Paclitaxel-etoposide-carboplatin/cisplatin versus etoposide-carboplatin/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

doi:10.7497/j.issn.2095-3941.2015.0012

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Figure 1
Kaplan-Meier curves for PFS of 62 patients with stages I-IV CSCLC. The median PFS of 3-drug group was not significantly longer than that of 2-drug group (10.5 vs. 9.8 months, P=0.484). PFS, progression-free survival; CSCLC, combined small-cell lung cancer.
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Figure 2
Kaplan-Meier curves for OS of 62 patients with stages I-IV CSCLC. The median OS of 3-drug group was not significantly longer than that of 2-drug group (24.0 vs. 17.5 months, P=0.457). OS, overall survival; CSCLC, combined small-cell lung cancer.
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Figure 3
Kaplan-Meier curves for PFS of 52 patients with stages III-IV CSCLC. The median PFS of the two groups nearly reached a significant difference (19.5 vs. 7.6 months, P=0.071). PFS, progression-free survival; CSCLC, combined small-cell lung cancer.
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Figure 4
Kaplan-Meier curves for OS of 52 patients with stages III-IV CSCLC. The difference in median OS between the two groups was marginally significant (22.8 vs. 14.3 months, P=0.269). OS, Overall survival; CSCLC, Combined small-cell lung cancer.
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Figure 5
Kaplan-Meier curves for PFS of 10 patients with stages I-II CSCLC. The median PFS of 3-drug group was not significantly longer than that of 2-drug group (10.5 vs. 30.5 months, P=0.061). PFS, progression-free survival; CSCLC, combined small-cell lung cancer.
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Figure 6
Kaplan-Meier curves for OS of 10 patients with stages I-II CSCLC. The median OS of 3-drug group was not significantly longer than that of 2-drug group (36.7 vs. 30.5 months, P=0.127). OS, overall survival; CSCLC, combined small-cell lung cancer.

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Table 1

General condition of 62 primary CSCLC patients, n (%)

Characteristics	EP/CE group	TEP/TCE group	χ²	P
Age (years)			0.433	0.551
>60	22 (51.2)	8 (42.1)
≤60	21 (48.8)	11 (57.9)
Gender			0.000	0.991
Male	34 (79.1)	15 (78.9)
Female	9 (20.9)	4 (21.1)
Smoking index			0.587	0.444
>400	25 (58.1)	13 (68.4)
≤400	18 (41.9)	6 (31.6)
KPS			2.935	0.087
>80	37 (86.1)	19 (100.0)
≤80	6 (3.9)	0 (0.0)
Stage			2.492	0.571
I	4 (9.3)	1 (5.3)
II	3 (7.0)	2 (10.5)
III	15 (34.9)	10 (52.6)
IV	21 (48.8)	6 (31.6)
No. of chemotherapy cycles			6.173	0.103
1-2 cycles	5 (11.6)	7 (36.8)
3-4 cycles	15 (34.9)	3 (15.8)
5-6 cycles	19 (44.2)	7 (36.8)
>6 cycles	4 (9.3)	2 (10.5)
First-line chemotherapy			1.897	0.168
Platinum
Cisplatin	19 (44.2)	12 (63.2)
Carboplatin	24 (55.8)	7 (36.8)
Chest radiotherapy	12 (27.9)	5 (26.3)	0.017	0.897
Prophylactic cranial radiotherapy (PCI)	8 (18.6)	1 (5.3)	1.890	0.169
Surgical resection	9 (20.9)	6 (31.6)	0.815	0.367
Second-line chemotherapy			3.217	0.522
No treatment	4 (14.3)	3 (42.9)
IP regime	8 (28.6)	1 (14.3)
The original regimen	6 (21.4)	1 (14.3)
TP regimen	7 (25.0)	1 (14.3)
Local radiotherapy	3 (10.7)	1 (14.3)
Third-line chemotherapy	8 (18.6)	2 (10.5)	0.636	0.425

Smoking index: (number of cigarettes smoked per day) × years. CSCLC, combined small-cell lung cancer; KPS, Karnofsky Performance Status; IP regimen, irinotecan plus platinum; TP regimen, paclitaxel plus platinum.

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Table 2
Comparison of response between two groups, n (%)
Group CR PR SD PD ORR DCR P
EP/CE 0 (0.0) 19 (52.8) 12 (33.3) 5 (13.9) 19 (52.8) 31 (81.6) 0.235
TEP/TCE 0 (0.0) 9 (90.0) 1 (10.0) 0 (0.0) 9 (90.0) 10 (100)
ORR = CR + PR; DCR = CR + PR + SD. CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease; ORR, objective response rate; DCR, disease control rate.

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Table 3

Cox regression analysis of the factors affecting the survival of 62 patients

Characteristics	n	MST (month)	χ²	P
Characteristics	n	MST (month)	χ²	Univariate	Multivariate
Age (years)			1.086	0.297
>60	30	19.5
≤60	32	21.9
PS (scores)			18.298	<0.001	0.015
>80	56	21.87
≤80	6	7.47
Gender			0.173	0.678
Male	49	19.5
Female	13	19.3
Smoking index			1.183	0.277
>400	38	17.0
≤400	24	21.9
Tumor size (cm)			1.478	0.224
>3	44	17.5
≤3	18	42.7
Lymph node metastasis			4.589	0.032	0.007
Yes	49	14.3
No	13	NR
Distant metastasis			7.781	0.005	0.007
Yes	26	42.7
No	36	10.1
Stage			10.980	0.001
I-II	10	NR
III-IV	52	17.0
No. of chemotherapy cycles			2.593	0.459
1-2 cycles	12	12.1
3-4 cycles	18	21.7
5-6 cycles	26	19.5
>6 cycles	6	NR
Chest radiotherapy			0.514	0.473
Yes	17	21.9
No	45
Prophylactic cranial irradiation			4.141	0.042	0.034
Yes	9	42.7
No	53	15.5
Surgical resection			6.889	0.009
Yes	15	NR
No	47	15.5
Second-line chemotherapy			5.477	0.242
No treatment	7	12.1
IP regimen	9	9.2
The original regimen	7	19.3
TP regimen	8	21.9
Local radiotherapy	4	12.5
Third-line chemotherapy			1.297	0.255
Yes	10	17.5
No	52	19.5

Smoking index, (number of cigarettes smoked per day) × years; NR, not reached; KPS: Karnofsky Performance Status; IP regimen, irinotecan plus platinum; TP regimen, paclitaxel plus platinum; MST, median survival time.