Clinical benefits of adjuvant chemotherapy with carboplatin and gemcitabine in patients with non-small cell lung cancer:
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(2020) 18:263
RESEARCH
Open Access
Clinical benefits of adjuvant chemotherapy with carboplatin and gemcitabine in patients with non-small cell lung cancer: a single-center retrospective study Shinogu Takashima1, Kazuhiro Imai1* , Maiko Atari1, Tsubasa Matsuo1, Katsutoshi Nakayama2, Yusuke Sato1, Satoru Motoyama1, Hiroyuki Shibata3, Kyoko Nomura4 and Yoshihiro Minamiya1
Abstract Purpose: In cases of non-small cell lung cancer (NSCLC), surgery remains the best option for cure, but surgery is of benefit only when the disease is localized. Although adjuvant chemotherapy reportedly has a significant beneficial effect on survival, the benefit of a carboplatin (CBDCA) regimen is unclear. We therefore investigated the efficacy and tolerability of CBDCA (area under the curve 5) plus gemcitabine (GEM, 1000 mg/m2) as adjuvant chemotherapy. Methods: A total of 82 pStage IB-IIIA NSCLC patients who had undergone complete resection and received adjuvant chemotherapy were analyzed retrospectively. Among them, 65 patients received CBDCA + GEM and 17 received CDDP + VNR. Propensity score analysis generated 17 matched pairs of both groups. Results: Sixty-five patients received CBDCA + GEM. Their 5-year relapse-free survival (RFS) and overall survival were 47.8% (median, 52.5 months) and 76.9% (median, 90.1 months), respectively. Toxicities, which included neutropenia, nausea/ anorexia, fatigue, and vasculitis, were significantly milder than with CDDP + VNR. There were no significant differences in RFS between CBDCA + GEM and CDDP + VNR (p = 0.079) after matching for age, performance status, and pStage. Conclusion: CBDCA + GEM was effective and well tolerated as adjuvant chemotherapy, with a manageable toxicity profile. Keywords: Carboplatin, Gemcitabine, Adjuvant chemotherapy, Lung cancer
Introduction Lung cancer is the most common cause of cancerrelated death globally. In cases of non-small cell lung cancer (NSCLC), surgery remains the best option for a potential cure. However, surgery is only of benefit to patients with localized disease and no evidence of mediastinal lymph node involvement or distant metastasis. Following surgical resection, patients with stage II–III advanced NSCLC face a high risk of relapse, and the * Correspondence: [email protected] 1 Department of Thoracic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan Full list of author information is available at the end of the article
treatment strategy for perioperative advanced NSCLC patients remains unsatisfactory [1, 2]. Adjuvant chemotherapy is now standard treatment for patients with completely resected advanced NSCLC. Randomized controlled trials (RCTs) and meta-analyses have shown that adjuvant chemotherapy improves survival over surgery alone [3–7]. The Lung Adjuvant Cisplatin Evaluation (LACE) meta-analysis reported that cisplatin-based adjuvant chemotherapy had a 5-year survival benefit of 5.4% with an overall hazard ratio for death of 0.89 (95% confidence interval [CI] 0.82–0.96) [5], which represents a
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