Second-line Treatment with Gefitinib or Docetaxel for Advanced Non-small Cell Lung Cancer

Hongmei LI; Xiumei WANG; Feng HUA

ABSTRACT

Objective:

To observe the efficacys and side effects of gefitinib(Iressa)and docetaxel(aisu)as the second-line treatment for advanced non-small cell lung cancer(NSCLC)patients.

Methods:

A total of 98 patients with advanced non-small cell lung cancer who had failed to previous fimt-line chemotherapy were randomly divided into two groupsgefitinib group and docetaxel group.In the gefitinib group,50 patients took Iressa 250 mg once daily until disease progression or intolerable toxicity occurred.In the docetaxel group,58 patients were treated with aisu 75mg/m~2 i.v.in 60 minutes in day 1.The regimen was repeated every 21 days for at least 2 consecutive cycles.They were assessed on the basis of RECIST evaluation standard of therapeutic effect for solid tumor.

Results:

In the gefitinib group,the response rate was 22.4%(11/49),the clinical benefit rate was 55.1%(27/49),median survival time was 7.1 months and 1-year survival rate was 35.9%.In the docetaxel group,the response rate,clinical benefit rate,median survival time and 1-year survival rate were 18.8%(9/48),50.0%(24/48),6.9months and 31.5%,respectively(P>0.05).The incidences of Ⅰ～Ⅳ degree and Ⅲ～Ⅳ degree rash were 51.0%and 10.2%in the gefitinib group,significantly lower than those in the docetaxel group (P=0.0000 and P=0.0296).The incidence of Ⅰ～Ⅳ degree diarrhea was significantly higher in the gefitinib group than that in the docetaxel group(P<0.01).The incidence of leukopenia was significantly higher in the docetaxel group than that in the gefitinib group(P=0.0000).The incidences of thrombocytopenia and anemia of Ⅰ～Ⅳ degree were also higher in the docetaxel group (P=0.0000 and P=0.0266).The improvement rate of quality of life was higher in the gefitinib group (P<0.05).

Conclusion:

Gefitinib has a similar anti-tumor effect as docetaxel on advanced NSCLC patients who have failed to previous fimt-line chemotherapy.Gefitnib can achieve higher improvement rate of quality of life in advanced NSCLC patients,with a lower incidence of toxicity.