Chemotherapy versus best supportive care in stage IV non-small cell lung cancer, non metastatic to the brain

• Autor(a) principal: Anelli,Agnaldo
• Data de Publicação: 2001
• Outros Autores: Lima,Candice A. A., Younes,Riad N., Gross,Jefferson L., Fogarolli,Ricardo
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista do Hospital das Clínicas
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0041-87812001000200004
• topic: Chemotherapy; Non-small cell lung cancer; Best supportive care; Mytomycim, vinblastin and cisplatinum; Fatal disease

Stage IV non-small cell lung cancer is a fatal disease, with a median survival of 14 months. Systemic chemotherapy is the most common approach. However the impact in overall survival and quality of life still a controversy. OBJECTIVES: To determine differences in overall survival and quality of life among patients with stage IV non-small cell lung cancer non-metastatic to the brain treated with best supportive care versus systemic chemotherapy. PATIENTS: From February 1990 through December 1995, 78 eligible patients were admitted with the diagnosis of stage IV non-small cell lung cancer . Patients were divided in 2 groups: Group A (n=31 -- treated with best supportive care ), and Group B (n=47 -- treated with systemic chemotherapy). RESULTS: The median survival time was 23 weeks (range 5 -- 153 weeks) in Group A and 55 weeks (range 7.4 -- 213 weeks) in Group B (p=0.0018). In both groups, the incidence of admission for IV antibiotics and need of blood transfusions were similar. Patients receiving systemic chemotherapy were also stratified into those receiving mytomycin, vinblastin, and cisplatinum, n=25 and those receiving other combination regimens (platinum derivatives associated with other drugs, n=22). Patients receiving mytomycin, vinblastin, and cisplatinum, n=25 had a higher incidence of febrile neutropenia and had their cycles delayed for longer periods of time than the other group. These patients also had a shorter median survival time (51 versus 66 weeks, p=0.005). CONCLUSION: In patients with stage IV non-small cell lung cancer, non-metastatic to the brain, chemotherapy significantly increases survival compared with best supportive care.