Cargando…
Palliative chemotherapy beyond three courses conveys no survival or consistent quality-of-life benefits in advanced non-small-cell lung cancer
This randomised multicentre trial was conducted to establish the optimal duration of palliative chemotherapy in advanced non-small-cell lung cancer (NSCLC). We compared a policy of three vs six courses of new-generation platinum-based combination chemotherapy with regard to effects on quality of lif...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group
2006
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2360695/ https://www.ncbi.nlm.nih.gov/pubmed/17047644 http://dx.doi.org/10.1038/sj.bjc.6603383 |
_version_ | 1782153112582094848 |
---|---|
author | von Plessen, C Bergman, B Andresen, O Bremnes, R M Sundstrom, S Gilleryd, M Stephens, R Vilsvik, J Aasebo, U Sorenson, S |
author_facet | von Plessen, C Bergman, B Andresen, O Bremnes, R M Sundstrom, S Gilleryd, M Stephens, R Vilsvik, J Aasebo, U Sorenson, S |
author_sort | von Plessen, C |
collection | PubMed |
description | This randomised multicentre trial was conducted to establish the optimal duration of palliative chemotherapy in advanced non-small-cell lung cancer (NSCLC). We compared a policy of three vs six courses of new-generation platinum-based combination chemotherapy with regard to effects on quality of life (QoL) and survival. Patients with stage IIIB or IV NSCLC and WHO performance status (PS) 0–2 were randomised to receive three (C3) or six (C6) courses of carboplatin (area under the curve (AUC) 4, Chatelut's formula, equivalent to Calvert's AUC 5) on day 1 and vinorelbine 25 mg m(−2) on days 1 and 8 of a 3-week cycle. Key end points were QoL at 18 weeks, measured with EORTC Quality of Life Questionnaire (QLQ)-C30 and QLQ-LC13, and overall survival. Secondary end points were progression-free survival and need of palliative radiotherapy. Two hundred and ninety-seven patients were randomised (C3 150, C6 147). Their median age was 65 years, 30% had PS 2 and 76% stage IV disease. Seventy-eight and 54% of C3 and C6 patients, respectively, completed all scheduled chemotherapy courses. Compliance with QoL questionnaires was 88%. There were no significant group differences in global QoL, pain or fatigue up to 26 weeks. The dyspnoea palliation rate was lower in the C3 arm at 18 and 26 weeks (P<0.05), but this finding was inconsistent across different methods of analysis. Median survival in the C3 group was 28 vs 32 weeks in the C6 group (P=0.75, HR 1.04, 95% CI 0.82–1.31). One- and 2-year survival rates were 25 and 9% vs 25 and 5% in the C3 and C6 arm, respectively. Median progression-free survival was 16 and 21 weeks in the C3 and C6 groups, respectively (P=0.21, HR 0.86, 95% CI 0.68–1.08). In conclusion, palliative chemotherapy with carboplatin and vinorelbine beyond three courses conveys no survival or consistent QoL benefits in advanced NSCLC. |
format | Text |
id | pubmed-2360695 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2006 |
publisher | Nature Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-23606952009-09-10 Palliative chemotherapy beyond three courses conveys no survival or consistent quality-of-life benefits in advanced non-small-cell lung cancer von Plessen, C Bergman, B Andresen, O Bremnes, R M Sundstrom, S Gilleryd, M Stephens, R Vilsvik, J Aasebo, U Sorenson, S Br J Cancer Clinical Study This randomised multicentre trial was conducted to establish the optimal duration of palliative chemotherapy in advanced non-small-cell lung cancer (NSCLC). We compared a policy of three vs six courses of new-generation platinum-based combination chemotherapy with regard to effects on quality of life (QoL) and survival. Patients with stage IIIB or IV NSCLC and WHO performance status (PS) 0–2 were randomised to receive three (C3) or six (C6) courses of carboplatin (area under the curve (AUC) 4, Chatelut's formula, equivalent to Calvert's AUC 5) on day 1 and vinorelbine 25 mg m(−2) on days 1 and 8 of a 3-week cycle. Key end points were QoL at 18 weeks, measured with EORTC Quality of Life Questionnaire (QLQ)-C30 and QLQ-LC13, and