, and 4.29%, respectively, for 47 patients who received non surgical management. There was no significant difference in survival rate between surgical and non surgical management (P > 0.05). Univariate analysis showed that clinical staging, PS score, chemotherapy, and radiotherapy were related with prognosis. The multivariate analysis demonstrated that clinical staging, chemotherapy, and radiotherapy served as independent survival factors (P < 0.05). Conclusions: There was no statistical difference in the survival rate of NSCLC patients at T4 stage with heart and great vessel invasion who received conventional surgery and chemotherapy and radiotherapy. Correct patient selection and skilled surgical technique assured complete tumor resection and increased the survival rate. Adjuvant chemotherapy or radiotherapy helped to prolong the post-operative survival time of patients.