Carboplatin and vinorelbine combination plus radiotherapy in advanced non small cell lung cancer (NSCLC)

Carboplatin and vinorelbine combination plus radiotherapy in advanced non small cell lung cancer (NSCLC)

Abstracts cycles or until progression. The main characteristics of the whole group were: median age 74 years (range: 70-82), M/F ratio= 16/4, stage IV...

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Abstracts cycles or until progression. The main characteristics of the whole group were: median age 74 years (range: 70-82), M/F ratio= 16/4, stage IV according to MountainÕs classification in 20 pts, no pt had a disability condition. RESULTS: 18 of 20 pts were fully evaluable after 3 cycles of therapy, 2 were early deaths. In the 18 evaluable pts we registered: 5 partial response, 9 stable disease and 4 progression. The median survival in the 18 evaluable pts was 9 months (range: 4-18) and 8 months in the whole group (range: 1-18). We observed gastrointestinal toxicity Gemcitabine related in 1 pt (ECOG grade 1) and leucopenia in 5 pts (ECOG grade 2 in 3 pts and grade 1 in 2 pts). When we analyzed the quality of life during and after the treatment, according to VMD, we observed in 16/20 pts a better clinical and functional condition in order to ADL and IADL scales, in 14/20 pts better spiro-index, in 15/20 pts less need for antalgic drugs and better nutritional parameters. During the treatment no pt needed a hospital admission or was in a disability condition. In all observed pts disability state occurred only 30 days before the death. CONCLUSION: Our preliminary data, according to LiteratureÕs data, allow the use of Gemcitabine in elderly pts affected by ANSCLC due to the ÒrealÓ benefit and the low grade of toxicity. Furthermore using the VMD to evaluate the quality of life and the grade of disability of treated pts, we indicate that this treatment is also ÒethicalÓ, due to the better level of authonomy and the reduction of disability observed in the most of pts. NSCLC-IV Initial treatment with 2 courses of chemotherapy G. Radosavljevic-Asic, V. Kacar, T. Cvok, S. Krstic, S. Pavlovic. CCS, Institute for Lung Diseases, Belgrade, Yugoslavia Introduction: In the limited conditions in which our health care system is functioning, CT is generally not applied in pts diagnosed as having stage IV NSCLC. Only exceptionally, it is applied in younger pts without body weight loss, PS 0-1, and the effects of the treatment are evaluated subsequent to application of each cytostatic course. Methods: A prospective analysis included 31 pts with stage IV NSCLC, averagely aged 52 years, PS 0-1, initially treated with 2 platinum-based CT, (PE or PV). In case of the favorable response, CT was continued until the moment of disease progression, or loss of the conditions required for CT. Results: In 90% of the pts more than one metastatic foci were evidenced. Among the treated pts, metastases were predominantly found in the lungs (42% cases) and bones (35% cases). There was less than half of the patients with liver metastases, CNS and N3 (15% each), other individually, who were candidates for CT. Histologically, the tumors were classified as squamous-ca in 55%, adeno-ca in 39%, and adenosquamous-ca in 6% of the cases. After two CT courses, PD was evidenced in 52% of the cases, SD in 13%, while PR was found in 35% of the pts. In case of SD, CT was continued and another 1-2 courses were applied. In pts with PR, up to 12 CT courses (averagely 7) were applied, along with protocol changes, CAP, MVP, CEP, and Gemcitabin in 2 cases. Maximum effect was recorded after 2-4 CT courses. The interval of the effect maintenance was 3-24 months. In 2 cases, a year subsequent to the discontinuation of CT, after progression of the disease, CT was repeatedly applied, however in absence of any favorable effects. Conclusions: Stage IV NSCLC does not necessarily imply large tumor mass, which indirectly shows high PS in some patients. Even partial response to cytostatic therapy justifies individualized application of CT in metastazed NSCLC. Carboplatin and Vinorelbine combination plus radiotherapy in


advanced non small cell lung cancer (NSCLC) A. Santoro1, M. Santoro2, L. Maiorino1, V. Forestieri2, P. Forestieri2. 1O.U. of Medical Oncology, San Gennaro Hospital; 2 Chair of Surgical Oncology, ÒFederico IIÓ University; Naples, Italy. Background: NSCLC still remains a disease with an extremely poor prognosis. In fact, a high mortality rate has been observed in patients with unoperable stage III or disseminate stage IV of disease (4-6 months). In Italy, the mortality rate is elevated in both sexes: around 26,000 deaths for males and 5,000 for females every year. The aim of the present work has been to verify if a carboplatin and vinorelbine combination plus concomitant radiotherapy allowed a local control of disease and a better survival. Patients and Methods: Since January 1998 to January 1999, 11 patients with the following features have been valued: 9 males and 2 females, median age 60 years; median ECOG P.S. 3, 7 Stage III of disease; 4 Stage IV of disease. The histological types were: 7 squamous cell carcinoma; 3 adenocarcinoma; 1 large cells carcinoma. All the patients resulted unoperable and were treated with the scheduled combination: carboplatin 300 mg/m2 i.v. on day 1; navelbine 25 mg/m2 i.v. on days 1,8; the cycle has been repeated every 21 days for a total number of 6 plus local radiotherapy. Results and Conclusion: The clinic and instrumental (thoracic CT scan) evaluation started after the 6 cycles of chemotherapy. A satisfactory local control of disease has been obtained for a median time ³ 12 months with a remarkable reduction of pain and dispnea. An acceptable hematologic toxicity and a discrete quality of life has been guaranteed. Moreover, since vinorelbine allows a less drug expense without reduce the therapeutic results, also the economic aspect has been safeguarded. Analysis of survival data in non small cell lung cancer 1992Ð1997 ErzsŽbet Juh‡sz MD, Gabriella Temesi MD, ƒva Mih‡ly MD, Antal Mar—ti MD, Kor‡nyi National Institute for Tuberculosis and Pulmonology, Pulmonological Department, Budapest Aim of the study: To analyse the survival time of lung cancer cases treated and controlled in our pulmonological department and outpatient clinic, to evaluate the efficacy of different type of treatment applied in non small cell lung cancer. The data analysing were performed separately in adenocarcinoma and in squamous cell carcinoma to realise the differences between the two hystological type. Patient and method: Data of 499 lung cancer cases, diagnosed in 1992Ð1997, were analysed in the study retrospectively. The following facts were studied: hystological type, staging, survival time regarding to the treatment and the relationship between them. Out of 499 patients there were 183/37%/ adenocarcinoma, 221/44% squamous cell carcinoma, 38%/8%/ other and 53/11% not verified. The average life time was same in both group/61,2-61,9y./ Results: Majority of the cases/72 % of adenocarcinoma,71% of squamous cell carcinoma/ were detected in Stadium III-IV, despite of the mass X-ray screening performed regularly in every year. Operation was performed in 31% of the cases /in both hystological type/, and 2633% percent of the operated cases were treated by adjuvant therapy. 32% of adenocarcinoma and 29 % of squamous cell carcinoma cases were treated by chemotherapy and /or irradiation, and the third part of the patients by supportive therapy only. 135 patients/73%/ died in the group of adenocarcinoma, and 176 /80% in the squamous cell lung cancer until the time of the analysis. The mean survival time was 9,6 months in the adenocarcinoma cases /