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Pretreatment clinical prognostic factors in patients with stage IV non-small cell lung cancer (NSCLC) treated with chemotherapy

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Abstract

Purpose.

We investigated the influence of potential pre-treatment clinical prognostic factors in stage IV non-small cell lung cancer (NSCLC).

Methods and patients.

A total of 285 patients were enrolled in two consecutive prospective randomised studies which compared (study 1) carboplatin and prolonged oral etoposide (group 1; n=58) with the same etoposide alone (group 2; n=59), and (study 2) carboplatin and prolonged oral etoposide (group 1; n=84) with the same carboplatin and high-dose intravenous etoposide (group 2; n=84).

Results.

The median survival time for all 285 patients was 7 months, while 1- and 2-year survival rates were 29% and 8%, respectively. Age did not impact on outcome (P=0.21), while female patients did significantly better than male patients (P<0.0001). Patients with KPS 80–100 did significantly better than those with KPS 50–70 (P<0.0001), as did patients with less pronounced weight loss (P<0.0001) and those with only one metastatic site when compared to those having at least two metastatic sites (P<0.0001). When evaluated regarding the metastatic site, only subcutaneous metastatic site did not influence survival. This was confirmed within univariate analyses, but when multivariate analyses were done gender, KPS, weight loss, number of metastatic sites, presence of liver metastases and presence of brain metastases independently influenced survival, while age and other metastatic locations did not.

Conclusion.

In this analysis, gender, KPS, weight loss, number of metastatic sites, presence of liver metastases and presence of brain metastases independently influenced survival in patients with stage IV NSCLC treated with CHT.

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References

  1. Ihde DC (1992) Chemotherapy of lung cancer. N Engl J Med 327:1434–1441

    CAS  PubMed  Google Scholar 

  2. Souquet PJ, Chauvin F, Boissel JP, et al (1993) Polychemotherapy in advanced non-small cell lung cancer: a meta analysis. Lancet 342:19–21

    CAS  PubMed  Google Scholar 

  3. Grilli R, Oxman AD, Julian JA (1993) Chemotherapy for advanced non-small cell lung cancer: how much benefit is enough? J Clin Oncol 11:1866–1872

    CAS  PubMed  Google Scholar 

  4. Non-Small Cell Lung Cancer Cooperative Group (1995) Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomized clinical trials. BMJ 311:899–909

    PubMed  Google Scholar 

  5. Marino P, Preatoni A, Cantoni G, Buccheri G (1995) Single-agent chemotherapy versus combination chemotherapy in advanced non-small cell lung cancer: a quality and meta-analysis study. Lung Cancer 13:1–12

    Article  CAS  PubMed  Google Scholar 

  6. Lilenbaum RC, Langenberg P, Dickersin K (1998) Single agent versus combination chemotherapy in patients with advanced nonsmall cell lung cancer. A meta-analysis of response, toxicity, and survival. Cancer 82:116–126

    Article  CAS  PubMed  Google Scholar 

  7. Depierre A, Chastang C, Quoix E, et al (1994) Vinorelbine versus vinorelbine plus cisplatin in advanced non-small cell lung cancer: a randomized trial. Ann Oncol 5:37–42

    CAS  Google Scholar 

  8. Wozniak AJ, Crowley JJ, Balcerzak SP, Weiss GR, Spiridonidis CH, Albain KS, Kelly K, Taylor SA, Gandara DR, Livingston RB (1998) Randomized trial comparing cisplatin with cisplatin plus vinorelbine in the treatment of advanced non-small cell lung cancer: a Southwest Onocology Group Study. J Clin Oncol 16:2459–2465

    CAS  PubMed  Google Scholar 

  9. Cardenal F, Lopez-Cabreirizo MP, Anton A, Alberola V, Massuti B, Carrato A, Barneto I, Lomas M, Garcia M, Lianes P, Montalar J, Vadell C, Gonzalez-Larriba JL, Nguyen B, Artal A, Rosel R (1999) Randomized phase III study of gemcitabine-cisplatin versus etoposide-cisplatin in the treatment of locally advanced or metastatic non-small cell lung cancer. J Clin Oncol 17:12–18

