ABSTRACT
The present study involves non-small cell lung (NSCLC) cancer patients with brain metastases, who were treated with radiation therapy, and our aim was to determine response rate and survival. A total of 167 patients were recruited, 155 (125 male, 30 female) of whom were evaluable. Performance status was 0-2 and histology or cytology included 66 (42.58%) adenocarcinomas, 62 (40.00%) undifferentiated and 27 (17.42%) squamous cell carcinomas. The stage of disease at diagnosis was IIIA-B in 92 (59.35%) patients and IV in 63 (40.65%). All patients had whole brain irradiation (3 Gy x 5 days/week for 2 weeks to a total dose of 30 Gy), which was performed by a linear accelerator and a 6-MV photon beam. Objective response was observed in 59/155 (38.06%) patients with 17 (10.97%) complete and 42 (27.09%) partial responses, and median survival of 5 months for all patients [95% confidence interval (CI) 3.9-6.1]. Responders had statistically significant longer survival than non-responders. Although responders represented less than half of our patients with NSCLC and brain metastases, they had significantly longer survival.
Subject(s)
Brain Neoplasms/radiotherapy , Carcinoma, Non-Small-Cell Lung/radiotherapy , Lung Neoplasms/radiotherapy , Adult , Aged , Aged, 80 and over , Antineoplastic Agents, Hormonal/therapeutic use , Brain Neoplasms/drug therapy , Brain Neoplasms/secondary , Carcinoma, Non-Small-Cell Lung/drug therapy , Carcinoma, Non-Small-Cell Lung/pathology , Combined Modality Therapy , Dexamethasone/therapeutic use , Female , Humans , Lung Neoplasms/drug therapy , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Staging , Survival Analysis , Time Factors , Treatment OutcomeABSTRACT
BACKGROUND: The purpose of this study was to determine the efficacy of paclitaxel (PCT) combined with vinorelbine (VRL) in adenocarcinoma of the lung. PATIENTS AND METHODS: Untreated inoperable patients with metastatic disease were enrolled and underwent front-line treatment with a new combination as follows: a 30-minute infusion of VRL at a dose of 25 mg/m2 followed by a 3-hour infusion of PCT 135 mg/m2. Chemotherapy was repeated every 2 weeks with the intention of administering 9 cycles. RESULTS: Fifty-four out of 58 enrolled patients were assessable; the median age was 63 years (range 48-81). All patients were chemotherapy-naïve and all had histologically- or cytologically- confirmed adenocarcinoma. Twenty-seven patients (50%) responded: 5 with complete response (9.3%) and 22 with partial response (40.7%); 17 patients had stable disease (31.5%) and 10 showed disease progression (18.5%). Median response duration was 6 months (range 2-14.5) and median survival was 10 months (range 2-35+). The main adverse reaction was myelotoxicity in 87% of the patients, of whom only 8 (14.8%) had grade 4 neutropenia which in 4 cases (7.4%) was febrile. No patient required dose reduction, but treatment was postponed by one week in 4 patients a total of nine times. Patients received 98.6% of the planned dose. CONCLUSION: The PCT and VRL combination is an active first-line treatment for lung adenocarcinoma. These two cytotoxic drugs produce acceptable toxicity when repeated every 2 weeks.