overall survival. Secondary end points were progression-free survival and need of palliative radiotherapy. Two hundred and ninety-seven patients were randomised (C3 150, C6 147). Their median age was 65 years, 30% had PS 2 and 76% stage IV disease. Seventy-eight and 54% of C3 and C6 patients, respectively, completed all scheduled chemotherapy courses. Compliance with QoL questionnaires was 88%. There were no significant group differences in global QoL, pain or fatigue up to 26 weeks. The dyspnoea palliation rate was lower in the C3 arm at 18 and 26 weeks (P<0.05), but this finding was inconsistent across different methods of analysis. Median survival in the C3 group was 28 vs 32 weeks in the C6 group (P=0.75, HR 1.04, 95% CI 0.82–1.31). One- and 2-year survival rates were 25 and 9% vs 25 and 5% in the C3 and C6 arm, respectively. Median progression-free survival was 16 and 21 weeks in the C3 and C6 groups, respectively (P=0.21, HR 0.86, 95% CI 0.68–1.08). In conclusion, palliative chemotherapy with carboplatin and vinorelbine beyond three courses conveys no survival or consistent QoL benefits in advanced NSCLC. Nature Publishing Group 2006-10-23 2006-10-03 /pmc/articles/PMC2360695/ /pubmed/17047644 http://dx.doi.org/10.1038/sj.bjc.6603383 Text en Copyright © 2006 Cancer Research UK https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Clinical Study von Plessen, C Bergman, B Andresen, O Bremnes, R M Sundstrom, S Gilleryd, M Stephens, R Vilsvik, J Aasebo, U Sorenson, S Palliative chemotherapy beyond three courses conveys no survival or consistent quality-of-life benefits in advanced non-small-cell lung cancer |
title | Palliative chemotherapy beyond three courses conveys no survival or consistent quality-of-life benefits in advanced non-small-cell lung cancer |
title_full | Palliative chemotherapy beyond three courses conveys no survival or consistent quality-of-life benefits in advanced non-small-cell lung cancer |
title_fullStr | Palliative chemotherapy beyond three courses conveys no survival or consistent quality-of-life benefits in advanced non-small-cell lung cancer |
title_full_unstemmed | Palliative chemotherapy beyond three courses conveys no survival or consistent quality-of-life benefits in advanced non-small-cell lung cancer |
title_short | Palliative chemotherapy beyond three courses conveys no survival or consistent quality-of-life benefits in advanced non-small-cell lung cancer |
title_sort | palliative chemotherapy beyond three courses conveys no survival or consistent quality-of-life benefits in advanced non-small-cell lung cancer |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2360695/ https://www.ncbi.nlm.nih.gov/pubmed/17047644 http://dx.doi.org/10.1038/sj.bjc.6603383 |
work_keys_str_mv | AT vonplessenc palliativechemotherapybeyondthreecoursesconveysnosurvivalorconsistentqualityoflifebenefitsinadvancednonsmallcelllungcancer AT bergmanb palliativechemotherapybeyondthreecoursesconveysnosurvivalorconsistentqualityoflifebenefitsinadvancednonsmallcelllungcancer AT andreseno palliativechemotherapybeyondthreecoursesconveysnosurvivalorconsistentqualityoflifebenefitsinadvancednonsmallcelllungcancer AT bremnesrm palliativechemotherapybeyondthreecoursesconveysnosurvivalorconsistentqualityoflifebenefitsinadvancednonsmallcelllungcancer AT sundstroms palliativechemotherapybeyondthreecoursesconveysnosurvivalorconsistentqualityoflifebenefitsinadvancednonsmallcelllungcancer AT gillerydm palliativechemotherapybeyondthreecoursesconveysnosurvivalorconsistentqualityoflifebenefitsinadvancednonsmallcelllungcancer AT stephensr palliativechemotherapybeyondthreecoursesconveysnosurvivalorconsistentqualityoflifebenefitsinadvancednonsmallcelllungcancer AT vilsvikj palliativechemotherapybeyondthreecoursesconveysnosurvivalorconsistentqualityoflifebenefitsinadvancednonsmallcelllungcancer AT aasebou palliativechemotherapybeyondthreecoursesconveysnosurvivalorconsistentqualityoflifebenefitsinadvancednonsmallcelllungcancer AT sorensons palliativechemotherapybeyondthreecoursesconveysnosurvivalorconsistentqualityoflifebenefitsinadvancednonsmallcelllungcancer |