    CAS  PubMed  Google Scholar 

  10. Sandler AB, Nemunaitis J, Denham C, von Pawel J, Cormier Y, Gatzemeier U, Mattson K, Manegold C, Palmer MC, Gregor A, Nguyen B, Niyikiza C, Einhorn LH (2000) Phase III trial of gemcitabine plus cisplatin versus cisplatin alone in patients with locally advanced or metastatic non-small cell lung cancer. J Clin Oncol 19:122–130

    Google Scholar 

  11. Bonomi P, Kim K, Fairclough D, et al (2000) Comparison of survival and quality of life in advanced non-small cell lung cancer patients treated with two dose levels of paclitaxel combined with cisplatin versus etoposide with cisplatin: results of an Eastern Cooperative Oncology Group trial. J Clin Oncol 18:623–631

    CAS  PubMed  Google Scholar 

  12. Giaccone G, Splinter TA, Debruyne C, Kho GS, Lianes P, van Zandwijk N, Pennucc MC, Scagliotti G, van Meerbeeck J, van Hoesel Q, Curran D, Sahmoud T, Postmus PE (1998) Randomized study of paclitaxel-cisplatin versus cisplatin-teniposide in patients with advanced non-small cell lung cancer. The European Organization for Research and Treatment of Cancer Lung Cancer Cooperative Group. J Clin Oncol 16:2133–2141

    CAS  PubMed  Google Scholar 

  13. Gatzemeier U, von Pawel J, Gottfried M, ten Velde GP, Mattson K, DeMarinis F, Harper P, Salvati F, Robinet G, Lucenti A, Bogaerts J, Gallant G (2000) Phase III comparative study of high-dose cisplatin versus a combination of paclitaxel and cisplatin in patients with advanced non-small cell lung cancer. J Clin Oncol 18:3390–3399

    CAS  PubMed  Google Scholar 

  14. Kelly K, Crowley J, Bunn PA Jr, Presant CA, Grevsted PK, Moinpour CM, Ramsey SD, Wozniak AJ, Weiss GR, Moore DF, Israel VK, Livingston RB, Gandara DR (2001) Randomized phase III trial of paclitaxel plus carboplatin versus vinorelbine plus cisplatin in the treatment of patients with advanced non-small cell lung cancer: a Southwest Oncology Group trial. J Clin Oncol 19:3210–3218

    CAS  PubMed  Google Scholar 

  15. Kosmidis P, Mylonakis N, Nicolaides C, Kalophonos C, Samantas E, Boukovinas J, Fountzilas G, Skarlos D, Economopolous T, Tsavaridis D, Papakostas P, Bacoyiannis C, Dimopolous M (2002) Paclitaxel plus carboplatin versus gemcitabine plus paclitaxel in advanced non-small cell lung cancer: a phase III randomized trial. J Clin Oncol 20:3578–3585

    Article  CAS  PubMed  Google Scholar 

  16. Schiller JH, Harrington D, Belani C, Langer C, Sandler A, Krook J, Zhu J, Johnson DH (2002) Comparison of four chemotherapy regimens in advanced non-small cell lung cancer (NSCLC). N Engl J Med 346:92–98

    Article  CAS  PubMed  Google Scholar 

  17. Jeremic B, Shibamoto Y, Acimovic LJ, Milisavljevic S, Milicic B, Nikolic N (1997) Prolonged administration of oral etoposide alone or with intravenous carboplatin in stage IV non-small cell lung cancer: a randomized trial. Lung Cancer 18:179–188

    Article  CAS  PubMed  Google Scholar 

  18. Jeremic B, Shibamoto Y, Milicic B, et al (1999) Prolonged oral versus high-dose intravenous etoposide in combination with carboplatin for stage IV non-small cell lung cancer. A randomized trial. Lung Cancer 25:207–214

