THE SURVIVAL IMPACT OF THE SEVERITY OF NEUTROPENIA IN FRONTLINE CHEMOTHERAPY WITH CARBOPLATIN AND PACLITAXEL FOR ADVANCED NSCLC

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Abstract

Background

The survival impact of neutropenia in chemotherapy for advanced NSCLC has been well discussed. We retrospectively analyzed the contribution of the severity of neutropenia to the survival of the patients who were treated with carboplatin and paclitaxel.

Methods

We retrospectively reviewed the medical records of all patients with NSCLC who were treated from January 1999 to December 2010 in Kansai Medical University Takii Hospital. Patients were included in this study if they had an advanced NSCLC (IIIb or IV) that was treated with front-line chemotherapy with carboplatin and paclitaxel.

Results

402 patients of NSCLC were treated in our hospital during above period. One hundred and sixty-seven patients were met to the eligible criteria. The median age was 65 (31–79). Female and male were 42 and 125 respectively. Adenocarcinoma, squamous cell carcinoma, and large cell carcinoma were 118, 44 and 4, respectively. Grade 3/4, 1/2 and 0 neutropenia were observed in 55.7, 23.4 and 21.0%, respectively. The overall response rates of the groups of grade 3/4, 1/2 and 0 neutropenia were 40.7, 38.5 and 21.9%, respectively. The MST for the patients of grade 3/4, 1/2 and 0 neutropenia were 13.3, 10.0 and 9.7 months, respectively. On univariate analysis, OS was significantly longer in the patients of grade 3/4 neutropenia than their counterparts (P = 0.0122). In addition, multivariate analysis revealed that the grade 3/4 neutropenia was an independent favorable prognostic factor for OS (HR: 0.357, P = 0.0005). However, there was no significant difference between grade 1/2 and 0 neutropenia.

Conclusion

The previous report showed that there was no significant difference between grade 3/4 and 1/2 neutropenia from the view point of survival benefit. However, our results clearly showed that only grade 3/4 neutropenia, other than grade 1/2, have survival implications for front-line chemotherapy for advanced NSCLC.

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