EFFICACY AND SAFETY OF FIRST-LINE PLATINUM-BASED CHEMOTHERAPY IN PATIENTS WITH POST-OPERATIVE RECURRENCE AFTER PLATINUM-BASED ADJUVANT CHEMOTHERAPY

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Abstract

Background and aim

Several studies suggest that cisplatin-based adjuvant chemotherapy improves survival in patients with completely resected non-small-cell lung cancer in stage II and III; thus, this chemotherapy is recognized as a global standard regimen. However, the efficacy and safety of first-line platinum-based chemotherapy in patients with post-operative recurrence after platinum-based adjuvant chemotherapy has not yet been fully assessed. The aim of this study is to assess these clinical outcomes of platinum-based chemotherapy in patients with post-operative recurrence.

Subjects and methods

Clinical records of patients with post-operative recurrence who received platinum-based chemotherapy as first line after platinum-based adjuvant chemotherapy at Juntendo University Hospital and Shizuoka Cancer Center between April 2008 and December 2011 were reviewed, and the clinical efficacy and the toxicity were retrospectively evaluated.

Result

A total of 11 patients were included in this study. The median age was 61 years (range, 36–71 years). Five patients were female. Eight patients were PS 0, the others were PS 1. Adjuvant chemotherapy regimens were CDDP + VNR in five patients, CBDCA + GEM in four patients, CBDCA + PTX in one patient and CDDP + TS-1 in one patient. 72.7 % of patients received at least three cycles of adjuvant chemotherapy. The median recurrence-free survival was 495 days (range, 98–1358 days). First-line chemotherapy regimens were CDDP + PEM in six patients (including one patient with a combination of VEGF-TKI), CBDCA + PTX + Bev in three patients, CDDP + VNR in one patient and CDDP + DTX in one patient. 63.6% patients received at least three cycles of first-line chemotherapy. The overall response rates and the disease control rates were 27.3 and 72.7% (CR/PR/SD/PD/NE: 0/3/5/0/3), respectively. The median overall survival was 841 days (range, 210–1918). Two patients (16.7%) were dropped out. The receiving dose was reduced because of toxicity in four patients (36.4%).

Conclusion

The first-line platinum-based chemotherapy was effective, but highly toxic in patients with post-operative recurrence after platinum-based adjuvant chemotherapy.

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