    Article  CAS  PubMed  Google Scholar 

  19. Hainsworth JD, Johnson DH, Frazier SR, et al (1989) Chronic daily administration of oral etoposide: a phase I trial. J Clin Oncol 7:396–401

    CAS  PubMed  Google Scholar 

  20. Ederer F, Mersheimer WL (1962) Sex differences in the survival of lung cancer patients. Cancer 15:425–432

    CAS  Google Scholar 

  21. Connelly RR, Cutler SJ, Baylis P (1966) End results in cancer of the lung: comparison of male and female patients. J Natl Cancer Inst 36:277–287

    CAS  PubMed  Google Scholar 

  22. Watson WL, Schottenfeld D (1968) Survival in cancer of the bronchus and lung, 1949–1962; comparison of men and women patients. Dis Chest 53:65–72

    Google Scholar 

  23. Glatstein E, Makuch RW (1984) Illusion and reality: practical pitfalls in interpreting clinical trials. J Clin Oncol 2:488–497

    CAS  PubMed  Google Scholar 

  24. Simon R (1984) Importance of prognostic factors in cancer clinical trials. Cancer Treat Rep 68:185–192

    CAS  PubMed  Google Scholar 

  25. Miller TP, Chen TT, Coltman CA Jr, et al (1986) Effect of alternating combination chemotherapy on survival of ambulatory patients with metastatic large-cell and adenocarcinoma of the lung. A Southwest Oncology Group Study. J Clin Oncol 4:502–508

    CAS  PubMed  Google Scholar 

  26. Finkelstein DM, Ettinger DS, Ruckdeshhel JC (1986) Long-term survivors in metastatic non-small cell lung cancer: an Eastern Cooperative Oncology Group study. J Clin Oncol 4:702–709

    CAS  PubMed  Google Scholar 

  27. Lanzotti VJ, Thomas DR, Boyle LE, Smith TL, Gehan EA, Samuels ML (1977) Survival with inoperable lung cancer. An integration of prognostic variables based on simple clinical criteria. Cancer 39:303–313

    CAS  PubMed  Google Scholar 

  28. Stanley KE (1980) Prognostic factors for survival in patients with inoperable lung cancer. J Natl Cancer Inst 65:25–32

    CAS  PubMed  Google Scholar 

  29. Sakurai M, Shinkai T, Eguchi K, et al (1987) Prognostic factors in non-small cell lung cancer: multioregressional analysis in the National Cancer Center Hospital (Japan). J Cancer Res Clin Oncol 113:563–566

    CAS  PubMed  Google Scholar 

  30. Einhorn LH, Loehrer PJ, Williams SD, et al (1986) Random prospective study of vindesine versus vindesine plus high-dose cisplatin versus vindesine plus cisplatin plus mitomycin C in advanced non-small cell lung cancer. J Clin Oncol 4:1037–1043

    CAS  PubMed  Google Scholar 

  31. O'Connell JP, Kris MG, Gralla RJ, et al (1986) Frequency and prognostic importance of pretreatment clinical characteristics in patients with advanced non-small cell lung cancer treated with combination chemotherapy. J Clin Oncol 4:1604–1614

    CAS  PubMed  Google Scholar 

  32. Sorensen JB, Badsberg JH, Olsen J (1989) Prognostic factors in inoperable adenocarcinoma of the lung: a multivariate regression analysis of 259 patients. Cancer Res 49:5748–5754

    CAS  PubMed  Google Scholar 

  33. Paesmens M, Sculier JP, Libert P, et al (1995) Prognostic factors for survival in advanced non-small cell lung cancer: univariate and multivariate analyses including recursive partitioning and amalgamation algorithms in 1,052 patients. The European Lung Cancer Working Party. J Clin Oncol 13:1221–1230

