Paclitaxel-etoposide-carboplatin/cisplatin versus etoposidecarboplatin/ cisplatin as first-line treatment for combined small-cell lung cancer: a retrospective analysis of 62 cases

Yue-Ya Li, Chan Zhou, Deng-Xia Yang, Jing Wang, Zhu-Jun Liu, Xin-Yue Wang, Kai Li

Abstract


Objective: To compare the efficacy and adverse effects of paclitaxel-etoposide-carboplatin/cisplatin (TEP/TCE) regimenwith those of etoposide-carboplatin/cisplatin (EP/CE) regimen as first-line treatment for combined small-cell lung cancer(CSCLC).

Methods: A retrospective study was conducted on 62 CSCLC patients who were treated at Tianjin Medical UniversityCancer Institute and Hospital from July 2000 to April 2013 and administered with TEP/TCE regimen (n=19) or EP/CE regimen (n=43) as first-line CSCLC treatment. All patients received more than two cycles of chemotherapy, and theresponse was evaluated every two cycles. The primary endpoint was overall survival (OS), and the secondary endpointswere progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse effects.

Results: ORR between the TEP/TCE and EP/CE groups showed a statistical difference (90% vs. 53%, P=0.033). Bothgroups failed to reach a statistical difference in DCR (100% vs. 86%, P=0.212). The median PFS and OS of the TEP/TCEgroup were slightly longer than those of the EP/CE group, although both groups failed to reach a statistical difference(10.5 vs. 8.9 months, P=0.484; 24.0 vs. 17.5 months, P=0.457). However, stratified analysis indicated that the PFS ofpatients with stages III and IV CSCLC showed marginally significant difference between the TEP/TCE and EP/CE groups(19.5 vs. 7.6 months; P=0.071). Both rates of grade IV bone marrow depression and termination of chemotherapy in theTEP/TCE group were significantly higher than those in the EP/CE group (26.3% vs. 7.0%, P=0.036; 31.6% vs.14.7%, P=0.004).

Conclusion: The TEP/TCE regimen may not be preferred for CSCLC, and this three-drug regimen requires furtherexploration and research. To date, the EP/CE regimen remains the standard treatment for CSCLC patients.


Keywords


Small cell lung carcinoma (SCLC); chemotherapy; CE regimen; adverse effects; survival analysis; prognosis

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