Platinum-based chemotherapy regimens for small-cell lung cancer
Sübutlu məlumatların xülasələri
22.09.2014 • Sonuncu dəyişiklik 22.09.2014
Editors
Platinum-based chemotherapy regimens appear not to provide significant benefit over non-platinum regimens for small cell lung cancer in terms of survival but appear to provide better complete tumour response rates.
The quality of evidence is downgraded by study limitations (unclear allocation concealment and blinding).
Summary
A Cochrane review included 32 studies comparing platinum and non-platinum chemotherapy regimens in the treatment of small cell lung cancer (SCLC), with a total of 6 075 subjects. The duration of studies ranged from 12 to 72 months (median 32 months), and the median age of patients in the vast majority of studies was between 60 and 65 years of age. Co-intervention with radiotherapy occurred in approximately 72% of studies. Eighteen studies presented data on extensive-stage disease, 9 studies presented data on limited-stage disease, and 11 did not present data based on the disease stage. There was no statistically significant difference between treatment groups in terms of survival at 6 months, 12 months and 24 months. There was also no statistically significant difference in terms of overall tumour response. However, platinum-based treatment regimens did have a significantly higher rate of complete response. Platinum-based chemotherapy regimens had significantly higher rates of nausea and vomiting, and thrombocytopenia
toxicity.
A Cochrane review
included 29
studies comparing platinum and non-platinum chemotherapy regimens in the treatment of small cell lung cancer (SCLC), with a total of 5 530
subjects. Co-intervention with radiotherapy occurred in 76% of studies.
There was no statistically significant difference between treatment groups in terms of survival at 6 months, 12 months and 24 months. There was also no statistically significant difference in terms of overall tumour response. However, platinum-based treatment regimens did have a significantly higher rate of complete response. Platinum-based chemotherapy regimens had significantly higher rates of nausea and vomiting, anaemia and thrombocytopenia
toxicity.
A systematic review
covering 19 studies and a total of 4 054 patients was abstracted in DARE. Patients with small cell lung cancer treated with a cisplatin-containing regime benefited from a significant reduction of the risk of death at 6 months (OR 0.87, 95% CI 0.75 to 0.98), and at 1 year (OR 0.80, 95% CI 0.69 to 0.93). This corresponded to a significant increase in the probability of survival of 2.6% and 4.4% at 6 months and 1 year respectively. Data regarding neutropenic infections, nephrotoxicity and ototoxicity were not reported consistently for the different trials. There was no significant difference in the risk of toxic death between cisplatin-based and non-cisplatin-based regimes, with respective probabilities of 3.1 and 2.7% (NS).
Ədəbiyyat
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Pujol JL, Carestia L, Daurès JP. Is there a case for cisplatin in the treatment of small-cell lung cancer? A meta-analysis of randomized trials of a cisplatin-containing regimen versus a regimen without this alkylating agent. Br J Cancer 2000 Jul;83(1):8-15.
- Amarasena IU, Chatterjee S, Walters JA et al. Platinum versus non-platinum chemotherapy regimens for small cell lung cancer. Cochrane Database Syst Rev 2015;(8):CD006849.