    CAS  PubMed  Google Scholar 

  34. Kawahara M, Furuse K, Kodama N, et al (1991) A randomized study of cisplatin versus cisplatin plus vindesine for non-small cell lung carcinoma. Cancer 68:714–719

    CAS  PubMed  Google Scholar 

  35. Rapp E, Pater JL, Willan A, et al (1988) Chemotherapy can prolong survival in patients with advanced non-small cell lung cancer—Report of a Canadian multicenter randomized trial. J Clin Oncol 6:633–641

    CAS  PubMed  Google Scholar 

  36. Shinkai T, Eguchi K, Sasaki Y, et al (1992) A prognostic-factor risk index in advanced non-small cell lung cancer treated with cisplatin-containing combination chemotherapy. Cancer Chemother Pharmacol 30:1–6

    CAS  PubMed  Google Scholar 

  37. Albain KS, Crowley JJ, LeBlanc M, Livingston RB (1991) Survival determinants in extensive-stage non-small cell lung cancer: the Southwest Oncology Group experience. J Clin Oncol 9:1618–1626

    CAS  PubMed  Google Scholar 

  38. Ewans WK, Nixon DW, Daly JM, et al (1987) A randomized study of oral nutritional support versus ad lib nutritional intake during chemotherapy for advanced colorectal and non-small cell lung cancer. J Clin Oncol 5:113–124

    CAS  PubMed  Google Scholar 

  39. Sculier JP, Paesmens M, Libert P, et al (1994) Long-term survival after chemotherapy containing platinum derivatives in patients with advanced unresectable non-small cell lung cancer. Eur J Cancer 30A:1342–1347

    CAS  PubMed  Google Scholar 

  40. Fukuoka M, Masuda N, Furuse K, et al (1991) A randomized trial in inoperable non-small cell lung cancer: vindesine and cisplatin versus mitomycin, vindesine, and cisplatin versus etoposide and cisplatin alternating with vindesine and mitomycin. J Clin Oncol 9:606–613

    CAS  PubMed  Google Scholar 

  41. Ferguson MK, Skosey C, Hoffman PC, Golomb HM (1990) Sex-associated differences in presentation and survival in patients with lung cancer. J Clin Oncol 8:1402–1407

    CAS  PubMed  Google Scholar 

  42. Hickish TF, Smith IE, O'Brien MER, Ashley S, Middleton G (1998) Clinical benefit from palliative chemotherapy in non-small cell lung cancer extends to the elderly and those with poor prognostic factors. Br J Cancer 78:28–33

    CAS  PubMed  Google Scholar 

  43. Green N, Kurohara S, George F (1971) Cancer of the lung, an in-depth analysis of prognostic factors. Cancer 28:1229–1233

    CAS  PubMed  Google Scholar 

  44. Harrell FE, Lee KL, Matchar DB, Reichert TA (1985) Regression models for prognostic prediction: advantages, problems, and suggested solutions. Cancer Treat Rep 69:1071–1077

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiotherapy, Klinikum rechts der Isar, Technical University Munich, Ismaninger Strasse 22, 81675 , Munich, Germany

    Branislav Jeremic

  2. Department of Oncology, University Hospital, Kragujevac, Yugoslavia

    Branislav Jeremic, Biljana Milicic, Aleksandar Dagovic, Jasna Aleksandrovic & Nebojsa Nikolic

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  1. Branislav Jeremic
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  2. Biljana Milicic
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  3. Aleksandar Dagovic
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  5. Nebojsa Nikolic
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Correspondence to Branislav Jeremic.

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Jeremic, B., Milicic, B., Dagovic, A. et al. Pretreatment clinical prognostic factors in patients with stage IV non-small cell lung cancer (NSCLC) treated with chemotherapy. J Cancer Res Clin Oncol 129, 114–122 (2003). https://doi.org/10.1007/s00432-002-0408-4

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  • DOI: https://doi.org/10.1007/s00432-002-0408-4

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