BACKGROUNDChemotherapy is very important in treatment of advanced non-small cell lung cancer (NSCLC), and the third-generation cisplatin-based chemotherapy regimens have been the standard treatment for advanced NSCLC. The aim of this study is to compare the efficacy and toxicity among four different chemotherapeutic regimens combined with radiotherapy in patients with stage III/IV NSCLC.

METHODSA total of 527 patients with stage III/IV NSCLC were enrolled, among whom there were 243 patients received cisplatin/vinorelbine (NP group), 163 patients for cisplatin/paclitaxel (TP group), 65 patients for cisplatin/gemcitabine (GP group) and 56 patients for cisplatin/docetaxel (DP group). The efficacy, side effects, median time to progression (TTP), median survival time (MST), 1- and 2-year survival rate were compared.

RESULTSThe response rate was 46.9% in the NP arm, 44.8% in the TP arm, 47.7% in the GP arm and 42.9% in the DP arm (P > 0.05). The response rate of patients with radiochemotherapy was 69.9%, and 40.8% for those with chemotherapy alone (P < 0.05). In group NP, TP, GP and DP, median TTP was 5.7, 5.3, 5.9 and 5.5 months (P > 0.05) respectively, MST was 10.4, 10.6, 11.5 and 10.4 months (P > 0.05) respectively, 1-year survival rate was 41.9%, 41.1%, 43.1% and 42.9% (P > 0.05) respectively, and 2-year survival rate was 21.3%, 19.4%, 23.1% and 23.2% (P > 0.05) respectively.

CONCLUSIONSThe third-generation cisplatin-based chemotherapy regimens may be the standard treatment for advanced NSCLC, and their combination with radiotherapy may improve the therapeutic efficacy and prolong the survival of patients.