Sequential Treatment of Advanced Squamous Lung Cancer:First-line Gemcitabine+/-platinum Followed by Second-line Taxanes+/-platinum Versus Reverse Sequence
10.3779/j.issn.1009-3419.2015.05.09
- VernacularTitle:吉西他滨单药/或联合铂类与紫杉类单药/或联合铂类不同顺序治疗晚期肺鳞癌的疗效与安全性
- Author:
XU JING
1
;
LIU XIAOQING
;
GAO HONGJUN
;
GUO WANFENG
;
TANG CHUANHAO
;
LI XIAOYAN
;
LI JIANJIE
;
QIN HAIFENG
;
WANG WEIXIA
;
QU LILI
;
WANG HONG
;
YANG HUI
;
YANG LIN
Author Information
1. 解放军第307医院肺部肿瘤内科
- Keywords:
Lung neoplasms;
Chemotherapy;
Sequential treatment
- From:
Chinese Journal of Lung Cancer
2015;(5):308-314
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective Gemcitabine and taxanes are effective agents commonly used in advanced squamous lung cancer. hTe best treatment sequence, however, is unclear to our knowledge. So we conducted this retrospective study in order to compare the effcacy and toxicities of ifrst-line Gemcitabine+/-platinum followed by second-line taxanes+/-platinum with the reverse sequence. Methods We totally analyzed 105 patients with stage IIIb-IV squamous lung cancer in our retrospective study. hTere were 49 patients receiving gemcitabine+/-platinum ifrst-line followed by taxanes+/-plati-num second-line (G-T group), and 56 patients receiving taxanes+/-platinum ifrst-line followed by gemcitabine+/-platinum second-line (T-G group). hTe primary endpoint of the study was overall survival (OS), and the secondary endpoints included progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR) and toxicities. Results hTe me-dian OS were 18.5 mo in G-T group and 19.0 mo in T-G group (P=0.520). hTe median PFS1 was 5.0 mo and 4.0 mo with ifrst-line gemcitabine+/-platinum and taxanes+/-platinum, respectively (P=0.584). hTe median PFS2 was 2.7 mo and 2.5 mo with second-line gemcitabine+/-platinum and taxanes+/-platinum (P=0.432). hTe ORR1 of G-T group and T-G group were 36.73%and 33.92%(P=0.577), and DCR1 were 79.59%and 89.29%(P=0.186);the ORR2 of G-T group and T-G group were 4.08%and 5.36%(P=0.085), and DCR2 were 51.02%and 66.07%, respectively (P=0.118). Hematologic toxicities was more frequent in G-T group, the patients experienced more grade 3-4 lower hemoglobin (P=0.027) and thrombocytopenia (P=0.002). Conclusion hTe effcacy of ifrst line gemcitabine+/-platinum followed by second line taxanes+/-platinum and the reverse sequence was similar, and the toxicities was tolerable. Both sequential patterns were effective in advanced squamous lung cancer.
