Chemotherapeutic treatment modalities in the management of lung carcinoma: an observational study in a tertiary care teaching hospital in north India

ABSTRACT

Background: Lung cancer is one of the leading causes of cancer related mortality accounting for 1.61million new cases per year with 1.38 million deaths annually worldwide. In NSCLC, concurrent Chemoradiotherapy is usually employed in stage IIIA and IIIB when performance status of the patients is reasonable and chemotherapy alone in stage IV, if the performance status of the patients is adequate. In SCLC, combination chemotherapy is given in limited stage disease as well as in extensive stage if the performance status of the patients is adequate. The objective is to study the chemotherapeutic treatment modalities in the treatment of lung carcinoma.Methods: The present cross-sectional prospective study was conducted in the Postgraduate Department of Medicine and Department of Pharmacology in collaboration with the Department of Oncology, Government Medical College, Jammu for a period of one year from November 2012 to October 2013. A total of 80 patients having histopathological documentation of lung cancer, registered under regional cancer centre (RCC) and referred from various departments of the institute and from other hospitals of the region were included in the study. The treatment for each patient was then decided on the basis of performance status, stage and clinical condition. The treatment modalities used were in the form of radiation therapy, surgery and chemotherapy. In the chemotherapy, the details regarding the type of chemotherapeutic regimen employed in particular type of lung cancer variant, their doses, number of cycles given and the duration for which these chemotherapeutic drugs were administered was noted down.Results: Out of 80 patients in the present study, 68 (85%) were males and 12 (15%) were females. Majority of the patients fall in the age group of 46 to 75 years (81.25%). Staging of the patients with non-small cell lung cancer showed that majority of the patients were in stage IV (31; 45.59%) of the disease. Eighteen (26.46%) patients were in stage III and 10 (14.71%) in stage II and 9 (13.24%) patients in stage I. In patients with small cell lung cancer, 4 (33.33%) patients were in limited stage and 8 (66.67%) patients. Various treatment modalities were employed with maximum number of patients receiving combined treatment (48.75%), followed by chemotherapy alone (22.25%) and radiotherapy alone (11.25%). Among patients who received combination therapy, various combinations of surgery, radiotherapy and chemotherapy were used but maximum number of patients i.e. 37 out of 39 (94.87%) used combination of chemotherapy and radiotherapy.Conclusions: Most of the patients presented in an advanced stage III and IV (75.9%) and the main treatment modality used in this study was combination therapy of chemotherapy and radiotherapy in (48.75%) followed by chemotherapy alone (22.25%). In the chemotherapy, cisplatin-based combination regimens were most commonly used regimens. Thus, more of such studies need to be done so as to make patients as well as the health professionals more aware of the risk factors and the effective treatment modalities associated with the disease.